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Revision to sleeve may 17 Lap band 2009 Sw 200 LW 161 CW 214 Sleeve schedule 17 May

Airwayman.. here is the policy that my bcbs goes by.... Sorry for its length. and here is the linkhttp://67.32.116.245/Internet/cmpd/cmp/mdclplcy.nsf/DispContent/F326B0F4EB49705E8525717700528079?opendocument CAM 70147 Surgery for Morbid Obesity Category:Surgery Last Reviewed:November 2006Department(s):Medical Affairs Next Review:November 2007Original Date:July 1996 Description: Morbid obesity is defined as an increase in weight over optimal weight that results in significant complications and a shortened life span. For example, morbid obesity has a significant impact on cardiac risk factors, incidence of diabetes, obstructive sleep apnea and various types of cancers (for men: colon, rectum and prostate; for women: breast, uterus and ovaries). The first treatment of morbid obesity is obviously dietary and lifestyle changes. Although this strategy may be effective in some patients, frequently the weight loss is not durable, with only five to ten percent of patients maintaining the weight loss for more than a few years. When conservative measures fail, some patients may consider surgical approaches. A 1991 National Institutes of Health (NIH) Consensus Conference defined surgical candidates as those patients with a body mass index (BMI)* of greater than 40 kg/m-2, or greater than 35 kg/m-2 in conjunction with severe comorbidities such as cardiopulmonary complications or severe diabetes. Super obesity has been described as a BMI greater than 50 kg/m-2. Surgery for morbid obesity, termed bariatric surgery, falls into two general categories: Gastric restrictive procedures that create a small gastric pouch, resulting in weight loss by producing early satiety and thus decreasing dietary intake. Malabsorptive procedures, which produce weight loss due to malabsorption without necessarily requiring dietary modification. The following summarizes the different restrictive and malabsorptive procedures. Gastric Restrictive Procedures: Vertical-Banded Gastroplasty Vertical-banded gastroplasty is probably the most common kind of gastric restrictive procedure performed in this country. The stomach is segmented along its vertical axis. To create a durable reinforced and rate-limiting stoma at the distal end of the pouch a plug of stomach is removed and a propylene collar is placed through this hole and then stapled to itself. Because the normal flow of food is preserved, metabolic complications are rare. Complications include esophageal reflux, dilation or obstruction of the stoma, with the latter two requiring reoperation. Dilation of the stoma is a common reason for weight regain. Vertical-banded gastroplasty may be performed using an open or laparoscopic approach. Adjustable Gastric Banding – (gastric restrictive procedure without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty) Adjustable gastric banding involves placing a gastric band around the exterior of the stomach. The band is attached to a reservoir that is implanted subcutaneously in the rectus sheath. Injecting the reservoir with saline will alter the diameter of the gastric band; therefore, the rate-limiting stoma in the stomach can be progressively narrowed to induce greater weight loss, or expanded if complications develop. Because the stomach is not entered, the surgery and any revisions, if necessary, are relatively simple. Complications include slippage of the external band or band erosion through the gastric wall. Adjustable gastric banding has been widely used in Europe. Currently, one such device is approved by the U.S. Food and Drug Administration (FDA) for marketing in the United States, Lap-Band (BioEnterics, Carpentiera, Ca.). The labeled indications for this device are as follows: "The Lap-Band system is indicated for use in weight reduction for severely obese patients with a body mass index (BMI) of at least 40 and a maximum BMI of less than 50 with one or more severe co-morbid conditions, or those who are 100 lbs. or more over their estimated ideal weight. It is indicated for use only in severely obese adult patients who have failed more conservative weight-reduction alternatives, such as supervised diet, exercise and behavior modification programs. Patients who elect to have this surgery must make the commitment to accept significant changes in their eating habits for the rest of their lives." OpenGastric Bypass – (gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb [less than 100 cm] Roux-en-Y gastroenterostomy) The original gastric bypass surgeries were based on the observation that post-gastrectomy patients tended to lose weight. The current procedure involves a horizontal or vertical partition of the stomach in association with a Roux-en-Y procedure (i.e., a gastrojejunal anastomosis). Thus, the flow of food bypasses the duodenum and proximal small bowel. The procedure may also be associated with an unpleasant "dumping syndrome," in which a large osmotic load delivered directly to the jejunum