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First I asked about getting the MGB before I got my revision to RNY for gerd, I was told that there are recent studies that MGB is linked to bile reflux. Because I was in the minority groups of VSG that got severe reflux (I think it's 15-20% of VSG), there is no way I was going to risk getting bile reflux. Also, my surgeon cautioned me against the MGB and told me to go RNY to help with my gerd. So, I was apprehensive like everyone else. I just suffered so bad and so long from gerd, I was actually looking forward to sleeping and no fake gnawing feelings of hunger that gerd gave me, or burning throat all day long... Etc. So 15 months since my revision, and no severe gerd. I also do not have any side effects like dumping, fluctuance, and am getting great post-op blood tests. I am feeling so normal (pre WLS op normal) but the only difference is I eat very little comparatively speaking. It has been an incredibly smooth ride.

I don't claim to be an expert here, but a few thoughts come to mind for you to consider: MGB is extremely rare in the US. (It's much more common on other parts of the world, especially Asia.) Part of the reason it's so rare here may be due to the fact that it's not an endorsed procedure by the American Society for Metabolic and Bariatric Surgery. I would suspect revisions are even less common, so there's probably not a lot a data on success rates? Because there's not a lot of data, it's a bit unclear if MGB will even address your GERD issue? I'm seeing a few studies out there, but results are unclear. Roux-en-Y GB is actually sometimes performed specifically to treat GERD due to its effectiveness in alleviating those symptoms. I would think if GERD is the main reason for the revision, this may be an important consideration?

The mini bypass has been kicking around for a long time - it was around the periphery of bariatrics some twenty years ago when my wife and I first started looking into WLS, and it's still there today, not having achieved mainstream status (and many, if not most, US insurance companies still don't cover it.) in the meantime, the BPD/DS, VSG and now the SIPS/SADI have gone mainstream, gaining acceptance by the ASMBS and insurance industry. It would pay to understand why that is. When I last looked into these things, 2-3 years ago, ASMBS was fairly positive about the SIPS/SADI, but they didn't yet have the data to recommend it; they apparently do now. I would suggest looking through their site to see if they have any current opinion on the MGB and why it doesn't get on their recommended list. Amongst the MX surgeons, the MGB seems to mostly be sold as a cheaper alternative to the RNY rather than a technically better one. Classically, bile reflux is one of the problems with these simplified, single anastomosis procedures. There are claims that some techniques have been developed to mitigate that problem, but I don't know how much of that is real progress and how much is marketing. The MGB does seem to be more mainstream in other countries, so there may be something to the claims of improvement, and it simply lost its best opportunity to be sold to the US industry and authorities. Given that, I would be apprehensive about getting it done while living here in the states, if for no other reason than long term support - how many US doctors, bariatric or otherwise, understand it, and how to treat you in the years ahead should there be a problem. It's something like owning a French car here in the States - parts and service are a problem. My wife has a DS, which has something of that issue, despite being mainstream and approved, as it is still something of a niche procedure, with few surgeons understanding it. It, however, has the redeeming value of having demonstrably better performance - both initial loss and most particularly regain resistance; the MGB doesn't, as it's not markedly different than the RNY or VSG in performance. Have you had your GERD evaluated as to its cause? A hiatal hernia or shape issue can usually be corrected while still maintaining the sleeve, though some surgeons may not be well practiced at that and would simply revise to a bypass to correct it (the old "VSG + GERD=you need an RNY" thing rather than fixing the basic problem - it might need an revision, or it might not.) In correcting regain, these revisions seem to be only moderately successful - count on maybe twenty pounds or so - about what one would expect from the intense dieting required around surgery time, and one can expect similar results from a hiatal hernia repair. Basically, you have already learned how to eat around a small stomach, so shrinking it further with a revision doesn't yield nearly as good a result as your virgin procedure. Some do show remarkable improvement, but they seem mostly to be those who take the regain seriously and swear to "not let that happen again" and really buckle down and get with the program. One can almost consider the revision to be a placebo. If I were looking to seriously tackle a regain problem, I would lean more toward the BPD/DS as that more directly addresses the metabolic problem, though not the GERD as it retains the sleeve - that would remain an issue as to whether the sleeve itself is the cause of it and that can be corrected.

When I had my sleeve, I was excited for it. I wasn’t overjoyed - I’d rather have never been obese in the first place 😅 - but I wanted to have it, took it very seriously, made all sorts of commitments to myself that were destined to fail (I’ll never have a cookie again - yeah, sure buddy). I was in the right mindset to succeed. I’ve regained some weight, but what’s really motivating my revision is GERD. All I can think about is that I didn’t want a bypass the first time around for some specific reasons (dumping, flatulence, nutritional deficits). I’m not excited for this. I’m not eager to make certain lifestyle changes. In short, I’m not in the right mindset. Who else went through this? How did you prepare yourself?

