RNY revision to more extensive RNY. ANY EXPERIENCES?

Joyce, BEAUTIFULLY said!  I suspect she was referring to my post as well.  And you're right, ask the question, get a variety of answers, that's what it's all about so you can consider all options, especially for those of us who have made mistakes and have had to learn the hard way. Btw, good luck next week, you're going to do great, I'll be thinking about you!

Hello Jory.. I understand your disappointment and hesitation when choosing a different decision then your surgeon recommends.  I had to do just that.

The surgeon I loved and that did my original RNY in 1993 wanted to do a procedure that sounds just like what your talking about... However he did say a few things that concerned me..

The one that sticks out to me is when he said that once you have a bypass (like what we did)  the liver will lay on the stomach... he said this is one of the dangers when doing a revision because he would have to 'chisel" my liver from my stomach... he said it may pop right up or it could take him a couple of hours to do just this... and there is the chance of leakage, etc.

I ended up going with a different Dr. that specialized in Lap bands.

Please see my post just below yours " 1 year anniversary band over RNY"... good luck..

Jeannie

Open your ears and eyes.  This is no time to be emotionally attached to a person, this is about your life - the rest of it.  People here are trying to tell you something wise.  They are trying to save you - they are trying to save you.  They've made the mistake and are showing you a path in which you don't have to make it.

Why did you post here if you did not want to hear "truths".  The surgery you describe seems like a poor surgery in comparison to the duodenal switch.

I wish you the very best.  please LISTEN!!!

I'm not selling a surgery or surgeon, but you are getting better advice here than from your surgeon.

I'm very concerned about the procedure you have described, and know that once that part of the stomach with the pylorus is cut out, your future options of revising to something else (God forbid you need another revision, but if you look at statistics, chances are good) you'll be screwed.

Please do some research, and heed the advice given here. YOU will be the one living your life with the consequences of what this surgeon is selling you, not him/her.

 Hi Jory,

First off let me say I wish you the best of luck with your new Journey and whatever choice you make.   Just remember it is yours to make so do your research and you and only you knows what is best for your cir****tances.

I had RNY in 2001 and suffered a regain.  In 2008 I had a revision to an ERNY.  This is where they lengthened the amount of intestine bypassed and gave me a common channel of 75 cm.  I had my pouch left alone because I was not comfortable with the risk involved in the take down and reconstruct of the pouch.  Unlike some of the others who have posted with many problems from distal rny's, my situation has been the exact opposite.  I am doing well, I am down to my goal weight, actually about 3 lbs under at 122, my labs are good and I am feeling fine.  So for me, at least at about 2 years out from my revision, it has been the right choice.

Not everyone responds the same to the many types of revision procedures out there.  This is why I still maintain that it is not a "one size fits all" scenario.  It should be a decision made between you and your surgeon.  The important thing for you to do is, do your research, find what's available and what the differences and risks are and find a surgeon who has a ton of experience in doing revisions.  As others have stated, revisions are more tricky and take a skilled hand.

Good luck to you in whatever your choice is.  Keep us posted on how you are doing.

MEW

Hi Mew,

Thank you for your support and for telling me a little about your personal story. It is great to hear that you and your revision has been so successful. How much did you loose the second time? Any advise for a soon-to-be 2nd chance newby? Do you know many others who stayed with the RNY revision and were also successful? Almost everyone here is pushing the DS which my surgeon does not recommend. I have been very happy with my RNY and had almost no issues at all. BUT, I have gained 25 lbs in 6 years.  I am up to 193 lbs and really want to be in control again. (Very tough with a wide open stoma and stretched pouch)

Also, did your surgeon do anything to prevent the stoma from stretching again?

Thanks again for taking the time and interest.
Jory

 Hi Jory,

The 2nd time around I lost 67 lbs.  It took me less then a year to do it in.  There are a few others who have had success with the ERNY/distal RNY, JRolfson, Michele (vitalady), Deanne K. are a few who come to mind.  I chose the ERNY as I did not have a ton of weight to loose and wanted to catch it before I gained it all back.

