Weird question

I see a ton of posts about revisions from lap or sleeve to RNY. Why is that? Is there anything you can revise on the RNY?

Just curious.... I had my rny on 9/11 but originally I wanted the sleeve because I felt like RNY was to invasive, my surgeon went through pro's and cons with me and insisted RNY was the way to go for me and I wouldnt change that decision.

I revised from sleeve to RNY because my sleeve caused uncontrollable GERD. I loved my sleeve, got to goal and had no issues . . . other than the acid was trying to kill me. I wish every single day that I could still have my sleeve. But, I never believed that the sleeve was less invasive than RNY, nor did I believe that RNY was (or is) the better surgery. Based on my history, my surgeon and I decided that I likely would do well with VSG.

As for revising an RNY . . . I have no idea.

Most revisions are lapband or VSG.

Unfortunately, many people get VSG and then suffer GERD, which is dangerous in the long term, both in terms of erosion of the oesophagus and the neurological problems caused by long term PPI use.

If I had EVER had heartburn, I would not get VSG, but it seems like too many people don't research the surgeries and blindly go with their surgeon's preference. VSG is a simpler and quicker surgery and insurance pays about the same, so it's a kerching for the practice.

Of course there are some people who never have GERD and develop it after VSG.

Any time someone anesthetises you and cuts into your abdomen, whether to place a lapband, remove half of your stomach or reroute your intestines, it's invasive. I don't really see how any one of those is less invasive than the other.

The only true revision to an RNY should be a DS, done by a fully vetted surgeon. It's an extremely rare and skilled surgery and there are only a handful of surgeons in the US qualified and experienced enough to do that revision. Again, some surgeons sell a revision and you get an over stitch or distal - neither of which has good statistics for revising because of regain.

Is that why most surgeons do EGDs before surgery to find out your level of acid and predict if you may have issues with gerd in the future?

My surgeon does pre surgery EGDs for a variety of reasons, to check your esophagus is one, to look for a hernia is another. An endoscopy will not tell you an acid level or accurately predict if you will have GERD post surgery. You need a manometry/pH study for that. I had an endoscopy prior to my surgery which showed nothing other than a healthy esophagus. I developed GERD post surgery that was measured at 409% higher than normal. Nothing in my EGD predicted that a VSG would result in a higher than normal acid level or that my GERD would be uncontrolled by medication.

My advice, and I know there are plenty of others who disagree, if you are pre-op and have been diagnosed with reflux/GERD or have issues with heartburn, I would stay far, far, far away from VSG. Again, just my opinion.

Yes to what Stacy said. The EGD before surgery will only tell them if you have acid issues if it has already done damage to your esophagus. There is no predicting.