RNY revision
Hi , i had RNY in 2006. SW 289 LW 192 CW 239. i had an endoscopy March 25 that found my stoma and pouch are EXTREMELY large. My surgeon wants to do revision. i want , need to be as informed as to what to expect as possible. What is the level of pain, same as 1st time , different ,worse. should i expect better restriction. tolerance for foods, dumping? I was ready for the 1st one but really do not know anyone else who has been thru it on any of my sites,(or at least they dont speak of it).
Hello,
I found out I have a gastric fistula in my pouch from an abscess that ruptured. My original open RNY was 14 years ago. I have seen three different surgeons, two were for WL and one is a gastroenterologist. They all wanted to do the Apollo Overstitch to repair the fistula and reduce my stoma but only the gastroenterologist can preform the Apollo Overstitch procedure. I can still be seen by the WL surgeons afterward if this procedure doesn't help.
I know my case is different than yours. This is what I know about revisions from my research and discussions with my doctors.
Open WL revision is very risky. I know that laparoscopic revisions are more common but open revisions are not done as much. This is important because it is important to know HOW MANY revisions are preformed by your surgeon in the past year as well as at the hospital you are going to have it done it. There is a ratio table online that specifically talks about how the number of WL Surgeries and WLS Revisions preformed at the hospital and by the surgeon directly relates to the complication rate and what numbers you need to be seeing to be safe and have better outcomes. Don't just look at some award they have.
And yes, an open revision will be just as painful, probably more, and have a long recovery rate. Laparoscopic revisions will still have pain but a shorter recovery rate. Everything I've been told by doctors is revision is not an easy surgery for them to preform depending of your specific anatomy and many won't do it. I've also read the statistics that report 20-40 lbs of weight loss after revision. That is disheartening and hard to believe and hopefully it is wrong. It's probably because there is not as much restriction as the first time.
I have been warned and know to stay away from WL clinics where surgeries are preformed. ANY surgeon can open one up tomorrow, with any old equipment they want to purchase. So if a complication happens or they drop something and they need to open up a new piece of equipment it comes out of their pocket. I don't want a doctor to choose between me or their wallet. Have all surgeries at a hospital where the hospitals is responsible for buying and maintaining the equipment and they have the latest and greatest.
Get a second opinion if you can. Meet other doctors and ask lots of questions, don't rush. The first surgeon that I saw preformed the endoscopic procedure and told me that my fistula was 6 cm, when my new stomach was only suppose to be 4 cm. So it's like I didn't even have the surgery. The second surgeon looked at the views from the procedure with me and I could see it is a small pin***** size, not 6 cm. For whatever reason the first doctor was wrong, maybe it was a typo or maybe he was high, who knows but I don't see him anymore. He also gave give me way too much medicine for the procedure which each doctor I've seen since thinks that is a typo also.
Good luck
