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I had my revision to RnY on Wednesday

It is always based on YOUR anatomical structure, now, after your first surgery, but I actually HAVE had a TRUE RNY bypass, in 2003, that was "reversed/revised" 20 months later, due to a non healing ulcer, and major malnutrition. I ended gaining about 100 lbs back, and LOTS of gastric problems. I finally found a surgeon (actually in same practice as my original surgeon), that agreed to take a chance on me. He "bypassed my bypass" 8/17/2020. Said it was first one like that he had ever done. That was 50 lbs ago. So, YES, IT CAN BE DONE- IN SOME CASES. SEEK OUT PROFESSIONAL HELP. GOOD LUCK.

I am so excited for you. I have not scheduled revision surgery yet. But would love to follow your journey. I was sleeved in 2010.

Anyone having revision surgery this month?? I am Monday, 2/8 and would love to get a group to help accountability like I had in 2012 when I had the sleeve done. Let me know!!!

Sadly, it happens - more frequently a few years ago (6-10) when most bariatric surgeons were still learning how to do sleeves than more recently, but I guess that there are always some who are still learning! The sleeve tends to want to bend in the middle, or form an hourglass shape, if it isn't done quite right, it may not yield a total blockage type of stricture, but it can leave the narrowing that can impede the flow and/or exacerbate reflux problems. While most surgeons in the US are now far enough up the learning curve to usually avoid this problem, knowing how to fix it can be beyond their experience, hence many prefer to go with a bypass instead. It may be possible to correct your sleeve, but you may need to find a surgeon who is very well experienced with the care and feeding of the sleeve construction. My suggestion, if you want to go for a second opinion (which I think anyone should do when considering a revision,) is to book a virtual consult with Dr. Ara Keshishian, who happens to be on the wrong coast for you, out in Pasadena, CA, but he has been doing virtual initial consults for years before Covid as he has patients all over the country. This will at least give you a reading as to whether this is a viable option in your case, or give you confidence that the RNY approach is the best. If a resleeve is an option, then you can decide whether to travel across the country, or seek out another surgeon closer to you who can do it. I would suggest looking for one who routinely does the duodenal switch (DS) procedure, as they tend to have the longest and most extensive experience with sleeves. I believe that there are at least a couple in FL, and several further north along the East Coast. If you do choose to proceed with the RNY route, do discuss things carefully with your surgeon, as there are tradeoffs in how he proceeds. Limb lengths, as suggested above, are a compromise as if they are too short to minimize malabsorption, you can be more prone to bile reflux. There are several Facebook groups that cater to total and partial gastrectomy patients (primarily for cancer or gastroparesis) and bile reflux is one of their common complaints. When I was considering such a thing a few years ago, the surgeon I was dealing with said that as long as he kept the limb over a certain dimension (80cm, IIRC) then they saw no problems with it. Hopefully, the surgeon that you are dealing with has enough experience on both the WLS and non-WLS side of it to know those tradeoffs. Bariatric programs that are associated with major cancer center hospitals readily "swing both ways" on that, but one that only specializes in bariatrics may not. I wouldn't worry too much about the malnutrition issue, as the RNY is very well understood; it is somewhat fussier than your sleeve in supplement needs but things are pretty straightforward on it if you keep up with labs and change things up as those dictate; it can be problematic for those who get overly casual about such things and let it slide - then you can get into trouble. If you fall into that camp, then I would try to do everything to preserve your sleeve and its greater flexibility; otherwise, the RNY is a good alternative. My personal preference, as I was faced with some similar decisions, is/was to stick with the sleeve if it is viable, as the RNY (or something different) is always an option for the future, but once one has an RNY, changing things gets more difficult, so options are fewer. Also on the option front, with the bypass, there remains a "blind" remnant stomach along with the duodenum and upper intestine which are unavailable for endoscopic evaluation or treatment (things much be done surgically.) As there are an increasing number of procedures that can be done endoscopically these days, and into the future, and I have already had one lifesaving endoscopy this is an option that I am keen to preserve, if at all possible. Short term, you may lose too much as you go through the high level of restriction that comes in those first few months after surgery. In that case, there are ways to "eat around" your pouch by basically doing all of the "wrong" things for your WLS - drinking calories, eating slider foods, higher calorie options particularly fats as tolerated. The tricky thing is to avoid making too much of a habit of it as the restriction does diminish over time and you can naturally eat more of conventional foods to maintain your nutrition