from the stomach produces abdominal pain and/or vomiting. The dumping syndrome may further reduce intake, particularly in "sweets eaters." Operative complications include leakage and marginal ulceration at the anastomotic site. Because the normal flow of food is disrupted, there are more metabolic complications compared to other gastric restrictive procedures, including Iron deficiency anemia, Vitamin B-12 deficiency and hypocalcemia, all of which can be corrected by oral supplementation. Another concern is the ability to evaluate the "blind" bypassed portion of the stomach. Gastric bypass may be performed with either an open or laparoscopic technique. Laparoscopic Gastric Bypass (laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy [roux limb 150 cm or less]) Essentially described the same procedure as above (see No. 3 above), but performed laparoscopically. Mini-Gastric Bypass Recently, a variant of the gastric bypass, called the mini-gastric bypass, has been popularized. Using a laparoscopic approach, the stomach is segmented, similar to a traditional gastric bypass, but instead of creating a Roux-en-Y anastomosis, the jejunum is anastomosed directly to the stomach, similar to a Billroth II procedure. This unique aspect of this procedure is not based on its laparoscopic approach but rather the type of anastomosis used. Malabsorptive Procedures: There are multiple variants of malabsorptive procedures, which differ in the lengths of the alimentary limb, the biliopancreatic limb and the common limb, where the alimentary and biliopancreatic limbs are anastomosed. The degree of malabsorption is related to the length of the alimentary and common limbs. For example, a shorter alimentary limb (i.e., the greater the amount of intestine that is excluded from the nutrient flow) will be associated with malabsorption of a variety of nutrients, while a short common limb (i.e., the biliopancreatic juices are allowed to mix with nutrients for only a short segment) will primarily limit absorption of fat. Biliopancreatic Bypass Procedure (also known as the Scopinaro procedure) gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption Biliopancreatic bypass (BPB) procedure, developed and used extensively in Italy, was designed to address some of the drawbacks of the original intestinal bypass procedures that have been abandoned due to unacceptable metabolic complications. Many of the complications were thought to be related to bacterial overgrowth and toxin production in the blind, bypassed segment. In contrast, BPB consists of a subtotal gastrectomy and diversion of the biliopancreatic juices into the distal ileum by a long Roux-en-Y procedure. The procedure consists of the following components: A distal gastrectomy functions to induce a temporary early satiety and/or the dumping syndrome in the early postoperative period, both of which limit food intake. A 200-cm long "alimentary tract" consists of 200 cm of ileum connecting the stomach to a common distal segment. A 300- to 400-cm "biliary tract," which connects the duodenum, jejunum and remaining ileum to the common distal segment. A 50- to 100-cm "common tract," where food from the alimentary tract mixes with biliopancreatic juices from the biliary tract. Food digestion and absorption, particularly of fats and starches, are therefore limited to this small segment of bowel, i.e., creating a selective malabsorption. The length of the common segment will influence the degree of malabsorption. Because of the high incidence of cholelithiasis associated with the procedure, patients typically undergo an associated cholecystectomy. Many potential metabolic complications are related to biliopancreatic bypass, including most prominently iron deficiency anemia, Protein malnutrition, hypocalcemia and bone demineralization. Protein malnutrition may require treatment with total parenteral nutrition. In addition, there have been several case reports of liver failure resulting in death or liver transplant. Biliopancreatic Bypass with Duodenal Switch (Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileosteomy [50 to 100 cm common channel] to limit absorption [biliopancreatic diversion with duodenal switch]) Specifically identifies the duodenal switch procedure introduced in 2005. The duodenal switch procedure is essentially a variant of the biliopancreatic bypass described here. However, instead of performing a distal gastrectomy, a "sleeve" gastrectomy is performed along the vertical axis of the stomach, preserving the pylorus and initial segment of the duodenum, which is then anastomosed to a segment of the ileum, similar to the above procedure, to create the alimentary limb. Preservation of the pyloric sphincter is designed to be more physiologic. The sleeve gastrectomy decreases the volume of the stomach and also decreases the parietal cell mass, with the intent of decreasing the incidence of ulcers at the duodenoileal anastomosis. However, the basic principle of the procedure is similar to that of the biliopancreatic bypass (i.e., producing selective malabsorption by