I'm lost. Please help me understand

I need a revision after a failed RNY weight loss (only lost 80 pounds, had to lose 190). My doctor recommended endoscopic suturing because of my dilated pouch. If insurance does not approve, then we'll try regular RNY revision. BUTTTTT What is the difference? I've read so many bad reviews about the endoscopic revision and good reviews on the laparoscopic. What is the difference? Don't they both make the pouch smaller? I'm completely lost.

I don't know much about RNY revision, but revising to a DS is an option as well, and has somewhat better long term results. A lot of surgeons won't tell you about it because frankly they don't know how to do it, so they'll advise you away from it. Before deciding anything, I'd go to a surgeon in your area that does do DS revisions and then decide which is best for you.

I have never heard of endoscopic suturing, but I do see some logic in it. It would certainly be easier for the surgeon. I can share what happened when I had a revision and what I learned beforehand....

A revision usually involves making your stomach a bit smaller with a smaller opening to the upper bowel connection, keeping food in the pouch longer, and moving the lower bowel connection further down so that less calories are absorbed. That said, each revision should be tailored to the specific person, depending on what symptoms that person is experiencing. For instance, if you were already experiencing malabsorption of nutrients, they probably would not move the connection further down.

One of my symptoms when I had a revision was recurring peptic ulcers. If I had had a Roux-n-Y recently, I would probably not have gotten this kind of ulcer because the part of my stomach that produces acid would not be present. However, eleven years ago, surgeons were sometimes standardly leaving this part of the stomach. I was also anemic from malabsorption and had a variety of vitamin deficiencies. I also had crazy blood sugars that I could not control through food or drugs. Numbers would go high very quickly and then drop even quicker and would go as low as 30.

The surgeon went in knowing that she was going to remove the extra part of stomach that had been left and that she was tightening the opening out of my pouch so that food would stay in as long as possible. She also wanted to check the lower connection and was going to move it up or down if something looked wrong. It turned out that the connection was fine so she left it. She did remove the extra stomach and tightened my pouch. She also discovered some other issues that would not have been found if not performed laparoscopically. I had a great deal of scar tissue from a major infection I had that almost killed me a few years ago. They were able to separate my liver and stomach and clip some other connections that were causing me pain and discomfort.

The good news is that I am ulcer free and therefore not nauseous all the time. My blood sugars have stabilized and I am not feeling unwell all the time. I am getting iron infusions and B1 injections. Basically, I feel better than I have in years and I am losing weight again. It is a bit more difficult this time around as my brain/body has adjusted to the pouch and malabsorption of calories, but it is happening and I am recommitted. It was worth a tough surgery and recovery not to be sick all the time...

Good luck with your revision. Please shop around for a surgeon before you make any decisions. I went to three before I chose.