I was hoping to get folks' opinion on the mini-bypass vs the bypass. Because I'm considering a revision, my thinking is I'd rather have the less dramatic revision. There are fewer adverse effects and nutritional requirements with the mini, and if in the future for some reason I need to convert to a full bypass, that option is on the table. On the other hand, I regret not going with the bypass 6 years ago. I didn't know how bad my GERD would get, but I also didn't think I'd regain as much weight as I did (40 pounds out of 140 lost). Who else has thought about these alternatives? What did you go with and why?

I was actually approved for the sleeve but am switching to bypass. In my own research, and much reading of this forum, I just see too many people experiencing GERD after the sleeve. Sometimes it takes years to show up or it can happen right after surgery, but there are many, many revisions because of this. I just couldn't risk living with the kind of medication resistant GERD people describe for a couple of years then go through a revision. I see much more satisfaction from the bypass side. I realize there are people perfectly happy with their sleeve and I hope that continues for them. This is my best decision for myself. I would just encourage you to search the sleeve forum for GERD and also stroll though the revision forum to see why they changed. The kind of GERD we are talking about makes living difficult. If not for this one issue, I would go with the sleeve, though the bypass is still considered the gold standard. Good luck with your own decision. Your surgeon can help with this.

Hello Angel2018 how is it going since the MGB? I am due to have my sleeve revised to MGB in 2 days and I'm excited!

I had a higher starting weight (My highest was 382 - down to 330 by the time I saw my surgeon) … I initially wanted sleeve because of many of the reasons you stated, but was prepared for my dr to recommend bypass because of my starting weight and reflux. After meeting with my surgeon I asked her opinion- based on my medical history and her experience of outcomes. I have IBS and for about 8 months prior to surgery was dealing with reflux. I also took a daily (2x a day) NSAID pre surgery that she advised that I stop until my post-op follow up, but that I could resume if needed after she saw me. I was really surprised when she told me she didn’t recommend bypass for me and why. She was a surgeon who had extensive experience with all of the surgery options, so I was confident she wasn’t steering me towards what she was comfortable with routinely doing. She actually recommended sleeve (with a hernia repair) and told me if I wanted a revision later - she’d recommend going with a duodenal switch. She mentioned to me that because of the extended length of the DS surgery time, she prefers to do that surgery in two stages. I was honest and told her the second phase of that surgery scared me a little. She was very understanding about that and told me that the sleeve and bypass had very similar outcomes in the 2 yr mark, reviewed the benefits and drawbacks of each and discussed with me that she has had quite a few patients have the sleeve (at my starting weight and higher) as the 1st phase who lost enough they decided not to go on to the DS, but knew it was an option if they wanted it. She was impressed with my weightloss up to that point and was confident with my history and medical conditions, I would be happy with the progress I would make with my surgery. I was 324 on the day of my surgery and at 10.5 weeks post op I’m down to 291. It’s definitely a slow progress, but I’ve had a few unrelated challenges in that time (being sick and dealing with issues from a car accident that occurred several years ago), but I’m headed in the right direction. At my followup she was very pleased with my progress and told me that she felt very good about the track I was on. I’m still very early in the process, but I’m glad I asked her what she recommended and why, based on her experience and my medical history. My husband and I were both comfortable with her explanations and very confident in our decisions because I felt like we had sound information to make a decision on. I’m hoping that I don’t decide to go in for a revision, that I can get down to a weight I’m comfortable with (I’m not sure what that number is yet, I’m hoping I know it when I feel it, lol), but if not - I know what my options are. Right now I’m still having some issues with being able to eat enough. I’m only able to eat very small amounts at a time, but other than that everything is going well. With the weight loss I’ve had - I have been able to stop my NSAID at this point. I had also stopped my PPI meds (but recently restarted it temporarily because a sinus infection stirred things up again… hoping to stop it as soon as that clears up). My IBS is still something I’m working with but so far it has been manageable. Best of luck in whatever you decide!

I understand your frustration and I’m a big believer in listening to your gut. If something feels “off”, I’d explore more. I would hope they would have told you if they were unable to do what they had planned. Did the surgery fall within the estimated time frame they suggested it would? Being a revision - with a smaller removal, after a significant weightloss (than your first surgery) it’s plausible the time was much less to complete. The suggestion of the surgical notes is a good idea as well. I do think the others are right about healing and extra acid being the culprit… but asking your team about your concerns (still feeling hungry and not having restrictions) can’t hurt. Maybe your PPI needs adjusted (even if it temporarily) or they can recommend something like smaller portions more frequently to help. I have Hashimoto’s also and it can really fight you every step of the way on this. My Endo has been working with with me in the WLS journey and has been a big help. I was taking something to help with my metabolic syndrome prior to my surgery. I stopped it about the time of the surgery (because it could make me constipated and didn’t want to have that compound the dietary changes which could cause the same) but ended up starting it back up again after I got through that. Also we check my labs and looks at my symptoms to adjust my Synthroid. Sometimes my labs look good but I feel off and we do minor adjustments to keep my fickle body happy. I hope you find some answers!