limiting the food digestion and absorption to a short common ileal segment). Long Limb Gastric Bypass (i.e., > 150 cm) (Gastric restrictive procedure with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption) Recently, variations of gastric bypass procedures have been described, consisting primarily of long limb Roux-en-Y procedures, which vary in the length of the alimentary and common limbs. For example, the stomach may be divided with a long segment of the jejunum (instead of ileum) anastomosed to the proximal gastric stump, creating the alimentary limb. The remaining pancreaticobiliary limb, consisting of stomach remnant, duodenum and length of proximal jejunum is then anastomosed to the ileum, creating a common limb of variable length in which the ingested food mixes with the pancreaticobiliary juices. While the long alimentary limb permits absorption of most nutrients, the short common limb primarily limits absorption of fats. The stomach may be bypassed in a variety of ways (i.e., either by resection or stapling along the horizontal or vertical axis). Unlike the traditional gastric bypass, which is essentially a gastric restrictive procedure, these very long limb Roux-en-Y gastric bypasses combine gastric restriction with some element of malabsorptive procedure, depending on the location of the anastomoses. Note that CPT code for gastric bypass explicitly describes a short limb (<150 cm) Roux-en-Y gastroenterostomy, and thus would not apply to long limb gastric bypass. Laparoscopic Malabsorptive procedure (Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption) Introduced in 2005 to specifically describe a laparoscopic malabsorptive procedure. Vertical Sleeve Gastrectomy is a procedure that induces weight loss by restricting food intake. Approximately 60 percent of the stomach is removed and takes the shape of a tube or "sleeve". Policy: Gastric Restrictive Procedures Open gastric bypass using a Roux-en-Y anastomosis or vertical-banded gastroplasty with an alimentary or "Roux" limb of 150 cm or less may be considered MEDICALLY NECESSARY in the following: Treatment of morbid obesity that has not responded to conservative measures. BMI (Body Mass Index) exceeding 40. BMI greater than 35 in conjunction with severe co-morbidities (CAD, Type 2 Diabetes, medically refractory hypertension, etc.). Laparoscopic gastric bypass using a Roux-en-Y anastomosis, or vertical-banded gastroplasty, is considered MEDICALLY NECESSARY in the following: Treatment of morbid obesity that has not responded to conservative measures. At increased risk of adverse consequences of a RYGB due to the presence of any of the following: Hepatic cirrhosis with elevated liver function tests. Inflammatory bowel disease (Crohn’s disease or ulcertative colitis). Radiation enteritis. Demonstrated abdominal surgery, multiple minor surgeries, or major trauma. Poorly controlled system disease. Laparoscopic Adjustable Gastric Banding (Lap-Band) is considered MEDICALLY NECESSARY in the following: Treatment of morbid obesity that has not responded to conservative measures. At increased risk of adverse consequences of a RYGB due to the presence of any of the following: Hepatic cirrhosis with elevated liver function tests. Inflammatory bowel disease (Crohn’s disease or ulcertative colitis). Radiation enteritis. Demonstrated abdominal surgery, multiple minor surgeries or major trauma. Poorly controlled system disease. Above minimum BMI requirement and, in addition, have a maximum BMI of less than 50. Gastric banding, consisting of an external band placed around the stomach, is considered INVESTIGATIONAL as a treatment of morbid obesity. Gastric bypass using a Billroth II type of anastomosis, popularized as the mini-gastric bypass, is considered INVESTIGATIONAL as a treatment of morbid obesity. Malabsorptive Procedures Biliopancreatic bypass (i.e., the Scopinaro procedure), biliopancreatic bypass with duodenal switch, or long limb gastric bypass procedures (i.e., >150 cm) is considered INVESTIGATIONAL as a treatment of morbid obesity. Vertical Sleeve Gastrectomy is considered INVESTIGATIONAL. Policy Guidelines: Patient Selection Criteria: Morbid obesity is defined as a body mass index (BMI) greater than 40kg/m-2 or a BMI greater than 35 kg/m-2 with associated complications including, but not limited to diabetes, hypertension or obstructive sleep apnea. *BMI is calculated by dividing a patient’s weight (in kilograms) by height (in meters) squared. To convert pounds to kilograms, multiply pounds by 0.45 To convert inches to meters, multiply inches by .0254 It should be noted that all bariatric surgeries require a high degree of patient compliance. For gastric restrictive procedures the weight loss is primarily due to reduced caloric intake, and thus the patient must be committed to eating small meals, reinforced by early satiety. For example, gastric restrictive surgery will not be successful in patients who consume high volumes of calorie rich liquids. In patients undergoing biliopancreatic bypass, reduced intake may not be as much of an issue, but