Search the Community

So true; the surgeon that now runs our support group does a good business revising RNYs to the DS (as does the surgeon who did my VSG). They all have a place in the world, and different procedures work better for different patients. And, the surgeons tend to gravitate toward what they find works best for most of their patients. The VSG, while a straightforward procedure in concept, has lots of subtleties and nuances when you get into them in detail, and these take time and practice to master, so I can see some surgeons giving up on them if they are already well skilled with the RNY. OTH, several of the docs I have worked prefer the DS as they have developed those skills, and reserve the RNY for only specific cases where the DS or VSG isn't appropriate. It's all a big YMMV thing.

Some stretch, or growth or adaptation is to be expected - we don't stay at eating only 3 tablespoons forever. This doc gives a good idea of the progression of meal volume that can be expected, and is consistent with my experience - You may or may not get along with his prescription for countering this effect, but it is a viable one. In short, we need to learn to accommodate some increase in eating volume without allowing the calories to get out of hand - taking up that added volume with high bulk, low calorie veg is a good way to do it. As to which procedure to go for a revision, the first thing I would want to know is whether the stretch that your doc sees is unusual - sleeves done by docs early in the learning curve of doing sleeves (and 2012 is consistent with that for many surgeons) may have undue stretch if it wasn't formed well to begin with. Sometimes excess fundus (the stretchy part of the stomach that is largely removed with the VSG) is left behind at the top or bottom of the stomach, or other shaping issues may lead to the problem. If the sleeve is nominally well done, there is probably little to gain be resleeving it - you will lose some at the outset from low capacity due to surgical inflammation and the very restricted diet that we have early on, but overall you shouldn't expect great things from it. Likewise, a bypass is similar in its overall power to the sleeve, but does have some temporary caloric malabsorption that can help get a little extra weight off, but doesn't do any better when it comes to resisting regain; in some patients it is worse in that regard due to reactive hypoglycemia inducing more inter meal hunger. Overall, when I think in terms of revisions, I see a procedure that is more complicated than the original virgin WLS, and usually less effective overall (think in terms of your stomach originally having a capacity of 32-64 oz, and now a few years post op it may have a capacity around 6 oz, so there is less difference to play with. Being more complicated both in implementation and in the reason for doing it in the first place, I like to get a second, or even third, opinion on the matter - different surgeons have different experiences and perspectives on these things. There is also the aspect that while doing a virgin sleeve is a fairly straightforward procedure, and most surgeons are now fairly well up the learning curve in doing them, repairing or revising a faulty sleeve is another matter, so I would look to a surgeon who has done lots of them. In NJ, I would suggest Dr. David Greenbaum as a good guy to consult with. A final thought - what is the capacity of your sleeve now? How much chicken or steak (and nothing else) can you comfortably eat? We usually remain fairly restricted on firm meats for a long time, but can eat an almost unlimited amount of "sliders" - things that just slide on through with limited restriction, which are frequently also pretty junky.

Have jumped through all the insurance hoops, My surgery date is 6-12-2019 pending insurance approval, don't see any issues with approval since this is a revision due to complications of the lap band. Looking forward to finally feeling better and losing weight. My lap band has a slip and rather than fix it, my surgeon recommended a revision to the sleeve. Lost 50 lbs with the lap band, but slowly gained back most of my weight that I lost, although I did keep the 50lbs off for over 10 years. Looking forward to finally dropping this weight and keeping it off. Any pointers or advise would be greatly appreciated.

Hiya @jb1809 My surgeon only does RNY now - mostly because of the reflux issues but also the much higher incidence of weight regain with sleeve. Myself, I am a band to RNY revision. And the RNY is SO SO SO much better - a doddle by comparison! Sure, the surgery is a bit of a drag, but I love ‘working’ the RNY. I reached and surpassed my goals, but mostly this time, knowing it was my last shot, I have changed. My new style of eating - well, I am just starting to like it. I went on a 5 mile walk during the week (had some time to kill before a flight so walked to the airport, saved $50 on the cab as well!) and half way, needed a toilet stop, rationalised having it as a burger place, along with a burger. And was a bit surprised at how little enjoyment this once-staple-of-my-eating gave me! I so prefer the light feeling of eating healthy now. And the added taste to a salad from pomegranate seeds, or spices, or lime dressing, or olives. I never thought that would change! But - no lie here - it took consistent work. And I guess will require effort, some days, for a while yet! Good luck with it. You know you can lose weight - throw yourself in hook line and sinker, I reckon!!

