a different kind of revision....

Jeanyjane,

    Do you have any statistics in particular regarding the band over bypass? I've personally had the opportunity to speak to 5 people that have lost 80 pounds or better and they are all 1+ years out. I think the success depends on the person and their readiness to change their lifestyle.  I've said it before and I'll say it again, I think everyone understands that the DS is the gold standard of bariatric surgery, I would never dispute that. But understand, not everyone has the monetary means (or insurance), or desire to go through another drastic surgery. I commend you for being so open about promoting the DS (as you should!), but it's unfair to say that something else is a complete failure in comparison, when certainly, it's not. It just requires more diligence and a lifestyle change.

                          ~Kel

Kel,
No stats here but experience.  I worked for a band surgeon and have yet to see a BOB work longer than the initial 6 months to year after it was placed.  If dieting worked for you before WLS then you might be fine but for the majority of us who struggled with the yo yoing of the lose-gain cycle and who have metabolic issues and/or genetic issues regarding weight.  No success!

As for saving money by going with a BOB?  That's like buying a clunker car that nickels and dimes you to death before you finally realize you need to buy a car that works!  ....  Why set yourself up for a possible 2nd revision in the future?

.....I understand your defense...I had it myself when I was championing my last revision to an ERny but.....I learned the hard way .....just had my 2nd revision to a DS.

I sincerely hope your journey goes well for you with whatever path you choose!

One study that cites studies on BOB is here:
http://bariatrictimes.com/2007/09/10/revision-procedures-for-failed-gastric-bypass/
One study with just 8 patients found an excess weight loss of around 44% at 24 months, another (more recent) reported just 20%. This is not exactly encouraging, I think, and that`s just the short-time results (2 years is not even midterm).

I DO understand very well that getting a revision to a full DS is a pain in teh ass and not possible for everyone. But it would be possible for a lot more people, if they would know about it and how to find a qualified surgeon, and if they knew that in the USA, most insurence companies can be forced to pay for a DS if they`d cover other revisions.

I do understand the wish of not going through such a drastic surgery as well.... the point is, you get what you pay for. Little surgery = little results. You`re right that some people always do better then others, and the BOB seems not to be completely useless - but you`re not serious that it "JUST" requires more lifestyle changes, right?? How well did it work out with "lifestyle changes" after the RNY? Why don`t you make the "lifestyle changes" now and loose the weight without any further surgery? Do you know that gaining weight back after the RNY is nothing but an extreme yo-yo-diet which has seriously screwed your metabolism and will make loosing weight through more restriction really, really difficult?

I don`t think everyone should get a revision to a DS, not at all. But everyone should know that all the non-invasive revision options (stomaphyx, ROSE, BOB and ERNY) are either not very effective or have very serious side effects (ERNY). It`s a very personal choice if you decide to go ahead nevertheless, with the risk that you wont loose what you need to loose, just that ANOTHER revision then will be even more complcated and risky since there will be even more scarring then after "just" having had the RNY. Or if you decide to fight for the surgery that gives you the best chance. It seems obvious what I would choose, but that`s just for me. Just know the risks of what youre getting yourself into.

 Even though docs all over the country are still doing it, the RNY is really going to be considered an archaic surgery a few years from now.   If your band isn't working, and you still have a high BMI, check out the DS surgery.   THAT'S the surgery that everyone wants and wishes they got in the first place.    

You only have to take a look at the revisions board to see that NO ONE is looking to revise from IT!!   If you can't get the DS, at least get the sleeve instead of the RNY.    The results that are in so far show that it's just as effective for excess weight loss as the RNY (especially once you consider the "bounceback" weight that comes back on after the RNY pouch stretches and the RNY patient's intestines become more adept at absorbing nutrients and calories from food).    

Once you get your stomach cut up into that RNY pouch, you SEVERELY limit your ability to easily revise to the DS.   Only a handful of docs perform the RNY to DS revision, but they could easily just add the bypass portion of the DS if you need it later on, as you will already have the first part of the DS surgery, which is the sleeve stomach.   Even if your sleeve needs to be made smaller, it is a MUCH easier surgery than dealing with revising the pouch.

The concept of the band over RNY (BOB) isn't anything new or  unique.   In Europe, I've read, that the surgeons install a lapband over the RNY with the original surgery, so that when the pouch stretches out, they can use the lapband to add restriction.

Good luck to you.

Absolutely NOT. You just get the worst of both with the BOB.  PLEASE, please, please at least take a few minutes to learn about the DS.  Go to www.DSFACTS.com.  It has proved to have the fastest weight loss AND the most maintained weight loss AND is what others revise to when the other surgeries fail.  Please don't put yourself through more surgeries without at least considering all of your options.

DS is actually called the Platinum Standard.

ETA:  DSFACTS.com also lists the accredited DS surgeons.  You can ask any questions you might have on the DS forum here.

Let me know how it goes, because I have the band and I would like to know if that works with both of them together.