Lap Band Revision to Bypass instead of VSG??

Hi All-  Just found this board and seems great.  I had a lap band done 5 years ago.  Initially lost 80# but have gained 50# back.  Band has slipped and just isn't working well for me any longer.   I was considering converting to a VGS by going to Dr. Garcia in Tiajuana.  After submitting my medical form, he suggested the bypass surgery.  I already suffer from acid reflux but it is controlled ok with omeprazole as long as I don't eat too much or too late.

I had a severe hiatal hernia that was repaired, but taken down to add the lap band - was supposed to "fix" the problem.  

I am very reluctant to go with full bypass after doing additional research.  Any advice would be terrific.  I would like to lose 120# total (goal would be 140#).

Thanks!

I'm not a revision patient, but I had my heart set on VSG for 3 years until my surgeon recommended RNY instead because of my severe GERD. All of my GERD symptoms have been gone since surgery and I have no more evidence of pre-cancerous cells in my esophagus. I was nervous about the increased risks of the full bypass though, so I lost as much weight as I could pre-op to lessen those risks, and my surgeon said that's why my "anatomy cooperated so well" with the surgery. I'm now extremely happy with my decision. My husband had VSG though and is also extremely happy with his decision. He didn't have GERD before surgery though and does now.

Thank you for the info!  Did you have it done in the states or did you go to Mexico?

I had it done locally in Oregon. When I was first considering VSG in 2012, I was going to be self-pay through the Ohio State University Medical Center to the tune of $16,000. When that plan got derailed, I waited until I had a new job with insurance that covered WLS.

Were you able to manage your GERD well with medication?  I am having pretty good success with OTC Omeprazole and not eating after 7 pm.  I see my PCP this week to discuss what she thinks.

It was partially managed, but I still had the nausea spells. They would hit me suddenly, last a few minutes, then the acid would irritate the vagus nerve, making me sneeze but also pushing the acid back down, and I'd feel better until the next one. They happened maybe 2 to 5 times a day. I had a lot of GI problems in early 2012 that led to a few endoscopies, which were where my GERD and esophageal damage were first discovered incidentally. I started Prilosec then. Last fall, I did a 24-hour pH test and had to be off my Prilosec for that, and it was a miserable few days, so I can't say it did nothing for me. My surgeon and his surgical fellow actually got into a bit of an argument during my consult. My surgeon said he would support me in either surgery, but let me know a revision to RNY might be necessary if my GERD got worse after the VSG. His resident was very convinced I needed RNY from the outset instead -- with the pH study, my DeMeester score was 53 (I believe "significant" GERD is anything over 14), and even though GERD often improves just with weight loss, mine hadn't gotten any better with the 80 lbs I lost pre-op. Every situation is different, and it's definitely something to talk to your surgeon about. I may have been fine with the VSG as well, but I don't regret going the RNY route, and my GERD is massively improved.

Hello,

I'm going through the same thing as you are.  I had the band on 12/2008, did great for 5 years and lost a total of 71 lbs.  Then my band slip and I developed gerd, a swollen esophagus and real bad acid reflux.  It was so bad that I'd wake me up several time during the night choking on the fluid.  Band was removed in 2013, the reflux subsided however the heartburn remains.  I too was advised on having the bypass instead of the sleeve because according to my doctor the heart burn or gerd will be much more with the sleeve.  I've gone back and fourth with my decision and i'm scared of the side effects the bypass might cause in the future. 

I finally made my decision to move forward with the bypass after my co-worker (who never had gerd) told me she suffered extreme heartburn after getting the sleeve 2 months ago.  It was so bad she was put on medication.   This coincides with the medical diagnosis i was given.   Even though i am moving forward, I am still nervous and pray all turns out ok.

Thank you so much for your candid feedback!  The sleeve seems less scary after reading about the bypass, but having suffered for 40 years with reflux, I can't imagine how bad it could get.  I have so much weight to lose that Dr. Garcia says I may not be satisfied with my results from the sleeve as I am getting older, closer to menopause, and it tends to be harder to lose weight after you've lost a significant amount over the years (call me a yo yo!).  Please keep us updated on your progress - all the best to you!

To you as well.  

I have suffered from pretty severe GERD for years prior to my VSG and post. 

I am currently looking to do a revision to RNY partly because even with weight loss my GERD is unmanageable with medication.  It was manageable with meds prior to surgery.  Now I take 40 mgs a day of Nexium and still have to use antacids at night as well as be very cautious what I eat.  Also, the GERD will make weight loss more difficult because it makes eating fruits and veggies (often higher in acid) more difficult. for me an empty stomach makes my GERD worse, so I tend to snack all day, which even with healthy snacks makes it difficult to lose.

I would recommend RNY with as much weight as you have to lose and your history of GERD.