I had sleeve 10/2013, lost 60lbs, gained it back, had some reflux but not terrible. Was revised to rny 2/12/19, SW 230, CW 190, no complications, no food intolerances that I know of (haven’t had any sugar, pasta, bread or rice). So far so good.

Hey, I am so glad to see someone who has been through it and did great through the same surgery I soon hope to be going through. I am waiting for approval from the insurance companies to get the surgery done. My reflux is so much worse than when I got the sleeve surgery 0ct of 2016. I am not pleased seeing the Dr.say because of age and it being a revision surgery we will lose weight slowly. I am almost 64 .So I have to get in gear and get some of this weight off before surgery. But congratulations on your success. Allie

Hey , I had severe reflux before my sleeve in October 2016.After surgery only 6 weeks of relief from the reflux and then it was way worse than before to the point of taking 10 pills a day instead of 2. I am currently waiting for approval from my insurance companies for the RNY revision surgery and was just diagnosed with barrett's esophagus due to the reflux getting soooooo much worse. I can't wait to get the surgery done and praying for approval. Congratulations on your journey and your surgery appointment. Keep updating us on your progress. Oh i did lose 87 lbs the first year but gained 22 back. Still fighting to get the extra back off. Allie in SC

I had the same thing happen to me. I am hoping for my revision June 10. Severe reflux, a large pouch on the sleeve and a hernia. When I was complaining of the reflux my doctor said it was my fault because I gained weight. I have something sticking out of my stomach and he just said I don't know what it is. Thank God he did an upper GI and Endoscopy and found my problem. Sent from my LGLS991 using BariatricPal mobile app

Hi Y'all, I had VSG in April 2016. Lost 53 pounds since day of surgery weight bur regained 30 pounds. I've had terrible reflux and was diagnosed with Gerd, and I have a revision scheduled for July 15. Anyone else in this situation? Do you feel as excited about this time around as last time? I don't, and that's really bothering me...

Hi! I'm 52 and had ROUNY in March. My starting weight on surgery day was 235. I'm 210 right now. My doc says that due to my age and that I'm a sleeve revision, I will most likely lose slower than average. Yay me...lOL. The surgery was perfect and I was back at work in 4 days. Mo complications so far.

Let’s talk weight gain if you are researching. This thread is not to discourage you. Many people lose weight, have no complications and keep weight off long term. It’s a good idea to understand weight regain and reasons for revisions. Information is power. The work does not end after goal. This may help you get in a mindset that this is lifelong work. https://www.youtube.com/watch?v=R7zBjwtL51M https://www.youtube.com/watch?v=vKBfkTqcwVo

It would depend on why you need the revision, I think.

Hi everyone, Has anyone had or going to have a sleeve revision? If so re-sleeve or will you revised to gastric bypass?

I have searched all over google trying to find a picture (animated) of what it looks like to go from VSG to MGB. There are plenty of what the MGB looks like as an original surgery but none that I have found as a revision from VSG. Has anyone found any??

I have searched all over google trying to find a picture (animated) of what it looks like to go from VSG to MGB. There are plenty of what the MGB looks like as an original surgery but none that I have found as a revision from VSG. Has anyone found any??

Just out of curiosity, what was your original surgery? A VSG, correct? I just find it very odd that you went through not one but TWO bariatric surgeries without this issue being corrected. I can imagine the first going wrong but why in the heck would they do the revision without noticing that the sleeve was too large???

my revision is July 15 also! revision is due to horrific Gerd.

