Question:
Revisions and mortality rates?

A surgeon here said that he basically refuses to do revisions, because 1 in 5 dies. Now...personally...I have never seen or heard anything like that. He did lose a patient recently during surgery (heart attack) and I think he's just heavy-hearted BUT what statistics have you heard? Can you link me to that? Please?    — Mendi M. (posted on November 17, 2003)

November 17, 2003
i can't link you to anything but being a revision myself, from the old intestinal bypass I had in 1981 to RNY, i can tell you my surgeon told me on our first visit that my chances of dying were three times higher than someone having the original surgery. Pretty scarey for me but i knew it going in and had no other option. that is still a lot lower than the one in five you mentioned. never heard that one before but i know i had a hard time finding someone to do mine.
   — Delores S.

November 17, 2003
Mendi, There is one surgeon that I know who has lost EVERY SINGLE ONE of his revision patients. Granted - I would say to anyone contemplating revision with him: run for the hills!!!! Seriously, though - it is a higher risk procedure to have a revision/conversion type surgery. There only a handful of truly top of the line surgeons in the world whom I would ever consider going to. Certainly something to think very seriously through, and of course, to make sure that any surgeon you or someone you know who might be contemplating gives you their stats on mortality, infection, and complication rates on that particular subpopulation. Blessings, dina
   — Dina McBride

November 17, 2003
Like Delores, I was revised from older style RNY to modern. I was told the risk of LEAK was 3X higher than the national avg of 1%. The risk of blood clot, pneumonia, infection (things that can happen in any surgery) remained the same. I just knew I could not go back to where I started and get back all my comorbs.
   — vitalady

November 17, 2003
Our local gastric bypass surgeon (Dr. Ralph Crum) performs revisions laparoscopically; those patients seem to experience the same general types of issues that the rest of us do and haven't seemed to suffer greater complications.
   — SteveColarossi

November 17, 2003
In 1985, I had gastroplasy, which the stapling of the stomach into a small pouch. On March 3, 2003, I was converted to a gastric bypass. My surgery took 5 1/2 hours due to the excess amount of scar tissue from my old surgery. (That one was an open procedure, but the conversion he was able to do lap.) I didn't have any complications and my surgeon had done about 2 dozen previous to me. In 9 months, I have lost 132 lbs. and have had no complications. My surgeon did say that the risks are a little higher.
   — Sue F.

November 18, 2003
Our practice no longer performs revisions. When we began our program we performed several revisions. We never lost a revision patient. They were just much more difficult to do and our revision patients (which is not representative of revision patients in general) did not experience the degree of weight loss that 1st time patients did. I don't know why this is. I think that 1 in 5 is an unrealistically high mortality rate. Perhaps if there is a university hospital in your area they will consider you. We refer all revisions who contact us to U.A.B. Medical Center and to my knowledge, all who have gone have done well. Best wishes to you!
   — ronascott

November 18, 2003
We still perform revisions. However, we are selective in choosing whom we perform a revision. All patients seeking a revision will first go through nutritional counseling (even if they have before) and they may go through psychological couseling again. We also will perform any labs/tests/etc we see fit. Fortunately, we have not lost a revision patient and they seem to do fine.
   — drum_mer1