patients must adhere to a balanced diet to avoid metabolic complications. In addition, the high potential for metabolic complications requires life-long follow-up. Therefore patient selection is a critical process, requiring psychiatric evaluation and a multidisciplinary team approach. Given these factors, bariatric surgery should be approached very cautiously in adolescents. References: National Institutes of Health. Consensus Development Conference Panel. Gastrointestinal surgery for severe obesity. Ann Intern Med 1991;115(12):956-61. MacLean LD, Rhode BM, Forse RA. Late results of vertical banded gastroplasty for morbid and super obesity. Surgery 1990; 107(1):20-7. Brolin RE. Results of obesity surgery. Gastroenterol Clin North Am 1987; 16(2):317-38. Kolanowski J. Gastroplasty for morbid obesity: the internist’s view. Int J Obes Metab Disord 1995; 19(suppl 3):S61-5. Melissas J, Christodoulakis M, Spyridakis M et al. Disorders associated with clinically severe obesity: significant improvement after surgical weight reduction. South Med J 1998; 91(12):1143-8. Hall JC, Watts JM, O’Brien PE et al. Gastric surgery for morbid obesity. The Adelaide Study. Ann Surg 1990; 211(4):419-27. Griffen WO. Gastric bypass. In: Surgical Management of Morbid Obesity. Griffen WO, Printen KJ (eds.). New York: Marcel Dekker, Inc; 1987. Pages 27-45. Pories WJ, Swanson MS, MacDonald KG et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 1995; 222(3):339-52. Flickinger EG, Sinar DR, Swanson M. Gastric bypass. Gastroenterol Clin North Am 1987;16(2):283-92. Cowan GS, Buffington CK. Significant changes in blood pressure, glucose and lipids with gastric bypass surgery. World J Surg 1998; 22(9):987-92. Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg 2001; 11(3):276-80. Doherty C, Maher JW, Heitshusen DS. Prospective investigation of complications, reoperations and sustained weight loss with an adjustable gastric banding device for treatment of morbid obesity. J Gastrointest Surg 1998; 2(1):102-8. Doherty C, Maher JW, Heitshusen DS. An interval report on prospective investigation of adjustable silicone gastric banding devices for the treatment of severe obesity. Eur J Gastroenterol Hepatol 1999; 11(2):115-9. Miller K, Hell E. Laparoscopic adjustable gastric banding: a prospective four-year follow-up study. Obes Surg 1999; 9(2):183-7. Suter M, Giusti V, Heraief E et al. Early results of laparoscopic gastric banding compared with open vertical banded gastroplasty. Obes Surg 1999; 9(4):374-80. Hell E, Miller KA, Moorehead MK et al. Evaluation of health status and quality of life after bariatric surgery: comparison of standard Roux-en-Y gastric bypass, vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding. Obes Surg 2000; 10(3):214-9. Scopinaro N, Gianetta E, Adami GF et al. Biliopancreatic diversion for obesity at eighteen years. Surgery 1996; 119(3):261-8. Totte E, Hendrickx L, van Hee R. Biliopancreatic diversion for treatment of morbid obesity: experience in 180 consecutive cases. Obes Surg 1999; 9(2):161-5. Nanni G, Balduzzi GF, Capoluongo R et al. Biliopancreatic diversion: clinical experience. Obes Surg 1997; 7(1):26-9. Murr MM, Balsiger BM, Kennedy FP et al. Malabsorptive procedures for severe obesity: comparison of pancreaticobiliary bypass and very very long limb Roux-en-Y gastric bypass. J Gastrointest Surg 1999; 3(6):607-12. Sugerman HJ, Kellum JM, DeMaria EJ. Conversion of proximal to distal gastric bypass for failed gastric bypass for superobesity. J Gastrointest Surg 1997; 1(6):517-25. Marceau P, Hould FS, Simard S et al. Biliopancreatic diversion with duodenal switch. World J Surg 1998; 22(9):947-54. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg 1998; 8(3):267-82. Baltasar A, del Rio J, Escriva C et al. Preliminary results of the duodenal switch. Obes Surg 1997; 7(6):500-4. Brolin RE, LaMarca LB, Kenler HA et al. Malabsorptive gastric bypass in patients with superobesity. J Gastrointest Surg 2002; 6(2):195-205. Mason EE, Tang S, Renquist KE et al. A decade of change in obesity surgery. National Bariatric Surgery Registry (NBSR) Contributors. Obes Surg 1997; 7(3):189-97. Mason EE, Doherty C, Maher JW et al. Super obesity and gastric reduction procedures. Gastroenterol Clin North Am 1987; 16(3):495-502. Brolin RE. Results of obesity surgery. Gastroenterol Clin North Am 1987; 16(2):317-38. Ontario Ministry of Health and Long-Term Care, Medical Advisory Secretariat. Bariatric surgery. Health Technology Literature Review. Toronto, ON: Ontario Ministry of Health and Long-Term Care; January 2005. Tice JA. Laparoscopic gastric banding for the treatment of morbid obesity. Technology Assessment. San Francisco, CA: California Technology Assessment Forum; June 9, 2004. Tice JA. Duodenal switch procedure for the treatment of morbid obesity. Technology Assessment. San Francisco, CA: California Technology Assessment Forum; February 11, 2004. Obesity Surgery Specialists Website for the LAP-BAND® System: LAP-BAND: Laparoscopic Obesity Surgery: A Renaissance in Surgical Procedures for Clinically Severe Obesity.