@Panda333 I’m a sleeve five years out maintaining in the 130’s. I am type one diabetic. My surgeon suggested the sleeve because there are times, I need to eat sugar to raise my blood sugars. WIth the sleeve, my intestines are not altered, I don’t have dumping syndrome with sugar. I am now well controlled and hardly use insulin. I want people that are researching weight loss surgery to know, many of us have had no complications and have maintained years out. Weight gain or need for a revision does not happen to all of us. Do your research, trust your surgeon’s advice do what’s best for you. Any type of bariatric surgery may need a revision due to complications, surgery not performed correctly, eating to the point of stretching your surgery (big debate on this issue) Grazing/eating around your surgery, eating disorders, or simply not following your surgeons plan. Only my opinion: For some, the sleeve is the wrong choice for them. Things I wish people knew about the sleeve. Your sleeve restriction will become less over time. you can hold more food. (it’s not back to full size) Long term success will be diet and behavior change. Just because you have more space does not mean you have to eat over your calories and macros to gain weight. If your surgeon has diagnosed that you stretched your surgery. Get counseling before a revision to make sure you don’t stretch a second surgery. Your intestines are not altered with the sleeve. Most of us can tolerate sugar without dumping. If sugar is an issue for you, investigate surgeries that give you dumping syndrome. You will feel real and head hunger at times (true with any surgery type) Hunger is more manageable after surgery. age 45 day of surgery 2014 - age 50 2019

Bypass all the way! I see way too many revisions from sleeve to bypass on this board. I decided on bypass and never looked back

Thanks, gabybab! I'm trying to keep my chin up!! I just read that 1/3 of patients with marginal ulcers and stricture need to have a revision to the RNY to re-do the connection. I really don't want another surgery!! Sent from my SM-N960U using BariatricPal mobile app

hello, I was self pay revision from lapband to bypass. My BMI was around 32 (up from 25 when my lapband was unfilled 6 months earlier). The Dr (not my original lapband surgeon) who helped me when I had the complication and required a complete unfill would only take the band out and revise in two stages. I wanted to find a Dr to do it in one stage. So the surgeon I ultimately chose did make me do the psych eval (which was very easy). Also for me personally (because I mentioned my binge eating problems) insisted I also start seeing an eating disorder counselor. Also saw the nutritionist one time and had an ekg and bloodwork. During the appt I thought I wanted a sleeve, but because the damage the band caused to my esophagus he recommended bypass. At first I thought no way, but after thinking it through (and getting a third opinion!) I decided to do the bypass. My initial visit was March 11 and scheduled for surgery April 26 (but due to my conflict it was moved to May 1). Hope this helps Stella

How far out are you from your revision? My revision was 9/10/18. I am 8 months out.

How far out are you from your revision?

I feel like my body doesn't want to go below 171. I have seen people post about there bodies having set points that were tough to get beyond. Anyone else experience this? I am a revision from sleeve to bypass. When I had my sleeve I got down to 168 for a short period and then I bounced back and maintained around 170-175. Now with the revision to bypass I have gotten down to 171. I fluctuation up and down 2-4 lbs, but I just seem stuck at a plateau. My diet is not perfect but I stick pretty close on my Keto/low carb diet. I have dabbled with intermitted fasting and was able to lose a pound or 2 when I had fluctuated up but I remain in the 170s. Don't get me wrong I am happy with what I have done it just seems that other seem that I look at others with similar stats to mine just blow by 170s and are in the 130, 140, 150 range so easily.

I met with a surgeon last week about revision surgery. I had RNY over 20 years ago. I have gained almost all the weight back that I lost. The surgeon I met with suggest a laparoscopic plication to reduce the pouch size and also he will reduce the stoma. Then he will put lap-band over it but not use the lap-band and may never. He said the chances of me stretching the pouch again are high so the lap-band would be there and be ready for if and when i stop losing weight. Some surgeons here offer the revision with an endoscopic procedure to reduce the pouch size but have read that the weight loss is minimal and within a year ill be back gaining weight. The surgeon I met with last week explained he doesnt do the procedure that way anymore because of the low success rate. I haven't decided what I will do yet, still researching but if I go with the surgeon i met last week it will be all out of network so I want to make sure its the best choice of procedure since it will be costly.