"Lightweight" needs revision to RNY and Stomaphyx -- Seeking Guidance

Hi everyone, I am interested in hearing about your journey with revision surgery after RNY. It will help me on my journey. I need to do something!

Here is my story: I had RNY gastric bypass in 2003 and went from ~285lbs to 185lbs. In 2008, I had StomaphyX because I had regained some weight -- I was like 205lbs, I believe. I went to 173lbs and a size 12. I was delighted! I kept the weight off for about a year, I guess, and planned to have plastic surgery.

Unfortunately, I am again around 200lbs and I feel and look awful. I refuse to get the plastic surgery until I can get this weight off. I'd be delighted to maintain 173lbs long term... even less than that would be great... but it must be long-term not short-lived.

I have my doubts about the success of BOB or another Stomaphyx but I have considered them. I did see one surgeon and she sad BOB has low success rate and did not recommend it for me.

I just learned that some specialists do a revision surgery and will take a look at that option. It would be nice to have insurance cover it. However, at the weight I am, I do not know if I am a candidate. Maybe I should lile and tell the surgeons that I got down to 137lbs and have regained a lot of weight??? I wonder if that would make a difference? I'd also probably have to fudge my BMI a tad. Maybe take an inch off my height and get weighed at the end of the day when I am heaviest, s/b good for another 5lbs. Doing this, I can probably present a BMI of 34.1. Has anyone heard about success rates with this surgery?

I see many posting about DS. Funny, that was the surgery that I wanted intially and my surgeon told me to get RNY. I guess that I should have spoken to other surgeons -- gotten a second opinion. I have the same concerns posted above about being qualigied a candidate for the surgery, even if I self pay. Does anyone know what are the success rates for RNY revision to DS?

Speaking of self pay, does anyone have costs on the DS? RNY revision?

Everyone thinks it is so easy to lose 25lbs but I am telling you that I have tried for a long time and the scale hasn't budged. So, if they think I need to lose 63lbs then maybe they'll see me as a candidate. And if I did get that thin -- well, hot dog! At my lowest weight I was 120lbs so I know that 137lbs would not be too thin.

I appreciate any and all help you can provide. Thanks so much, HJ.

The only revision surgeon who goes from RNY to DS in the NJ area is Dr. Greenbaum, and he's not taking new revision cases. My insurance covered it completely, so I'm not sure how much it would have been self-pay.

Stomaphyx doesn't work, so don't beat yourself up. BOB has a low success rate, your doctor is right. It's restriction without malabsorption. Your body has been dieting for years and has learned to hold onto whatever it can.

Revision criteria is based on either mechanical failure or a regain to a BMI of 40 or over. If your BMI isn't over 40, and you have no problems, insurance might be a hard sell. If, in fact, it's shown that your RNY has problems they might cover a revision. My RNY included a permanent ring around the stoma that caused problems, so it was approved based on that. I weighed 221 when I revised. Since I'm short, I also made the 40 BMI mark.

Revision patients lose a little more slowly, but the DS is the best option for keeping weight off long-term. Go to ww.dsfacts.com to read up on it.

I wish you well, I know it's frustrating.

Thanks so much for your reply. My bmi is 34.1 or thereabouts. I have comorbidities of diabetes, sleep apnea, hypertension, and arthritis. I believe some insurance companies will take that as criteria. Do you think that is correct?

I was so excited when I saw that you had your revision in NJ. Then to hear that he isn't taking new patients... So disappointing. Do you know why that is? Can you tell me what insurance co covered the surgery and also if you had to appeal?

Thank you again for posting!

My BMI was 21 when I was revised from Rny to DS.  The BMI doesn't make much difference if the need for the revision is medical.  Your revision surgeon may need to qualify that with your insurance.  All insurances are not created equal but building a case for "medical necessecity" can be your ticket to the DS.

Good luck!

Wow, Joyce, you were uneweight. Did you loose even more after the DS? Thank you for he feedback.maybe there is a medical necessity for me. I am pretty close to the 35bmi with comorbidities anyway. Unfortunately, from what I understand from redading this forum is that the one doc in my area who does rev from ray to ds is not taking any new patients. I will reach out to him anyway. Please wish me luck!!!!

I gained weight before having the DS revision.........was able to avoid the tpn.  Had the DS....lost weight.....had feeding tubes for 6 weeks and gained weight.  I'm 23 BMI now and working on losing a few so more of my old clothes fit   The revision for me was NOT to lose but to get healthy!  .......It's working 

I wish you oodles and oodles of luck!!!!  I don't normally wish "medical issues" on anyone but if it helps you get a healthy procedure covered then .............(I hope they find medical problems!!!  lOL!)  If you can't get the answers you need from Dr. Greenbaum then shoot emails to the Westcoast surgeons (Keshishian and Rabkin) .......at least you'll find out the possibilities!