RNY Revision

I am 8 Years post op, starting weight was 545, maintained 275 for several years and now at 325. Went to same surgeon to ask about revision. I have had no complications at all. Dr is suggestion to make my pouch smaller. Does anyone agree or disagree -pls advise....

I disagree completely. Go to a surgeon who does ALL types of surgery, not just one or two.

Most of the regain with RNY is because malabsorption goes away, not because the pouch gets larger. Consult with a real revision surgeon. Try Dr. Roslin in Manhattan.

 I totally concur with Baileymouse. The fact that you've regained is because of metabolic syndrome, and from what I've learned, the DS is the best for insulin resistance. 

I'm surprised you're eight years out and haven't had trouble with hypoglycemia.

Lynda

I seem to be pasting this for a lot of people lately. Here is what was said in my decision from an independent medical review when fighting for a revision to the duodenal switch.

A 37-year-old female enrollee has requested bariatric revision surgery (duodenal switch) for treatment of her obesity.  Findings:  The physician reviewer found that the medical literature supports the opinion that the performance of a revisional procedure similar to the initial operation will fail in many instances, because the basic problem is metabolic and not mechanical. Rapid gastric emptying, as seen in this patient's case, leads to an enhanced insulin response resulting in either hypoglycemia or hyperglycemic episodes, and the most dramatic rises and falls have been associated with small pouches and wide anastomoses. Duodenal switch is a medically appropriate solution to the problem. If this procedure is not performed, the patient's comorbididites will likely worsen. Thus, bariatric revision surgery (duodenal switch) is medically indicated for this patient.

I don't know how much they expect you to lose from a smaller stomach, but I would be looking into all of my revision options and not just making my pouch smaller.

Baileymouse took the words right out of my mouth!!!!

Go get a consult with a surgeon who does all 4, yes FOUR weight loss surgeries!!!!



RNY to DS Revision Surgeons


Dr. Rabkin, Dr. Keshishian, both are located in California

(((((I had a face-to face consult with Dr. Keshishian March 2, 2011. I do have his cash pay fees:
These are just the Surgeons FEES Only!!!!
Open DS: $8650.00
Lap DS: $9525.00
Sleeve: $2000.00

REVISIONS:
Revision - Lap Band to DS: $8650.00
Revision - RNY, VBG, Fobi Pouch, or other unknow bariactric procedure to DS: $11,000.00
(I was told that the $4,000.00 program fee is included in this $11,000.00 fee)
On my paperwork, The hospital fee (I think it was for a 4 day stay) was $17,500.00)))))
So, a revision from RNY to DS surgeons fees are $11,000.00 and the 4 day hospital stay is $17,500.00 for a total of $28,500

Dr. Elariny, located in Virginia

Dr. Roslin, located in New York

Dr. Buchwald, located in Minnesota

Dr. Greenbaum, located in New Jersey -- 9/2010 No longer doing a RNY to DS revision -- but pushing Distal/ERNY

Dr. Husted-No one knows about him anymore -be cautious!!!!! -- he has lawsuits


Of course, the above doctors are in the United States


Dr. Gagner, located in Canada

Dr. Ungson, located in Mexico

Dr. Baltasar, located in Spain

Dr. Marchesini, located in Brazil



Hope that helps!!!
-Jamie

I am a self-pay bariatric case. My suggestion is that you should be very aware of what costs are included in the quotes above.  Are the disposable surgical instruments, are the pain meds, surgical meds,  anesthesia, supplemental oxygen etc included.  I had good solid quotes from the anesthesiologist, surgeon, hospital and OR, but was a little surprised at the other costs.

Oh, also read this!!!!!  GREAT info!!!!

http://www.dssurgery.com/about/publications/duodenal-switch- safe-operation.pdf



-Jamie

My opinion is to get the DS. I'm not a revision, but I have many friends and family members with wls and they didn't pick right the first time. They have the same issue with regain, or they didn't get to goal to begin with. Just do yourself a huge favor and get the DS.