a vsg redo??

i was wondering if anyone has had or knows if possible to redo a sleeve to make smaller??  i had surgery in 2008,lost 60lbs and then  i had a lot of things going on in my life and i didnt follow the rules and have put weight back on. i cant exercise at this time but maybe when i can start again it might kick start .my hubby thinks i should have the second part of surgery adn get the ds,but i am not sure i want the malabsorption, i  was wondering if just  making the sleeve smaller,tighter, might help.or am i one of the people that this just didnt work for??knowing my luck, that is probably the case. thanks for any and all info. 

 Hello,
Yes it is possible to do a redo gastrectomy, only after an upper GI (contrast x-ray studies) shows that the fundus of the stomach is large. This means either inadequate resection at the time of the first operation, or stretching of part of the stomach. As a surgeon I have done this many times. I am not a big fan of the sleeve gastrectomy, since on one hand if you make it too small patients have problem with reflux, and on the other hand the patients do not loose a lot of the weight long term. (At the present time there are only a few mid term studies that talk about efficacy of the sleeve gastrectomy-The jury still out on it.) 
I would recommend completion of the DS regardless of the findings with the upper GI series. If you have a large stomach then your surgeon, experienced with DS should be able to redo the sleeve, without making you have reflux for the rest of your life. 
Hope this helps
Good luck.
Ara

I had the same issue, VSG done Dec 2006, I did loose weight, but never reached my goal, then regained 30+ lbs over the course of a year.  I decided to get the DS because I didn't want to have the sleeve tightened, then 2 years from now be right back where I started.  Don't worry about the malabsorption, the surgeon can adjust how much of the small intestine to bypass, and if you don't have too much to loose, then your malabsorption will be minimal.  You will need to take vitamins daily, and I haven't had any issues with diarrhea since my surgery.  When my surgeon went into my abdomen, he said my suture-line from my VSG was not in a line (like it should be) but up, over and around my sleeve, causing a big "bulge" in my sleeve towards my back!  My sleeve was over 200cc (should be 120-140) and shaped like a boot, not a banana.  I recommend you get the sleeve tightened as well as the DS, but do your research, you have to do what is best in your situation.  Hope that helps!!

I am the same as the both of you.  I had a VSG in Dec 06....only lost 60 lbs when I should have lost more than double that.  I have regained 40 lbs.  Now I am considering the DS or RNY.  I still have a lot of hunger - true hunger!  I can also eat a lot!  I know the bougie was too big and I didn't get enough restriction.  I am worried that the DS won't be enough to get me to where I need to be.  I am wondering if I should have the RNY as I might need the restriction and dumping to control my eating.  I too don't really want to have the sleeve tightened - i have quite severe reflux and think tightening would worsen it.  What has your surgeon said in regards to just the intestinal part of the DS w/o the tightening.....does he think you'll still be successful and keep the weight off?   I'm wondering how successful I might be if I can still eat quite a bit but have the malabsorption to help.  

If you are wondering and haven't please do post over on the DS forum.  Dumping is not all it's cracked up to be and the malabsorption of the DS would be of a greater benefit (in my opinion) in the long run.

If your problem is carbs and simple carbs and sugars almost NO WLS will help you.  I have seen tons of RnYers *****gain and a few DSers as well.

I also know SEVERAL girls who had RnY and dump but because of their addiction will eat the food anyway.  I also know of SEVERAL who never dumped a day in their WLS life.  Dumping is a 50/50 gamble at best.

Ms Shell

Hi, This is an interesting question. I had the vsg done in aug 06. Last year I had an endoscopy as I was having reflux and had been on protonics as my stomach was on fire for awhile, some of it to do with major stress. Anyway my stomach looked  like an hour glass instead of a banana. I checked into the reasons, either surgery done improperly or a stretched stomach. A few months ago I had an upper GI and have a moderate hiatal hernia. I am going back to my surgical bariatric group and next week they will do an upper GI  to see what is going on and fix the hernia. I told the doctor that I also would like more restriction, we will see. I also feel like I have a "hernia" or something around my belly button area, buldges when I sneeze etc. I am going to call the surgeon about that tommorow and see if he can figure this all out. I have to fly to SF for surgery so I want anything in need of repair to be done in one shot.
I will let you know  what he tells me regarding the "revision" if he does it  etc.
Good luck

 If the upper part of the hour glass is large, it can be used for the nissen repair of the hiatal hernia. This will depend what is found in the OR, and if the top part of the stomach has blood supply intact.
Thanks
Ara

Thank you for responding. I wonder if the hour glass shape is a malfunction of the VSG surgery? Or did overeating cause this? Also wonder if the hernia repair will help with restriction?

 Hello,
I am not sure if malfunction is the word, more like a possible complication. The very top part of the stomach can stretch, and if you had a funnel type stomach, then that would be the cause.
The hiatal hernia repair, if it incorporates the top part of the stomach will cause restriction.
Thanks
Ara

Thank you so much..It is great to know a doctor in this area that is so familiar with the VSG.