Question re: revision surgery

Has anyone ever gone into a revision surgery and not exactly sure what you will come out with? I know it sounds strange but I had a lapband more than 3 years ago but have a really severe slip that has caused some damage. I have had it unfilled and am waiting for inxurance to give me approval for revision.

Now the big question is I might come out with a gastric sleeve, rny, or a combination of both due to my odd anatomy damage and not sure what will be fixable when they go in. I have read up on all surgeries and though I do feel that there is one that would be better for me I agree with my new doctor of a year that it might not be the safest option for me when they are able to actually go in and find out what is damaged. I am ok with my doctor doing what he does best as he is one of the best revision surgeons in out area and I am driving 2 hours one way to go to him, but as a human the unknown is kinda scary. 

Just so you know I am not going into this and letting the doctor just fo what he wants, it is a damage of internal organs andstomach damage that will be the choice making factor.  

My surgeon would give you the surgery you request. He would fix the damage or work around it. I think it's scary to sign a consent for any surgery and deal with what you wake up with.

 I don't know where you live in Texas but Dr. Stewart is an excellent surgeon who has been doing revisions with good success.  You might want to check on him.

 There are more and more people out there who are asking for the gastric sleeve or the DS surgery, so a lot of surgeons are adding these surgeries to their repertoire.   You may want to see how much experience with the sleeve your surgeon has.   His DECIDING factor may really be what is EASIER AND FASTER FOR HIM and not what is best for you.  Then, when you wake up, the doc tells you that you had too much scar tissue, blah, blah, blah - for him to do the surgery that you wanted.

When you say a "combo" of the RNY and the gastric sleeve, it sound as if you are speaking of the DS.   The main difference between the RNY and the DS surgeries is that the RNY utilizes a "pouch" and takes your pyloric valve out of the equation, where the DS utilizes a sleeve stomach which keeps your pyloric valve.   In the RNY, the remainder of the stomach is left floating inside you and it is still producing Grehlin, the hunger hormone 24/7.   With the DS or the sleeve, the outer curvature of the stomach where the majority of the Grehlin is secreted, is completely removed.  The sleeves can also be made in different sizes, depending on what size "bougie" is used.

It sounds as if you need to figure out what you want and then see if this surgeon you are planning on going to has enough experience doing it.  If he doesn't, then HE WILL GIVE YOU THE SURGERY HE WANTS, and "convince" you after the fact that it was the "right one for you".   And, how are you going to know what the truth is, unless someone videotapes your surgery close up?

I've seen several people on here come out with surgeries that they weren't expecting nor were they happy with.   Better to do your homework and ask questions BEFORE getting cut open and save yourself another expensive and dangerous revision to fix this one!

Yup, this happened to me.  I went to my surgeon who is an expert in revisions.  I had a old stomach stapling 20 years ago and Dr. U. assured me a ds except I woke up with a scopinaro procedure.  ****!  BE very careful on who u choose.

If someone removed my pyloric valve from my body without my knowledge and consent I would soooo sue!!

What I have learned is this:  if there is too much damage, the surgey will either be done in two stages, or you may end up with a combination as you described.  In my case, I want a sleeve, not the RNY, so my surgeon will know that going in.  If he can't do the sleeve at the same time, then I'll have to heal for 6 to 12 weeks, and then have VSG surgery.  Good luck to you, sending you good thoughts.....

Well my appointment is next week for all of my pre-op testing and another gi study. Last study took about an hour as it went way beyond the usual barrium swallow. I have decided that if everything is good to go I will have my revision on September 29th, I am not hoping to be out of workj too long if I can get released fast enough, The first thing they have to do is remove the band and repair the Hiatal hernia. Fro there if the damage is no to bad I should be able to come out with the gastric sleeve. Hopefully done in one shot, maybe two or three, I am going to do it as I need to to be safe.

I can tell you right now, you're not going to get a revision to the DS from this guy...or, if you do...you'll be the "let's try this and see if it works" patient.  I'm saying that because if you go to HIS page at OH, you will see that on the pages he pays for where they list all of his experience, there is not one DS listed. 

DS surgeons in TX can be located at dsfacts.com

If they don't do revisions, you may have to consider out-of-state.

Really, you don't want to come out of urgery with some bizarre hybrid configuration because it was all the surgeon there that day could figure out.  If you think you want a DS, go to a DS surgeon.  There aren't that many, but it's worth it.