This is extremely hard since you need to be signed off by your doctor to get the approval letter sent to your insurance. I found away around going to my primary doctor and went to my obgyn. she was caring, compassionate and sent in the referral for my revision surgery. Now I drive 2 hours away (4hrs round trip) out of network to get the proper care from my New surgeon. So there is an additional cost but I think I am worth it! Good luck!

Many have come back and posted after weight regain. You are not alone. Your options are to have a surgery revision or Get back on track. The only way to know if you stretched your sleeve is to have it diagnosed by a surgeon. Many sleeves have less restriction years out, but our stomachs are not back to full size. I can hold more food volume. I had to find strategies to fill the extra space and satisfy hunger with out regain. Many people confuse grazing/ eating around your surgery with stretching. Grazing is eating many small meals healthy or unhealthy choices that total over your weight loss/maintaining calories. When you eat small meals, you don’t feel your surgery restriction. The calories quickly add up and you will gain weight. When you eat around your surgery the sleeve will no longer works. If you get back to basics and control what you eat again, you can start losing weight. Getting back to basics and finding the right mindset and discipline is not as easy as it sounds years out. I would suggest getting a counselor and dietician to support you through all this. Bariatric Basics. Eat your bariatric real food plan - Weigh your food on a scale, log your food in a food app,(my fitness pal or baritastic) drink a minimum of 64 oz of water, exercise. **stay within your weight loss calories and macros ** You can ask a dietician for a meal plan and calorie range. Other people here that are years out are willing to share their plans. I'm five years out with the sleeve. Some do the pouch reset suggested above. Some find it too restrictive. Real food plan can be more satisfying.

