second thougths on type of revision

Hi-

First of all, I want to say thanks to so many of you who have been helpful to me on this board and I know this may seem silly to some, but here's the situation:

Had RNY/Fobi in 10/2001 down from 417 to 192 and llfe was good for about 5 years, eventually rebounded to 270 and then down a few to 256, still have food sticking/vomiting  issues and dumping.  So, I made the decision to revise to the DS....I've had my consults, am approved and scheduled for surgery...but in seeing the experience of many RNY to DS revisions, even the one's like Kerry, who has done great and is so inspirational....it seems like they have all gone through some very major and in many cases life threatening challenges to get there.  My surgeon is very open minded and says that the RNY to DS is the revision of choice but is open to modifying the RNY as an alternative, which seems to be much less risky as the majority of leaks seem to be connected with converting the pouch into the sleeve.

So, here are my concerns:

1. Does anyone know of an RNY to DS revision who did well and had the standard 4-6 week recovery without major complications (and if so, who was their surgeon)?  if I were to have complications like some others what would I do if my surgeon is many states away?

2. What would your opinion be on the prospect of shortening the common channel on the RNY to 200cm and leaving the pouch intact....I know it would not address the dumping/food sticking but also much less risky from what I'm told....any opinion to whether it would help lose remaining 60 lbs and maintain.  Gottta get the weight off as sleep apnea, high blood pressure, etc. have returned.

Thanks for your input, wish I had the DS in the first place, I asked for it back in 2001 but it was still considered experimental then, so it was the RNY  or nothing.  I still think the DS is the best WLS approach, but as a revision with the risks being much higher, I'm not sure it's the best route.  Thanks for all of your input.
 

Hi Flucca,

I had ERNY - shortened my CC from a 2001 original RNY.  Same thing....gained weight.  I only had about 60 lbs to loose so I went with the ERNY due to the higher risk factor with the DS pouch take down.  BUT...I did and do not have the food getting stuck issues or the dumping issues to contend with.

There are many different results with the ERNY from person to person.  I am at 123 and maintaining now for about 8 months.  But my CC was made to 75 cm.

There are a handful of DS REVISION surgeons who specialize in RNY to DS revisions.  Dr. Greenbaum, Dr. Kehisian (SP?), Dr. Husted.  and a few more.  Go to dsfacts.com for a complete list.  I would also suggest posing these questions on the DS board as there are many RNY to DS revisioners there who could provide you with more specifics.  Every surgery has risk involved....all depends on what you are willing to take.  

But the one thing I would seriously consider if I were you and if you decide to go with the DS.  Do it with a surgeon who has literally hundreds of these types of revisions under their belt as it is a more complicated surgery.  It also increases your chances for less risk and problems after the procedure.  Travel if you have to.  You can find a PCP who has knowledge in or around your home town who can support your after care.

Good Luck to you,
MEW 

What she said.

But also, I don't think a CC of 200cm will get you what you want.

Be thinking of 100-150, maybe.

I've known some ppl who had issues BUT THEY WERE SICK BEFORE REVISION. And some who had time to prep, build their levels and they coulda done it as a drive thru procedure, KWIM?

YOur #1....ask on the DS forum.  There are oodles.  Most surgeons with successful patient's are the ones listed on www.dsfacts.com  I'm going for the Rny to DS with Dr. Keshishian in CA.

#2 ..200cm?  Possibly not short enough.  Probably 100-150.  I went the direction of the ERny for my revision and have had an awful quality of life ever since.

Kudos to you for asking the questions.  Our bodies have been through a lot and I am honestly scarred to death as well to take down my pouch and have a sleeve built.  I understand the high risk for leeks and such ....BUt......I also understand that my chances of absorbing calcium and iron are better with a partial stomach....and, that with my recently diagnosed arthiritis, I will be able to take certain medications with a sleeve (DS) that I can't with the ERny.

Take Care!

Thanks for your replies, for those of you that had the erny, did your surgeon also tighten the stoma or pouch.  My surgeon has indicated that if we go this route he would approach it by simply shortening the common channel and not touching the pouch at all, but I have heard others say that their surgeon also tightened the stoma and pouch when doing the erny, any thoughts?  Thank you.

 I did not have my pouch or stoma revised.  They were left alone.  Only my CC was made shorter.

I don't know your coast.  On the left coast, Rabkin and Keshishian are both HIGHLY REGARDED revision surgeons.  (Keshishian was my DS surgeon.)  

Lemme ask around...I'll see if anyone can help you on your side of the world.

Greenbaum in NJ.

Yup, I know a number of RNY to DS revisions who have done just fine. The East Coast surgeon to contact is Dr. Dave Greenbaum in Willingboro, NJ. www.duodenalswitchdoc.com

Hi there, I am "kind of" in the same boat as you.

I have not been approved, yet, but, hopefully my surgeon in California, Dr. K will have all of the paperwork in the next few weeks to get everything submitted again (we tried in September, but the secondary insurance company wanted more testing done)

I LIVE IN ALASKA

I had my RNY in 2002, I flew out to Washington, and had it done there.  Traveling, for me.  It is my health, and I am willing to go out of Alaska again.  No complaints!!!!


That is just my two cents.  Check out my blog, if you want to.


Good Luck on YOUR JOURNEY!!!!   And NEVER stop asking questions!!!!
-Jamie