I was converted to RNY from VSG for structural (and other) reasons too. My surgeon just said we were doing bypass so I’m not sure if there any specific differences between that and what you will have done. It’s completely possible to maintain (and even gain) weight after your revision. The malnutrition aspect comes with how long of a bypassed Roux (or alimentary) limb will be. Your surgeon may choose to make that length shorter to prevent excess weight loss, but that’s a plan you will come up with together. Below are links for both the steps of a gastric bypass and info on just the gastrojejunostomy. Hope that helps ❤️ https://www.laparoscopic.md/bypass/surgery https://www.ncbi.nlm.nih.gov/books/NBK560493/

Well it did. Took a couple months for the hunger to go away. I was 216 on revision day. And today I’m 186. I do not regret it. It boy it’s a lot harder than the sleeve. You really gotta chew your food or it will get stuck and if I eat greasy food m tummy hurts and I dump. It helps tho cuz then I make sure not to make bad choices. Lol I’m very happy. I burning and on my reflux med anymore. Soooo nice shy a relief! I do not regret this! :)

Has anyone had their sleeze revised by the EGD overstitch prodcedure? If so, how have you done?

I'm seeing my surgeon next week and expecting him to recommend revision to bypass for my weight gain and Gerd. I'm concerned about the hunger some of you are describing, but I'm really concerned about not feeling the restriction. Does that feeling go away after the bypass revision? Sent from my SM-G986U using BariatricPal mobile app

Feb. 26th revision VSG to RNY.

I had the revision a week ago too, just keep getting up n walking, that gas pain will go away day 3 ish!

Revisions are different for everyone. I had a lot of anxiety afterwards because of not having restriction like I had with the sleeve. It has taken me a long while to finally get use to it. Part of that anxiety was me thinking I would have problems with regain because of not having the restriction. I dump and get violently ill from eating wrong thing or too much food, so I am very careful now. You will lose the weight just make sure you follow the plan like you did with VSG. I was at goal with my revision but I lost 12 lbs the first month. I weighed in on Dr scale yesterday at 157. I am down 23 lbs and holding. I will say this. It is a lot easier for me to maintain my weight now then with the VSG and I stay 10 to 15 lbs lower then with VSG. Good luck and PM me anytime

hi there question, so you had the sleeve, then they did the REVISION to the BYPASS?

My surgeon didn't have a goal weight for me, only that he said he would consider me a "success" if I lost 60lbs in the first year (This was calculated as 60% of excess weight, based on BMI 25 ideal weight). I had different ideas: I aimed for 120, which was just about the mid-range of "healthy" BMI for my height, AND was the weight I was when I met Mr. back in my 20's. I later changed this to 127 as I felt it was enough at the time. Anyhoo...I got to surgeon's goal at 3 months. I got to my revised goal at 7, then to my original goal anyway at 8.

Hi everyone. I am one year and six months post op gastric bypass surgery. I originally had a sleeve but got a revision due to bile reflux and a hiatal hernia. It seems like I am constantly nauseous off and one. Some days nothing and other days it's terrible. I have had a lot of testing done and I was told some can just have this post op. I have tried a ton of different medications and no luck. Any advice or suggestions would be greatly helpful and appreciated. Thank you! Sent from my LM-Q730 using BariatricPal mobile app

For treating a regain problem, I prefer the DS as it is stronger metabolically than either the VSG or RNY - the RNY is too close to the VSG in strength to reliably offer a significant improvement in weight loss, from what I have seen over the years. Figure maybe 20lb loss on average - about what one would expect from going through all the intense dieting associated with going through surgery again. (There are some who do significantly better, bit it seems to be more a function of their determination to "make this work" or "not screw it up again" than the actual surgery itself. Call it something like a surgical placebo, lol.) By your surgeons not finding the codes for the DS implies that they are talking about the newer SIPS/SADI/"loop DS" which is a single anastomosis adaptation of the traditional BPD/DS (biliopancreatic diversion) which has been routinely covered by US insurance and Medicare for the past 14-15 years, but is a more complex procedure that relatively few bariatric surgeons perform. Some practices that do the SIPS/SADI use the BPD/DS billing codes which is technically insurance fraud, but if they're comfortable doing it, that's their concern. Revising the VSG to a DS, of either flavor, is straightforward as each use the VSG as its basis (some don't even consider it a revision, more a "completion" of the ultimate configuration.) The strong point of the BPD/DS is its regain resistance - regain is possible as it is with any of these procedures, but it is harder. I know many with the DS who are 10-20 years out (my wife included) who are still maintaining a healthy weight; some are up a bit more and working on losing their "Covid 19" - just like "normal" people but major regains are relatively uncommon. The SIPS/SADI type of DS seems to fall somewhere in between the VSG/RNY and the BPD/DS - I have seen a few in the various forums who have had it and seem to be doing well with it, but it doesn't have as long a history. Any of these procedures - the RNY, DS or SIPS - will be somewhat fussier and less care-free than your VSG when it comes to supplements and follow up; the RNY is maybe a bit less so, but one can get into some serious trouble with any of them if one slacks off. If keeping up with supplements and annual labs is not an issue with you, then any of them should be fine.

