Hiatal hernia and revision

Good morning! I'm looking at the potential revision from vsg to rny due to reflux. But I don't know what to do.

I was sleeved in 2010, apparently there was a small hiatal hernia that the surgeon did not fix, but no problems until I was pregnant in 2014/2015. My pcp referred me to get an endoscopy and it was shown I had a 3 cm hiatal hernia. My omeprazole was bumped up to twice a day and I still continued to have reflux. Went to my surgeon, I've since had another endoscopy, barium swallow, manometry, and bravo test. All have confirmed the reflux and shown no abnormalities otherwise.

I want to keep my sleeve. Surgeon wants to revise me to rny to resolve the reflux. Seems to me the hernia could be repaired without revising but surgeon says there's only a 50% chance it will help the reflux.

Has anyone repaired a hernia and then later needed a revision? Or should I go straight to rny, or insist I just want the hernia fixed? I'm feeling pressure to make a decision because I assume all these test results are only valid for a certain amt of time, and I definitely don't want to have to repeat any of them. I'm also afraid if I revise, I could potentially be trading one problem for another.

Talk, talk and talk again with your doctor. Ask.him about his experience with revision. Look at all the information you can. Then do what is best for your life. Your body your way! As I type this it's so clear. I am going to fight for my revision.

Thank you! I've been searching fb groups, googling potential rny drawbacks. I've talked to my surgeon several times and he's adamant that revising is the only way to get rid of the reflux. I was also his first sleeve and he's mentioned how it's not the smallest or the prettiest so I don't know if there's something technical he sees that he's not telling me. Although I was 4 yrs post op when it started. I've now had all the tests he wants and both the reflux and hernia have been proven. Not sure the time limit on the test results (if there is one for insurance purposes) but feeling the pressure to make a decision. I'll keep reading and asking questions!

I had my band over bipass with repair yesterday. I'm on all liquids and I feel great considering. Good luck

So the hernia can be repaired without losing the lapband? That's good to know. I have been having reflux off and on for quite a few years but was afraid to mention it. A January exam showed the hernia and I have more reflux since I knew about it (probably psychological). I am fine with softer foods. Had the band for 10 years.

Hi there!

Just spotted your post. I had my first hiatel hernia repaired at the time of the vsg. Zero reflux for a few years. Then slowly it got pretty bad, but this was also when my gallbladder was taking a turn for the worse. When it was time to get the gallbladder out, the large hiatel hernia was discovered in the testing for the gallbladder. I had it fixed when the gallbladder was removed. Dr thought at first he would have to "tighten" the sleeve because it was shown to be pretty malformed, but it turned out in the surgery once he put it back where it was supposed to be it was fine.

Now about 2 years later I am having a ton of reflux again, constant belching, and strongly suspect the hernia has returned yet again. I have been seeing the gastro doc, but thus far other than taking pantoprozole nothing being recommended. My other dr did say if it happened again it would have to be a revision to rny. In hindsight, I wish I would have just gone rny... as much as I didn't want that. If it would have prevented whatever is going on now it would have been worth it. But... that is based only on my "thinking" the hernia is back, and please know that has not been confirmed. The reflux could just as easily be from the bile issues I have post gallbladder removal.

Thank you for your reply! Lately I've been thinking of just going straight to RNY. My surgeon HAS agreed to fix the hernia although he also wants to use LINX. 50% chance it resolves the reflux. I have a few concerns. One being what if just fixing the hernia doesn't work? Then I would have had surgery for nothing. Also, I don't really want to have another surgery to revise if it doesn't work. But #2, I'm worried that I'll end up with more deficiencies and be one of the lucky ones that gets dumping if I do go RNY. I'm used to my sleeve. I'm a single mom, and I have a hard time with childcare, so the recovery of 2 potential surgeries (if just repairing the hernia doesn't work) has me nervous. But my mom has pointed out, if I go straight to RNY there's no going back. So then I'm back at the decision of baby steps and seeing if the repair works. Lol I'm all over the place! I have another appt with my surgeon in a month, I need to quit smoking before he'll submit to insurance. Gives me more time to research!

How are you ? are you doing better...? I had a Hiatal hernia repair but same issues and pain after eating tomorrow I will see my Gbdoctor

Can you let me know about you?

thanks

claudia

Hi Amy

I had vsg in 2009. I've gained quite a bit back and also have a hiatal hernia and reflux. My Dr wants me to have the rny in about a month. I have diabetes as well and my Dr says that in his opinion I had the wrong surgery to begin with.

I've decided to go ahead and just do it. I made a lot of mistakes the first time. I know I'll do better this time. I'm not anxious this time because I pretty much know what to expect.

You have to do what's right for you. I just want to get on with it.

Good luck to you.

Did you ever get a surgery date? Mine is for April 17th VSG to RNY