My surgery is March 7th. Liquid diet first week not maintaining but am during better. This is not my first time . I am getting a revision. Doctor called me yesterday to say I need a colonoscopy before surgery. I did do the home one this summer hopefully that will do. No sure yet. Han an endoscopy in 22 so he didn’t discuss that. good luck

I've used fitday.com (no good phone app, just on laptop) every day since 2009 (lap band surgery was in 09), and I just recently had a sleeve revision. I wish it had a good app, but I like it because it has graphs, pie charts and stats that I love to "study" through the years. I track everything I put in my mouth: Calories, carbs, fats. They have a really good database and I input all the foods I buy at the grocery store. I also put in my exercise, and in my journal there I put in any changes of my day (like if I have a cold, if the dr. changes my meds). It's really an invaluable tool and I find it to be "calming", strange maybe?

I had a sleeve in 2017 and told my best work friend and parents. When I started losing weight so rapidly, people thought I was dying, like from cancer or something. And I had no idea until said work friend came to me and was like “this is getting out of hand, how have you not heard anything, say Something!” Ha. Now I’m doing a revision to bypass and I am shouting it to the world. I’m so excited! And definitely want no one to think I’m dying!

BAND REVISION TO VSG 4/30/13 I AM ALMOST 6 WEEKS OUT AND HAVE FELT FINE/ FINE/ FINE .... UNTIL NOW. ALL OF A SUDDEN I CANT' HANDLE Vitamins OR KEEPING drinks DOWN. STILL HAVE NOT BEEN ABLE TO GET BEYONG THICK pureed. NOW I SEEM TO BE FEELING REALLY WEAK , CANT' CONCENTRATE AND ALL OF A SUDDEN I/M ITCHING EVER WHERE. I HAVE NEVER HAD AN ALLERGY PROBLEM WITH ITCHING SO I CANT SEE IT AS ALLERGIES. I JUST FEEL MY GENERAL IMMUNITIES ARE DOWN AND WONDER WHY THE SUPPLEMENTAS ARE NOT HELPING. I HAVE BEEN UP SINCE 2:00 JUST UNCOMFORTABLE. WENT TO TAKE A SHOWER AND HAVE WHAT LOOKS LIKE MOSQUITO BITES HERE AND THERE MOSTLY AROUND JOINTS. NOT A LOT BUT IF IT WERE MY KID I WOULD WONDER IF IT WAS START OF CHICKENPOX...... THE SHOWER FELT BAD LIKE Water WAS MAKING ME ITCH MORE THOUGHT MAYBE I SHOULD EAT SOMETING SO WARMED UP SOME chicken broth BUT MY STOMACH IMMEDIATLEY STARTED MAKING LOUD GURGLING/ GROWLING NOISES AND I FEEL LIKE I DESPERATLY NEED SOMETHING TO DRINK BUT I KNOW THAT WILL ONLY FLY BACK OUT NEED TO WAIT AT LEAST 45 MIN FOR ME. HEAVEN HELP ME I JUST FEEL LIKE **** TODAY AND HATE TO MISS ANOTHER DAY OF WORK !! BUT MY JOB IS SO HIGH STRESS/ HIGH QUOTA THAT I MUST CONCENTRATE TO MAX AND I CAN'T !!

I would like to know how the revisions are going? We have the Protein items in Maine that you are using Banded... I love each I have tried, except the broc cheddar Soup I thought was nasty.... I need to try the lemon!

Morning! I see my surgeon today for my week follow up. Doubt the staples will come out, but maybe less restrictions? Post-op 18 day Laparoscopic / 15 days post-op revision...... Wt loss: 23#. when I saw my PCP tho their day she congratulated me for doing the surgery, and for the wt loss right now. I'm only 5'0" and have not been under 200 # since 2008. That day I was (totally honest!) 199.9! Dawn

My band revision is on July 16 so I ordered a 11 pack sample pack of Syntrax nectar from BJs Bariatrics.com for $15.00 +$4 shipping. Who used Nectar and is it good? When I had my band I spent a fortune at GNC.com and hated everytning. So I ordered a sample pack. Website says that each individual flavor (2.8 lbs or 36 servings) is $35.00. Can I get a better deal somewhere else? I've checked Amazon and its about the same. Also, should I get an unflavored one also so I can put it in juice, crystal lite, etc? Is it really flavorless? Just curious which brnds are yummy and where I can get the best deal...

I got my band in 2005. Lost 85 lbs the first year and then had horrible reflux issues. They took out the fluid and I yoyo dieted for 8 yrs. I finally decided to have revision surgery. I never liked the idea of bypass so when I heard about the sleeve I was all in. I had my surgery on 4/30 and I am so glad I did. The doc said my band was a mess and ended up pulling my stomach out in pieces. He said my stomach was close to closing off. Very scary. I can't begin to tell you how much better I feel with that band gone. No reflux, no more vomiting, no more stuck. And my hunger is gone, it never was with the band.

