Which revision? How did you decide?

Hello, I'm about to embark on month three into my insurance requirements for a revision. For years I've wanted this band out and a sleeve. Now I finally have a reasonable cause to get a removal. I'm in a new state with a new surgeon and I was surprised when he asked what I wanted to revise to. He was concerned with the sleeve bc reflux is a major problem for me and the band actually helped it for years but I'm back on nexium. I've had acid reflux since I was eight and a hiatal hernia was diagnosed when I was old enough to realize something was wrong with this awful acid and went to a GI doctor and had an endoscopy. I hadn't even considered RNY, at the very most I have about 35 lbs to lose. The more I think about it I'm wondering if it would help, I only lose weight if I'm at 700 calories a day or less. Myfitnesspal tells me 1300 calories a day. Yeah right lock me in a room and slip food through the door equaling 1300 calories, weigh me in a week and I'll be up ten lbs. my thyroid is fine, I've just got something hormonally wrong that's never been identified. As I get older I know my metabolism will get even worse. So now I'm wondering if the restriction alone isn't going to do it for me. I've read so many stories in a Facebook group of bands that revised to sleeves with minimal weight loss. I am very compliant with calories, protein, exercise but reading all these stories of minimal restriction with the sleeve scares me. My band is empty now. I have no restriction and I'm starving. I'm not eating bad but I'm needing about 1000 calories a day and I know I can eat much more, I just don't. My surgeons concern is that my reflux will get worse with the sleeve and it can't be undone. So I'm really confused. The RNY seems so drastic but I'm wondering if it's better in the long run. I'd love to hear other stories of people who are band revisions and how they decided which to revise to and if anyone had the RNY at a non obese BMI?

RNY isn't drastic, it's just another - different - option. But, I think it's common to feel that it's somehow more extreme. I had VSG, but looking from a post-WLS standpoint RNY would not have been any bigger deal to me.

Generally, folks with chronic GERD are not-so-gently shoved in the direction of RNY and I'd follow your surgeon's suggestion on that because longterm GERD, as I'm sure you know, can lead to cancer.

I am currently in the same process. I have to wait a minimum of three months between having my lap band removed and doing a revision. In that time I am going to assess my reflux. I think it has gotten worse because of the band issues. If it is my body, I will go with a DS or RNY. However, my preference is for the sleeve. If I don't have bad reflux without the band, that will be my choice.

I have had some experience with this as I just had my revision on the 26th. I had my band for 11 years and the last 3 suffered from acid reflux and GERD symptoms. I meet with my surgeon in July to discuss options and she suggested band removal and revising to rny. I wasn't thrilled with the option of rny at first but after we further discussed my options I realized this was best for me. I had never had acid reflux before my band. I was waking up at night choking on acid and I was on a lot of meds because of it. She explained this could lead to Barrett's esophagus and then maybe lead to cancer. That sealed my deal. She said that rny had the greatest chance of curing the GERD. My band was removed in August and the process started all over for the revision. I had to meet with the psych, 2 nutritionists, 3 nutrition classes, 3 lifestyle classes, complete that awful pro-op diet and not regain any weight during the 90 days of insurance wouldn't pay. I managed to do it and here I am now. Surgery went great. I have had zero pain just a little discomfort - like I did a million situps and I am already on full liquids. I wish you luck deciding what is best for you.

If I had pre-existing GERD/Reflux, I would never revise to VSG. My initial surgery was VSG, I didn't have any issues with reflux prior to being sleeved, but developed severe reflux, post surgery. I've since had to revise to RNY to control my reflux and prevent/reverse damage to my esophagus. For me, it makes no sense to revise to a WLS that has the potential to increase GERD. I would pick RNY. I was about 10 lbs from goal when I revised (I was at goal, but gained when my acid was at its peak since the only food that provided any relief was crackers.) If your concern is losing too much weight, I wouldn't be a deterrent. My surgeon told me it could take a year to lose back down to goal. It didn't but I only lost about another 15 lbs after my conversion to RNY, which put me back at goal.

I revised to RNY and so glad I did. I just wish I'd skipped the band and done RNY to begin with. I also initially went in thinking sleeve and my doctor definitely steered me to bypass. He basically warned me that revision is a big deal and did I want to risk needing two. I also had GERD from the band. I'm GERD free now. what a relief.

Though he also does sleeves he did caution me about the newness of it and the lack of longitudinal studies. I took a risk with the band in the exact same cir****tances and it was an unmitigated disaster and of course the longitudinal studies all reflect the complications well all know only too well. He said sleeve looks good so far and recommended it as a back up should the scar tissue be so bad he could not do an rny revision in one procedure and I didn't want to wait and do the revision in 2 procedures.

Agree with others. disconnecting and reconnecting intestines doesn't seem any more drastic than permanently removing 80% of my stomach. I learned my lesson with the band and making a decision out of fear.

My band failed so I was more obese at the revision than I'd ever been in my life.

You will lose weight at a higher calorie level with either sleeve or bypass because they are both metabolic surgeries... the band is not. basically bypass or sleeve interrupt the hormones and give you a metabolic reset. I was like you. struggled to lose weight. now I maintain at 1500-1600 calories a day and will lose if I drop below 1250.

Sleeve is strictly a "portion control" type of surgery. It is not a malabsorption type of procedure as is the RNY or DS. I was sleeved in 2009, wish I did have malabsorption.

Hi

May I suggest to review about MGB( mini gastric bypass).

I must go thru a revision from VSG and considering MGB, the main reason is that I regained most of the weight lost in the VSG and MGB it is not as drastic as the RNY.

Just an idea, check on MGB too.

Regards

Pedro

MGB is one anastomosis gastric bypass, whereas RNY is two anastomosis gastric bypass.

Im curious to know, how are you able to get your insurance to pay for a revision with a non obese BMI or other comorbdites?