I got the sleeve in 2011 and I lost about 100 lbs after.. since then I have gained about 60 back. I had a many complications with the surgery and had my staples pop and had to have follow up surgeries. Since then I have found an amazing doctor who I trust and he spoke to me about a revision surgery for weightloss. He recommended the DS but apparently their was not a surgery code to bill it yet * this was last January 2020 * . He then recommended the bypass. I agreed and started everything with hopes of getting the surgery by June 2020 before he retired. Due to covid my surgery got pushed indefinitely and he retired. In august when they started to do elective surgeries again a Doctor from his group reached and said that my original doctor asked this new Dr. to take me on as a patient moving forward with the surgery. I had decided that I did not know him that well and would not proceed at that time. Well I am still struggling with weight loss. A huge amount it is effecting my daily life I work in trauma and psych in the hospital and I am in nursing school and having issues keeping up due to my energy and weight. I have recently made the decision to continue with the pre op tests and get my chest xray and labwork redone to see if I can fast forward this surgery and get it by end of march beginning of april. I was just wondering for people who have had the revision surgery --- sleeve to bypass or sleeve to ds - how it ended up for them. I doubt I will be able to get the DS even though that is what I want due to the insurance issues so bypass is the way it looks. Also recovering times and everything else please. I am doing this one solo only 1-2 friends will know I am having the revision due to so much stress and people giving me their opinions about the situation the first time I do not feel like dealing with again.

I had a revision on 1/11 and I am going back on 2/1 , so 3 weeks with no lifting required job. I wanted 2 but Md said no, and I'm glad because I still get tired. Sent from my SM-G965U using BariatricPal mobile app

So i got my authorization for an appointment with the Biatric team. Its next week. I just really hope they approve me for my REVISION.

This is the most recent comparison that I have. SW (5/1/19) 327, VSG (12/17/19)- 264, RNY revision (8/11/20)- 211, Thanksgiving weight- 185 I had emergency surgery 12/26/20 so I haven’t taken a current photo lately but my current weight is 157, so 7lbs from goal.

I have RNY Gastric Bypass 16 years ago. Due to the complications listed below, I am having revision surgery. Has anyone gone through this procedure? How much weight did you lose after the surgery?

Curious. I have seen a couple of sleevers over the years have that problem, but doe seem to be unusual, particularly compared to acid reflux (isn't it nice to be "special"?) but it doesn't seem to be any more prevalent with us than with the general population. It seems that most anyone can be subject to it on an occasional basis; it's the chronic condition that is problematic, so I guess that you continue to monitor things and see how it goes. There are tests that they can do to determine if this is a chronic thing and if something needs to be done, so keep on them about it if it continues to be a bother. There was one gal a few years ago whos surgeon revised her to an RNY to treat it, which seemed odd given its' predisposition toward it, but it seemed to work (at least initially - like most, she dropped off the forums after a few months) so presumably the surgeon did everything in the RNY toolkit to avoid it. The better approach if things are that bad is to revise it to a DS as that is as good of a cure as one can find (it puts the stomach and bile ducts at near opposite ends of the GI tract, so it's virtually impossible for the two to mix), but most bariatric surgeons don't know how to do that one. Hopefully, you don't need to go so far as a surgical solution. Good luck!

lucky you !!! i am happy for you. That is literally my next option if my insurance doesn't approve my revision. I am going to just pay out of pocket. ugh !! don't really want to do that since i have 2 insurance policies. but it is what it is. I need my REVISION ASAP !!

Girl you got this. those are all normal fears. Let me tell you the pain is not all that bad. I wish i was going through it again. I had my surgery 8 years ago and i am trying to get a REVISiON. Just got authorization for appointment. Now i am hoping they approve my REVISION. You will be fine.

I just got my authorization for an appointment with the biatric team. Now its up to the case manager. I am crossing my fingers and hope she approves my revision !!! i really hope my Gerd and weight gain qualifies me to get REVISION !