The only things I can recommend is:

1.  Do tons of research.  You're starting out in the right place and by asking questions.  I would suggest going to other sites as well.

2.  Understand that your expense and the necessity for elevated vitamin levels will go up substantially.

3.  Know that not everyone has the same results regardless of the revision type.

4.  Your bathroom habits will change.   Whether it is a ERNY or a DS you choose.

5.  Start increasing the amount of protein you intake.  180 grams a day would not be to much.

6.  Maybe think about getting a 2nd opinion.  It can't hurt and all you loose is a couple hours of your time.  Try to find a surgeon who does more then one type of revision so you get a more well rounded picture of your possibilities.


There is a huge DS following on this site.  This is one reason you see so much pushing of this procedure.  The other reason is that  it has yielded pretty good results for most.  But it is also the most complicated to do as a revision and this may be one reason your doctor might be uncomfortable with performing it.  I would suggest asking her why she is so against it.  If you choose the DS there are only a handful of capable surgeons who can perform it to increase your odds of no complications.  It is something to be considered.  Can you travel?  This is probably what it would take.  Some insurance clauses won't cover  traveling more then a certain amount of miles away from your home.  Mine had that clause that I did not know about and I am still fighting it 2 years later...  Also, while the odds are better for the DS I would like to see the statistics for 15 to 20 years out from the procedure.  There's not many out there yet.   I have talked to a few who had some issues, but it seems percentage wise it still gives the best results.  If this had been my first WLS there would have been a good chance I would have chosen it knowing what they do today.

My pouch or stoma were not touched.  I am one of the lucky ones who does not feel the intense hunger all the time.  I also do not dump and food does not get "stuck".  I heard of others who have had their stoma's decreased in size during the revision or have a ring put around it (not sure of the success for this).  But I am not sure there is anything out there that will give you a 100% guarantee that your stoma will not stretch again.

If you want more detailed information feel free to PM me and I would be happy to answer any more questions you may have.

MEW

Thanks for all of your insights Mew, I just read all of your posts and you have a calm, encouraging attitude toward everyone it seems. I have emailed my surgeon with lots of questions and have asked for a detailed description of my proceedure in case I have misunderstood anything. My insurance approved it and I am scheduled for June 14th. Your success makes me feel excited about my outcome.

You're so very welcome!    June 14th, just right around the corner for you!  How exciting, nervous, happy,...etc you must be getting.  Let us know how it goes and what you find out.

Thanks for your kind words.  Good luck and I will send a prayer your way for a very successful and uneventful surgery.

MEW 

Before you do anything, Jory ... do you own research.   Learn the "ins and outs" of the various types of surgeries and make your OWN decision.   Don't go by what any doctor, patient or person tells you.   These suggestions are just "jumping off" points to get your thinking and researching.

And, please don't forget, AND THIS IS IMPORTANT, a doctor will sell you on whatever procedure he or she does - not what is most successful for the patient.   Remember THIS!   

Some people have had great success with the distal RNY and the extended RNY, but they have not had THEIR ENTIRE STOMACHS REMOVED.   Those who have come on here and have told you they are successful have had something DIFFERENT than what your surgeon is proposing.  

Google the Scopinaro Procedure and see  if this is what your doc is planning.   If so, it is an ARCHAIC surgery which has been abandoned by the majority of the medical community.  Some docs may still be doing it because they aren't schooled in the proper, modern DS.  Your doc may be one of them.   

Please, PLEASE go to the DS board and ask them about both your surgeon and the operation which is being recommended to you.   If it is the Scopinaro, they will not only know detailed info about it (because some of them know people who have had it), but they will also know if your doc is experienced in revisions.   Only a HANDFUL of docs in the world have the still and competence to perform revisions from RNY to DS and the rest of the docs will try to "sell" you on something else.  

Please don't be a "Guinea Pig".   I've been reading these boards for over 3 years and have seen people come on here all excited about some surgery their doc says will work for them - then a year later, after that surgery failed, they are getting something else - then the next year, it's something else again.   Many were warned by others on here, but they "trusted" their own doc to their own detriment.  

I'm sorry if I seem "negative", but I feel that you are a sheep going to slaughter.