Revision Surgery

So I got the band in 2009 and currently am scheduled for revision to sleeve in November.  But I am seeing a lot of people are revising to RNY (is that the bypass) or to DS. 

What helped you make the decision to go RNY or DS versus sleeve?

I'm so scared the sleeve won't be successful either for me so of course now that I'm seeing so many are revising some other way I am getting more doubtful about the sleeve.

I know it's different for everyone and my doctor actually thinks the sleeve will be very successful for me so I will probably still do that because I trust him explicitly.

Just curiousity.

I think it has everything to do with the surgeon you go with to be perfectly honest.  My band failed and my original surgeon moved out of state.  For me, it took a while to find a surgeon who would even look at me.  My doc specializes in RNY and so that's the direction he wanted to go.  I think those that specialized in DS point you towards DS and those that do sleeve go that route.  From my research the differences are in restriction and malnutrition element vs. just restriction.  The Sleeve is only a restriction surgery, making the small sleeve restricts your food intake and limits your calories producing weight loss.  The RNY is a WLS that hits on both restriction and malnutrition meaning a pouch is created and the intestines/bowel is rerouted in order to limit calorie absorption.  DS is also a restriction with malnutrition element and to be perfectly honest I do not know that much about the DS but from what I've seen on this sight is has a more extreme malnutrition element.  (DS folks please chime in as I am not up on exactly what is involved). 

RNY has been around for years and years.  DS and sleeve are both newer surgeries.  Why I went with RNY instead of sleeve is because for me I didn't want to go with a newer surgery again.  I did not do my homework on lapband just went with the newest and greatest thing and I regretted it.  So I did my research and RNY fit for me and I think this is the key....do what is right for you after you do you homework (this may mean changing surgeons). 

Thank you that is very helpful information.  Luckily my doctor does all of the surgeries so my only obstacle would be changing surgeries and getting insurance approval.  I see my doctor 10/4 so I am going to discuss further with him.

Lisa

The great debate... which is the best?   It is a highly personal decision and there are 'issues' with each and every one of them.  Only you and your surgeon are going to be able to make the right decision for YOU.  What are your weaknesses and issues that you have with food?  How are you going to deal with those issues?  What roadblocks do you perceive to still be battlegrounds for you post surgery... how will you address them as they crop up?  Support?  Ongoing support?  All of those weigh in to your long term success and which surgery will be the right fit for you.....

For me?  I know it is the RNY...  for some others...that wouldn't be an option... etc....   

wishing you the best....   and know that we are all here for the same reason... we want to be health and do what we have to do to attain that !  ((hugs))

Thank you and you are right ultimately I have to trust my doctor, which I do!

You bring up very valid points about my "issues" with food and that is what I need to discuss further with my doctor.  I don't want to do a surgery that will allow me to still fallback on my old habits.

Lisa

I was originally thinking I would have the Sleeve because I did well with the Band until I developed complications and chronic Reflux.  My surgeon will not do the Sleeve on me because of the reflux which is the number one, long term complication of the Sleeve.  The RNY is the only surgery that basically does away with reflux AND knowing what I know about myself after living with the band for almost 5 years a little malabsorbtion will be a good thing for me and I won't mind at all if I am one of the 30% that experiences dumping from sweets!  

Seriously though, my surgeon considers the Bypass (RNY) to be the gold standard and feels it's the best choice for me.  He also feels that the Sleeve is equally as dangerous a surgery to perform because the staple line is so long there is a lot of opportunity of leakage.  He only does DS on Super Morbidly Obese patients with serious comorbidities that require fast weight loss so with a BMI of 40 I don't qualify.

You're doing the right thing.  Ask a lot of questions and choose the surgery you feel is right for you once you understand all the differences.  Your surgeon will guide you but ultimately they can't make the decision for you.  If you were successful with the band (restrictive surgery) and you don't suffer from reflux, the Sleeve may be a good choice.  If you need more that restriction then RNY may be the best choice.  It's such a personal thing!

Best wishes as you make your decision!

Lisa O.

Lisa,

Thank you that is alot of great information.  You are right, my doctor and I have to really look at everything and then make the choice.  I never did suffer from reflux so I'm confident I'll be okay if I go with sleeve as far as reflux is concerned.

Lisa

I chose RNY for a few reasons: my surgeon's recommendation and vast experience, many friends who succeeded with RNY; and my comfort with the surgery. That said, I think each surgery has a good success rate. The ultimate choice comes down to a surgery that you are comfortable with and can live with for the rest of your life.  -- Tom

That's the bottomline, thanks for reminding me of that :-)

Just an FYI on the sleeve, it has been done for decades as a surgery for cancer and ulcers so the surgery itself isn't new, just using it for weight loss. I have a relative that had it done for cancer over 20 yrs ago and he is doing great, plus stays trim! Like the others have said you need to research and then research some more. I feel for you because I'm stuck with a useless band too, worst mistake I ever made!