Revision Surgery

You are right about the research, I really need to get my ducks in a row before my next doctor appointment 10/4.  I was just telling my husband over the weekend that I need to wrap my head around this revision as I did when I first got the band.  I was so disciplined and regimented but it worked to get me through the approval, pre-op diet, etc. 

Thanks,

Lisa

On September 25, 2013 at 7:26 AM Pacific Time, lmbfmm wrote:

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.

Some surgeons only do the RNY and band so will only revise to RNY.  One of the two centers here only do band and RNY. So if all their revisions are band to RNY and 1/4 of ours are, 62% would be RNY.  But, 75% of the revisions at our center are sleeve. With the RNY after a few years out your body adapts and you no longer mal-absorb calories and you still mal-absorb nutrients and supplementation and labs for life.  The RNY for the most part can't be converted.  There are very few surgeons qualified to take down a RNY and convert to a DS.  

The sleeve is the first stage of the DS.  The surgery used to be done in two stages for the very obese or high risk.  What they found was some did so well with the first stage, VSG/sleeve, that they didn't go back for the second mal-absorption stage. The sleeve as stated above has been used for a long time for cancer and ulcers.  My brother had this done last year for that very reason.  So if you did well with restriction only of the band the sleeve is a good choice.  If you do need the mal-absorption it can be changes to the DS.  

The DS has the highest weight lose but, also the most follow up of lab testing and supplementation.

I would go read on all the boards to get an idea of what would fit for you.  For me the sleeve was the right surgery as I did well with restriction only and didn't want the re-route if not needed with the extra supplementation.  I am doing great and loving my choice.

Thank you for the information.  My surgeon does all the surgeries so at least I am lucky in that aspect if I decide to change to RNY.  I never had problem with restriction so I am still thinking the sleeve is the right choice.  I had problems with mal-absorption but only because I couldn't eat the solid protein we are suppose too.

Lisa

Your surgeon does not list the DS, and I've never heard of him as a DS surgeon.

If I had to choose between the Sleeve and the RNY, I'd go with the Sleeve every time. All it does is make the stomach smaller, and the long-term weight loss results are about the same as the RNY. By preserving the pylorus it remains a fully-functional stomach and avoids dumping syndrome. It also seems to have far fewer chances of developing reactive hypoglycemia, and you can still take NSAIDs. Also, if the Sleeve alone doesn't give you all the help you need, it's the easiest one to revise to the complete DS.

I chose the complete DS, for a lot of reasons. I knew that my metabolism was very efficient---I could store 4 out of 5 calories. I NEEDED malabsorption. (And malabsorption does not equal malnutrition---two entirely different things.) I was quite willing to commit to taking vitamins and supplements for the rest of my life if in return I could lose weight, eat well, and keep that weight off long-term. I'll be ten years post-op this December, and I've had zero regain. I also eat very well. (*grin*)

What sort of problems with malabsorption did you have with your Band? The Band doesn't cause any malabsorption as it's a restriction-only procedure.

I think she meant mal-nutrition with the band due to not being able to eat right.

Ah---that makes sense.

I am in the same boat currently....was banded in 2007 and didn't start having issues till October 2010 when my band slipped and since then it has slipped 2 more times (Band was unfilled 6 weeks ago due to being slipped again....).  What I found out just this week by another doctor I have reached out too, because my original doctor will not discuss fixing the problem or communicate with me, is that after the first slip it should have been fixed.  So I too am trying to gather as much info as I can on what procedure to switch to. Currently there is an exclusion on my health insurance by my employer for these procedures so i will probably have to end up being self pay which I really dont like but I will do what I need to cause having a tool that isnt working is not good. 

That is crazy that it has slipped so many times and your doctor hasn't fixed it right.  Hopefully your insurance will take into account that you need a new surgery to correct the band and they will approve.  Good luck!

From all I've read, if a Band slips once it's much more likely to slip again. It's a real shame your surgeon didn't remove it when it slipped the first time.

Have you considered going outside the US, since you'll be self-pay? There are a couple of excellent Sleeve surgeons in Mexico, and the prices are much better.