I had the band installed in 2011, and whereas I lost 70 lbs then, it just stopped working and ended up causing more issues in the long run. I revised to RNY March 21, 2018. I was nervous as well, but, it was the best thing I've done and I really wish I did it before. Now, to your questions. It's going to be hard for you to just hide your new eating requirements. You can keep it to yourself, but, you might get questions about why you are not eating breads, or sugars, or high fat foods. If you haven't researched it, the bypass can (and does) cause dumping if you eat certain foods, dumping sucks. My nutritionists hammer the 5/5 rule. If the food has added sugar, then it can't have more than 5 grams of sugar per serving, and fats should be less than 5 grams per serving. This is harder than it looks at first because of how many foods have added sugar that you just wouldn't figure would. So, ordering appetizers (which are typically bready or fried) might not be the best answer. But you can eat a nice side order sized salad with some grilled chicken and balsamic or other dressing that would fit your personal restrictions. I've eaten a whole slice of pizza, took me a while, no dumping or major issues, except I felt like crap shortly afterwards, very run down and drained. It's a major lifestyle change. Not to scare you off, I wouldn't go back to eating the way I did for any reason at this point. Don't think you can't enjoy yourself, oddly (for me anyway and it seems most people are the same) I have ZERO problem with natural sugars. So, I could sit and eat a ton of strawberries and not have a single issue. Plus there are the whole taste changes that seem to happen to folks. For me, I can't stand the taste of things that are too sweet or have too much added sugar in them anymore. So, bottom line, you can flub a bit, tell folks that you've made an eating habit change, which isn't a lie exactly, and that's why you are eating differently, but that's really going to depend on your friend/family base if that answer is going to appease them. Good luck on whatever you decide!

I had my Lap Band removed last April and awaiting revision to RNY also. And yeah I'm having to do the regular pre op program with my surgeon...

@@gebbiabn you're so right. That's the long and short of it and how it was explained to me by my surgeon. Which is why i revised from band to bypass.

OMG.I am so sorry to hear this.There should be a class action lawsuit and a ban on the lap band procedure.I have so much damage and I am awaiting approval from the insurance company..In pain and I feel bilious because my port has flipped...I had a doctor that I saw in the same practice that was known as the "lapband Doctor ".No personality and a bad attitude when someone came in complaining and seeking a revision.He performed some sleeve procedures but was adamant that he performs the procedure 6 months apart.First removal then revision.I have had a DVT...not looking to have to separate procedures.I was originally going for a revision to a sleeve but my acid reflux is off the charts.This band has caused damage to my insides.Plus I developed breast cancer...hmmm....silicone in body...erosion... I changed to another doctor in the same practice....you could tell they know the band is faulty....you could see it when you discuss all your problems...they have heard it all many times before.If I don't get it out soon...I am in trouble I think you should seek a lawsuit!!!

Gloria-- Here is a link to a study that was released about the sleeve. If I lost my band, I would have the sleeve revision. Of course, just because that is what I would do doesn't mean its what you should, we each have to find our own way, but I thought you might like to see the studly. Initial Outcomes Following Laparoscopic Sleeve Gastrectomy in 292 Patients as a Single-stage Procedure for Morbid Obesity | Bariatric Times Good luck.

I'm not sure re-sleeved is actually a thing. I've never heard of it. I've heard of having your sleeve revised to an RNY, but not a re-sleeve as in taking your existing sleeve and making it smaller. I honestly can't see that the benefit from that would outweigh the risks involved in the surgery. The original surgeon already cut out what s/he considered the disposable portion of the stomach.

