VBG revision to RNY or DS??

I have been set on the DS since I started checking into this.  I am 11 years out from a VBG and only lost 50 pounds with it.  I am now at 300# and a BMI of 46.5 and want a revision.  I'm 43 and I've got to change my life. 

So I'm driving my self crazy and need input specific to my situation.  I'm already approved for a revision surgery and my surgeon said that means we can do anything we want.  HOWEVER, he will only do a revision to a  LAP RNY.  He says it's too risky to do a DS revision from a VBG because of the way the stomach was cut, stapled and banded with the VBG. 

So yesterday I  called around to various other MDs to see who might be willing to do a DS.  I was fortunate to find one clinic manager at one location that told me his perception of the DS post VBG.  (His office does not accept my insurance so I felt he had nothing to gain from telling me this).  He said that DS revisions from VBG are safe and effective.  He said that many doctors either don't feel confident doing them or it's about $$.  He said the reimbursement from my particular insurance is the same whether they do the RNY or DS.  The RNY takes 2-3 hours, the DS 5-6 hours because it is so complicated.  So if he's getting reimbursed the same for either, then it makes dollar sense to do the RNY.  I would hate to think that's what it's about, but the world is a crazy place.

Any one else had this situation?  I am tired of thinking about it.  I know everyone will tell me to do what's right for me, but I need some advice. 

The RNY would put me back in action sooner and would be easier on the front end as far as getting back to work, etc.  However, I worry about the long term - will I keep the weight off, etc.

The DS would be harder on the front end (especially since it is open).   I would have a longer recovery, etc.  But I think I would have better long term results.

I just know back in 2002, my doc talked me out of the RNY to do the VBG saying it was so much safer, etc... and now I wonder if I had done what I had wanted to do back then, would I be where I am now?  Now I'm in the exact same boat with a MD selling me on something that makes sense when he talks about it, but it's not necessarily what I think is best for me.

Any advice is greatly appreciated guys!!

FYI - I have a tentative date for the RNY for 5/21.. but I'm really thinking of pushing it out to give me more time to do research and see what the DS docs have to say.

I'd do DS in a heartbeat. The success rates are just so much higher. Why would it have to be done open? My BFF had her band to DS revision done lap. 

Thanks Amia. Today has been a total DS decision day. I think I've made my decision

Pretty much all I have seen is the revision to DS being done open... But I'd definitely take it lap lol

Here's a link to a post that lists all the 'vetted' DS revision surgeons: http://www.obesityhelp.com/forums/revision/4599894/RNY-to-DS -revision-surgeons/

I am 13 years out from having the VBG. I lost 150 pounds and have gained back 80 pounds. The surgeon I am using for my revision won't do anything but the RNY from the VBG. He says it's much safer that way and it will take about an hour and a half to do. I believe attitude has alot to do with how you do on your revision. I am going into this with faith and a positive attitude that I will lose this weight again. You have to make the decision for yourself as to what is best for you. Just weigh your chances of which is best as far as how long the surgery will take, which is more safe than the other and recovery time.What insurance do you have? I have Aetna and they required alot of steps to take before my case will even be submitted. I have one more visit with my nutritionist and I'm praying Aetna will approve me and I'll be getting my surgery in June. Have a positive attitude with whatever you decide to do and you'll do fine.

 

 

So... 

The DS has a much better success rate. My insurance only covers it with a 50+ BMI so it was not an option for me.

However, it is a very complicated surgery.  I would not find someone simply willing to do it.. I would find an EXPERT.

Have you been to dsfacts.com?

Good luck!!

Hi,

I have revision from RNY to DS in Dec. My RNY was LAP and the revision was open. It really was not a big deal. The scar is only about 5 inches and it was numb so there was not any pain associated with it. I would not let this determine your choice of surgeon. 

Best,

Whitney

Thank you for the info Whit! DS is what I wanted from day 1 and I'm not going to let another MD talk me into the surgery he does vs the DS. I need to o what I think is best for me.

I have found a great surgeon that is n the list of vetted DS surgeons. He's sending me for an UGI next week then we will do the consult. If I feel comfortable with him then I am going to proceed with the DS as long as he thinks its doable. I just really did not care for the MD that I consulted with for the revision. He was an ***.

I have BCBS federal Basic and they approved me within 10 days of submitting once I met their requirements. Now I just need to get the approval with the new surgeon but it should not be an issue.

Good for you! Please keep us updated.

Whit