hiatal herniorrhaphy vs conversion to RNY gastric bypass

[sleevedjohnson16 5]

Hey all, super new here ! I have been struggling with getting the help from google, or locals who have been sleeved, so I am looking to gather more information to help make the best decision...

I was sleeved in June of 2016 - I started at 286lbs, 5ft 6 in tall. Fast forward to now, I am 140lbs, and a BMI in the low 20s. I am active, thin, little loose skin, and LOVING the new life I have been blessed with...for 99% of the time...

The kicker is the GERD symptoms I have are out of this world. I was someone who had this pre-op, and had I known what I know now I would have never agreed to the sleeve vs bypass. I have been in the midst of a whirlwind of testing..first my NEW bariatric dr suggested perhaps I have a flare up of the H. Pylori I was known to have after the stomach contents were biopsied, so we started with a stool test for that, thinking we will start small. This came back negative, and I then went in for a barium swallow which showed from his report to me, a "Massive" hiatal hernia in which he defiantly was interested in repairing. Then, I went in for a CTA to look for SMA Syndrome, basically the superior mesenteric artery compressing the duodenum - this was negative. Now, I am waiting on the ph & manometer testing to determine if I am a candidate to just have the hernia repaired by normal forms...but, Here inlays the questions I have, and personal experience is worth every bit to me.

IF you have a hernia now (and DID NOT) have one prior to VSG - its causing you so much discomfort that you can not sleep, eating and swallowing pills has become challenging and you basically just refuse it all...what decision do you make..is a hernia repair going to be enough to cure this without the possibility of it returning..OR do you go with the revision to bypass to FIX it once and for all ? My dr has given me a lot of literature to go over and read and things to think about. I just don't know which is best. He has agreed to do either of these to help, provided my esophagus is operating in proper order following the results of my ph probe. He has asked that I TRY to maintain this weight and not lose any more, I am at the bottom of the scale where I ever wanted to be, frequently falling into the high 130s .

Other questions I have are - am I going to lose more weight if I am revised to RNYBP? Will I have an intolerance to foods with ANOTHER new tummy? Will I need an open repair to revise this? also, if I choose the hernia repair will I end up with tighter restriction again with them using part of the tiny tummy I have to cuff at the top to fix the hernia? Is mesh safe to repair a hiatal hernia these days should that be the "fix" ?

Has ANYONE been through this situation with these quirks. I don't need revision due to weight gain, I am already pretty small for my height. I have been this weight for 15 months or more. Please help! any insight or personal experience either way would be amazing.