I had my vsg done as outpatient. I had to be there at 6am, I had surgery a couple hours later. I was out the same day, maybe 3ish? I can't remember. I didn't have much pain at all. A little nausea but they gave me something for it, went away immediately. I had a 45 to 1hr drive home, I just slept the entire time. I lived on the second floor and climbed up them with no problem. That was one of my pre-surgery worries. I took my medicine and fell asleep. I really had no issues but a abdominal cramp here and there. Nothing alarming. No problem with drinking liquids or walking to the restroom... Etc. Like others, pretty uneventfuln and painless. My revision seemed even easier. Gotta love medical technology.

I hate this fight. My insurance can pay for my revision. However, I am tired of this 3 year fight. I currently have an advocate fighting with me. It's not just about weight loss. I am fighting for my quality of life. I work and pay for my insurance. How dare they act like I don't have a disease called obesity! Sent from my SM-G996U1 using BariatricPal mobile app

I was sleeved at 293 back in 2017 I lost 100 lbs within 6 months and unfortunately most of my hair in the process. I didn’t cope with things properly and here I am 5 years later weighing 286. I am scheduled for a revision to MGB this Thursday so here’s hoping I get this right! I’m going to follow these rules

Did you have sleeve or bypass? Apparently reflux is VERY common with sleeve patients. This is exactly why I went with bypass. I already had severe acid reflux (GERD) and I couldn't bare making it worse. There are a lot of times sleeve patients have revisions to bypass due to acid reflux alone. In addition, are you on any meds for it? I was on a pepcid for the first 3 months post op to cut the stomach acid and to prevent ulcers and allow my stomach to heal properly. I was told I could stop unless I had any acid symptoms and now 7 months post-op and I have ZERO acid related issues and off all meds. I was on 2 prescriptions and still eating tums/rolaids pre-op.

Just had my revision on 10/14 with hernia repair. I felt the same way and it's been great. I think because I knew what to expect. Also, they have so many food options available compared to when I had my first GNY in 2007. Sent from my SM-S906U using BariatricPal mobile app

I’m having band to bypass revision in January. My band is 10 years old and has never been filled. If it was in good shape and in place/no erosion they can do it in one. If not, it’s a two step procedure. My fluoroscopy and endoscopy showed it’s in great shape and in place so it will be removed and bypass in one. I’m almost through my preop stuff, and hoping for a date in January after approval.

Hey guys just a little backstory, I was sleeved 2017 and lost 100lbs but due to bad habits creeping in have regained most of it back 5 years now. I just had my consultation with the doctor and I’m getting revised to mini bypass. I’m excited and hoping to lose about 100lbs. Looking for others who may have gone through this revision.

I just love the fact that I can wear a matching set of something again!Haven’t had the bottoms and tops as the same size in ages. Hoping this journey continues smoothly. Doing it all over post revision but having fun with it!

Weight loss is slower than sleeve but I’m still ahead of the curve according to my surgeon’s office. -80 in 5.5 months with 75 to lose still. I’m in Saint Louis but both of my surgeries were in Kansas City where I lived when I started the sleeve journey. I was so comfortable with that office I went back for the revision instead of seeking a STL provider. I do follow with the Mercy system support group though! I know they have a Springfield location of that group too. 🥳

I had read that that if one still has gerd after rny, it is due to a too short roux limb and get get it lengthen. When I had my revision, my surgeon discussed how important it was to have a longer roux limb in the cases.

I didn't have much pain in either the vsg or revision. I didn't even bother taking the pain meds after the first day in both cases. I just took otc Tylenol. Only because I can't handle the groggy feeling. The gas pains back then (vsg) was a bit painful but just walk, walk, walk it off if you can and take gas relieving otc meds. My surgeon suggested gasx strips but I like mylanta mini fruit chews.

Yes I’m a vsg. No revision. I do not take vitamins my vitamin levels are normal.

I'm a bit confused. Did you have revision, sleeve to bypass? You're showing marked as a sleeve patient and I recall you saying in another post a few days ago that you don't take vitamins, you just rely on a healthy diet to get your vitamins, which isn't recommended for bypassers. So the two posts are sort of contradictory, junk food vs healthy diet for vitamins. And also sleeve on your profile and now you're saying you got bypass two years ago. Can you clarify the details for us please? Thanks!

My revision was virtually painless. I had no pain, no problems, no side effects and the restriction is everything I have always wanted. My surgeon was excellent though. I wasn't even in the hospital 24 hrs.

Yeah. I got my revision to bypass last week. So far, this has been easier than the sleeve, and I’m just exhausted, but nothing hurts. I had horrible GERD, so they corrected a large hernia and cut my prior sleeve even more, to make it look good (it was enlarged). After all, the surgeon said everything looked great, and I felt ok. I’m hungry, but I think this is more mental than anything. I need to lose around 50 pounds to meet my goal. I was around 20 pounds short with the sleeve, but I could not do it.

I had my sleeve to bypass revision last thrusday. how is everyone doing?