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Thought I had my procedure chosen and now reconsidering.



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I have sleeve done and after doing a lot of research and wondering if I should go with full bypass. Years ago I had lapband - I was very successful, lost weight quickly and the golden child for my surgeons office. The one issue I had as I kept filling the band, terrible reflux. I was 10 lbs from my goal weight and researching plastic surgereons. Unfortunately the reflux it got so bad that I had pneumonia for several months and I was finally forced to totally un-fill the band. I had to wait 3 to 4 months before I restarted fills. I was never able to get back to the amount I had in the band previously and the reflux started again. I regained a lot of weight. Now fast forward 4 years, just before Christmas in 2015, I experienced a lot pain In my abdomen and found out that the band had broke. I had emergency surgery to remove the band. After a year and half and regaining all my weight, I'm ready to do gastric again. I've been dieting and eating much better for the last few months. I am now mentally prepared to make the right eating choices. I'm wondering if the sleeve would be a good procedure for me because of my prior issues with reflux. Although, the only time I have had reflux was when I had the band. I really want the sleeve but I don't have the same issues with reflux. TIA

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1 hour ago, LWA-Lori said:

I have sleeve done and after doing a lot of research and wondering if I should go with full bypass. Years ago I had lapband - I was very successful, lost weight quickly and the golden child for my surgeons office. The one issue I had as I kept filling the band, terrible reflux. I was 10 lbs from my goal weight and researching plastic surgereons. Unfortunately the reflux it got so bad that I had pneumonia for several months and I was finally forced to totally un-fill the band. I had to wait 3 to 4 months before I restarted fills. I was never able to get back to the amount I had in the band previously and the reflux started again. I regained a lot of weight. Now fast forward 4 years, just before Christmas in 2015, I experienced a lot pain In my abdomen and found out that the band had broke. I had emergency surgery to remove the band. After a year and half and regaining all my weight, I'm ready to do gastric again. I've been dieting and eating much better for the last few months. I am now mentally prepared to make the right eating choices. I'm wondering if the sleeve would be a good procedure for me because of my prior issues with reflux. Although, the only time I have had reflux was when I had the band. I really want the sleeve but I don't have the same issues with reflux. TIA

Not go with the sleeve, reflux is almost guaranteed if you had prior with band.

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I agree with OutdideMatchinside. With your prior reflux, the sleeve is not the right option; instead, you're better off with one of the non-sleeve surgeries (RNY, MGB, DS).

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I had GERD yet my surgeon recommended the sleeve. He said I most likely had a hiatal hernia and he'd fix it during surgery. He said that was almost always the cause of the GERD. I stayed on the omaprezole for 6 months and now I take it only occasionally. My surgeon said if I had another 100 lbs to lose he would have recommended the RNY but he said that the risk of long term complications, while low, of the RNY was higher than the VSG, so why risk it if the GERD would most likely be resolved?

Of course, you have to do what you're most comfortable with, but I thought I'd share my experience with you.

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Here's the thing-If you have a sleeve and get severe reflux, you can always revise to the bypass. Once you get the bypass, there is no going back. I have a history of reflux and still got the sleeve. He also repaired a hiatal hernia, which may have been contributing to reflux. I had my sleeve done with a 40 French bougie size and resection (stapling) started at 6cm from my pylorus to hopefully lessen my chances of problems.

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It's extremely important to know if your reflux is diet induced or otherwise.

If it's diet induced the sleeve still works the vast majority of the time without keeping or causing more reflux. The indications are that for diet induced reflux, with necessary dietary changes it will vastly improve.

On the other hand if it's not caused by diet then I would pick bypass.

Sleeve has less risk associated with the surgery itself and less issues with malnutrition post operatively. Incidence of dumping is far less with the sleeve, and won't cause potential future surgery risks if you need work in the abdominal cavity area later on for whatever reason.

So pick sleeve unless you are sure your reflux isn't caused by diet. Can always revise the sleeve.

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