RNY and adding a Lapband?

Hello,

There are several options opened to me, however, I am researching adding a lapband to my current RNY by my original surgeon who will also be doing all the fills.

Anyways, the other option is DS, however, after enduring a leak and quite a harrowing experience 10 yrs ago. I am a little skeptical about having a DS because the risk of a leak is 5 times greater than RNY and of course, I already hit those odds.... lol...

Any thoughts on band added to RNY? Any thoughts on DS? Just trying to get some feedback.

Thanks
Shirley

Hello Shirley,

I'm a revision from the old SRVG to the DS back in Oct 2007.  I researched all surgical options and knew the DS was for me based on statistical evidence that DS offers the highest percentage of initial weight loss and the most effective and highest rate of keeping the weight off long term.  During all of my research (and I had to do a lot because I had to fight my insurance to approve the DS) I never came across anything that said the DS has a 5x's great risk of leaks than the RNY.  Where did you get that information?  The DS surgery is no more riskier than the RNY, and complications, including leaks, can happen to anyone as you well know.  I, too, battled a leak after my revision but the leak happened in a part of my stomach that wasn't even touch during surgery. 

The lapband in and of itself has another whole set of problems.  If you are going to go through the pain of another WLS, you might as well go for the best option (statistically, and in my opinion, the one that offers the best quality of post-WLS life) and just go for the DS.  The boards are filled with people seeking a revision from the lapband because of slippage, erosion, etc.  I just don't see why anyone would want to try to fix one failed surgery with another that has a high failure rate, too.    Just my 2 cents.

Please come over to the DS board and ask about experiences from those who have undergone a revision from RNY to DS.  We have several.

Good luck with whatever you decide.

All I can tell you is that I had the lap band for almost 7 years, and now have the VSG. You couldn't pay me to have the lapband again. Yes, I lost a lot of weight, but once the problems started, you either have to have surgery again (which I did 2x) or have a complete unfill (which I did) and gain most of the weight back because you can eat whatever you like.
If I only wanted one surgery, I would go with the DS....The statistics on it are wonderful, and less issues surgical wise than the band.

Can you direct me to the source that shows the risk of a leak is 5 times higher for a DS than for a RNY?

Thank you.

Becky

Shirley,
 I had your same decision but after talking to my doctor we thought that the DS would be best for me. I too had the RNY and what he is going to do is the switch part and not mess with the pouch to me that is where the complications come in with having to reconstruct the pouch but as far as the switch is concerned he says that is a fairly simple procedure that would take about 45min to do and I could be back to work within a week. I was most concerned about not having to sit before him again 5 to 6 yrs from now with the band and still unhappy so bascially what it came dowm to was I cant guarantee to success with the band and that I could possibly stop losing before I reached my goal but with the DS I had a much more better chance at reaching my goal and MAINTAINING IT ( which is really important to me)   I hope this helps in your decision and Good Luck in whatever you decided.

Hey Chynadoll,

If I"m understanding your description correctly, you are not getting a DS but an Extended Rny (aka Distal).  If you maintain your Rny pouch and have your common channel shortened then that is still an Rny.

That is what I did with my revision and was told the same thing as you "lets not mess with the pouch"!  .....  Don't do it!!!  The ERny is awful for the majority!

I'm on deck for a 2nd revision to a real deal DS this time.  I need a normal life and chances are slim to nill with the Rny and all it's varieties!

It's never too late to get another opinion!  www.dsfacts.com

Good luck!

Joyce

Joyce if you could tell me what your experience was with what you call the ERNY, because I really dont experience much of the dumping anymore, I can just about eat anything I want and how I want however I still have the restrictive part of the pouch when it comes to eating a meal but I thought that even with the DS you still were restricted as far as the stomach was concerned.

My Rny pouch is wide open so only the dryest and leanest of meats hang around long enough to provide any kind of satiety.  I'm always hungry and eat pretty much around the clock.  You are fortunate if you have some restriction left.  ....  I dump terribly which is a good thing if it were limited to the naughty food category but, unfortunately, I can dump off of protein drinks or even a salad.  At the time of my revision, I was told that it was really the malabsorption of the shortened common channel that would be the weight loss tool and that whether I had an Rny pouch or a stomach with a sleeve; it wouldn't make a difference.  That may be true in some cases but for me it's been a horrible combination.  I don't have any stomach to benefit from in absorption and my common channel is way too short for my nutritional needs.  I have suffered with chronic diarrhea for over 2 years, had anemia issues, poor labs, poor health, hypoglycemic problems, low energy, odors, etc.  I realize that a small portion of DS'ers may some of these issues as well but the ticket for me with getting a DS is that I'll have restriction again (yay for satiety!), be able to take some major meds that I can't with an Rny, be able to absorb some nutrition again, and take advantage of the Grehlin (sp?) gift (losing my ravenous appetite!)

Vitalady has been coaching me for over 2 years with vites and I finally have labs in a decent place.  I know how to be compliant after being forced to live glutten free, lactose free, sugar free and mostly fat free!   I have about a 20 BMI right now so my revision is not about weight loss.....I was dealt a crummy hand with the ERny and after oodles of research; it looks like there is a light at the end of this crazy tunnel (thanks to Dr. Keshishian!)....

wish me luck!  My insurance gave me the green light so I'm just waiting for the surgery date!!!!

Good luck with your journey!

Joyce

Just realized I didn't answer your question!  LOL!  ...a revision from an Rny to an Extended Rny is when the pouch is normally left alone and the stem of the "Y" is shortened=common channel.  That is why it is "similar" to a D.S. but it is not a true D.S.  It is generally easier for surgeon's to do and doesn't require the same expertise as a revision to a D.S.  I believe that is the reason many surgeon's prefer it and recommend it.

Joyce,
Its sounds like you had a horrible experience I cant imagine going through that for 2 years. I hope the DS is the answer for you and put all your troubles to an end. But now I'm confused ok so what exactly is the BPD/DS? I know there is a procedure where they keep the pouch but the bypass part is exactly like the DS and not just moving the connection further down the intestines(not ure whether its up or what)

Oh man I wish I knew all there was to know about the DS and all it's varieties but all I know is what I had was called an Extended Rny and it involves an Rny pouch and a "DS type" common channel.  I think I remember Dr. Keshishian saying that it is similar to an older version of the DS that is no longer used?  Hopefully the DS guru's will jump on board and correct me.  I'd hate to lead you astray with my partial understanding.

Dr. Keshishian are you out there?  LOL!  I'd like to know the differences as well.

Joyce