Hi everyone. I had the lapband placed on August 26, 2008. When my journey started I was 363 pounds. I had to do the 6 month diet and I got down to 300 pounds the day of surgery. I lost a grand total of 208 pounds getting down to 155 pounds(my goal was 140 pounds). I went from a size 28 to a size 8. In March 2012 I discovered I was pregnant and did as advised and had my band unfilled. I gained 85 pounds and was horrified. I went at 4 weeks postpartum and had my band filled back up and have lost 45 pounds but can NOT get the last 40 back off. My weight fluctuates between 193-198 pounds. I am seriously considering having my band removed and getting the sleeve. Initially I wanted the sleeve but my insurance would not pay for it so I settled and got the band. And just an fyi I have the realize band and I am somewhat of a medical marvel to my weightloss dr and nurse. I currently have 8.25 cc in my band which they tell me is unheard of for a female. They also told me they only have a few males with the realize band that have that much saline in their bands. The realize band is designed to only hold 10cc of Fluid so I don't see it really being an option for me to get more fluid in my band. I mean I know technically I can but it seems almost pointless. So my question is for those of you that did have the band and had it removed and the sleeve procedure performed how has it worked out for you? How much weight did you want to lose when you had the revision and how much have you actually lost? I've attached some pics of me before and after. The after pics are me at my smallest-size 8, 155 pounds.

I think that anyone who has not had a band to sleeve revision won't feel what we feel. Alas...you are in luck. I know exactly what you are feeling and seeing and feel that I have adequately navigated through it. I was banded for 6 years. Lost 75 lbs, gained 50, lost 60, gained 10, etc. I had to have a revision because I couldn't eat foods that are good for me because of the restriction. If you are looking for the same feeling of restriction with the band and sleeve, stop now. You won't get it. It is so different. I can drink plenty of fluids, eat all of the slider foods, and anything liquid or soupy that I want without ever reaching that full feeling. I know my satiety depends on what I am eating. If I am doing sugar, carbs, dairy, fruit or anything like that in anything other than really small quantities, I never reach a "full" feeling. I know it is hormonal and blood sugar related. If I eat mainly protein and veggies with the occasional taste of sugar, I have to force myself to eat. I'm never hungry. I don't know if this helps, but it is my experience and it is a tough road to navigate! You can do this!

I hate my sleeve and am going in for a Rny in June coz my sleeve dose not work right. 6 months 35lbs that's it almost 7 months now. No weight loss in 12 weeks no inches lost in 14 weeks. The sleeve has a 20% chance of failure rate Check out The high revision rate for the sleeve I wish I would have before I got it.

I'm now scheduled for a revision to sleeve next tuesday, Jan 13. I've gone all around this. My doctor has been great. He spent 30 minutes with me on the phone today discussion the pros and cons. He wasn't pushing anything. My band doc was really pushing me to do something and I just went along with it. After the slip I told him to take the band out and I didnt want him to put anything back in. Just let me be. He talked me into it and I've had so many issues. 't good to hear Gauge Mom you are doing ok with the sleeve and they got the band out without issue. Are you feeling hungry? I just want that thing out of me. The sleeve may have it's own issues but I have to do something. I can't lose the weight myself and if I don't I"m headed for a lot of disability in my senior years. Turning it over and hoping for the best.

I am also considering revision surgery. I have had my lap band since 2008. I did great at first. I lost from 289 to 174. BUT I had to have my gallbladder out because they felt that was why I was having so much reflux. Since that surgery in 2010 I have struggled so much with my band. I started gaining weight quickly I currently have about 7.5cc in a 10cc band and they really don't want to put any more in. Most days I feel stuck up top with reflux and stomach growling below. I throw up frequently. I have gained back up to 240lbs and I do NOT want to gain any more. I am going to see my surgeon in 2 weeks to discuss revision. I am hoping he can take the band out and do the sleeve in the same surgery otherwise I am not going through with it. That's my biggest concern along with insurance possibly giving me trouble......

Thanks for the info I had my surgery about three years ago and I did the test because I feel hungry all the time [emoji854] [emoji38] I was worried that it might have stretched over time. Since I am now my pre surgery weight. My concerns are on a high level. I am nervous that the doctor might not revise my surgery. I ate all the right stuff kept away from soda candy and chips. I made my food home took it with me every where I went. Not to mention I baked all my proteins. Sent from my SM-G981U using BariatricPal mobile app

Popsicle brand makes a fudge pop "no sugar added" ice cream pop that's a good chocolate craving treat. Not sure yet if it makes you sick yet, my revision to the bypass is sometime in the next 2 months. Sent from my N9560 using BariatricPal mobile app