question

 so i go tomorrow (friday) for my appointment with my surgeon. when i started my weight loss journey i was 550 pounds im a few days shy of being 16 months post op. i have lost almost 250 pounds and im stuck at 345. ive been at my stall for 4.5 months. ive been doing everything they tell me too and i eat and exercise. so tomorrow we are going to talk about a revision. i know nothing about a revision. i had RNY on aug 16th 2010. anything will help tia :)

With your BMI your best bet would be a DS.  It is the big guns of WLS.  It has the best statistics for the amount of weight lost as well as keeping it off.  It is serious business because it involves a lot of malabsorption and unlike the RNY the malabsorption is permanent but that also means you need to be very good about taking vitamins and getting labwork done.  If you have been used to doing that with a RNY it shouldn't be that much of a problem although you will have to take even more then with the RNY.
The biggest problem is getting a revision from the RNY to a DS.  It is a very complicated procedure that involves taking down the RNY, including putting the pouch back together and then making the stomach into a sleeve and redoing the intestinal configuration.  There are only a handful of surgeons who are skilled enough to do it.  Two of the best are in California, Dr. Keshishian and Dr. Rabkin.
You could always contact one of them and get their opinion but it is worth considering.