VSG to RNY revision for GERD--Hunger question

[Foxbins 516]

I had my sleeve done and a hiatal hernia repair in 2011 and reached goal in about 11 months. I lost 100 lbs and have kept it off ever since. Fast forward nine years and I have esophagitis, an esophageal stricture, another hernia, and crazy bad GERD. My surgeon has presented me with two options. Option one, keep my sleeve as it is, but partially cut through the muscles of the esophagus to ease the stricture and then fold some of the stomach inward (like rolling the top of a sock inside itself) to keep the acid in my stomach. Or Option two, convert to a RnY. I love, love, love my sleeve because afterwards I had no hunger. None. And it's still gone, I can go all day if I am busy without eating and only remember if I start to get lightheaded or cranky.

So, people who lost their hunger with VSG and had to convert to RnY, did your hunger stay lost? If you were at goal, how much weight did you lose? My BMI is 22, I can't lose too much more.

I am dreading another surgical recovery and those awful Protein Drinks, too.

Thanks for reading!

[GreenTealael 18,170]

I never lost hunger after VSG so I can not answer that question but here's what i know:

You will lose your pyloric sphincter with the conversion (which may result in accidentally giving you ability to have great volume because the filled signal may disappear so that's a consideration)

You can maintain your weight after conversion if you are diligent and careful

You may experience new bathroom habits

You may develop Vitamin deficiencies if you are not diligent and careful

Ask the surgeon if the first surgery is performed (it sounds like Cardiopexy with Ligamentum Teres) and does not work, can RNY conversion still be performed?

Link to research on Cardiopexy with Ligamentum Teres below

https://www.researchgate.net/publication/277085887_Cardiopexy_with_Ligamentum_Teres_in_Patients_with_Hiatal_Hernia_and_Previous_Sleeve_Gastrectomy_An_Alternative_Treatment_for_Gastroesophageal_Reflux_Disease

ARTICULOOBESITYSURGERY (1).pdf

[Foxbins 516]

Thank you so much for your comments, Greentealael. That article is excellent, I just wish the study authors had done a longer follow-up than six months. It looks like the failures had low manometry pressures; I don't know mine, but I will mention this paper to my surgeon. He was not planning on using the Ligamentum Teres. He did say that RNY could be done if his sleeve preservation surgery didn't work.

[GreenTealael 18,170]

14 minutes ago, Foxbins said:

Thank you so much for your comments, Greentealael. That article is excellent, I just wish the study authors had done a longer follow-up than six months. It looks like the failures had low manometry pressures; I don't know mine, but I will mention this paper to my surgeon. He was not planning on using the Ligamentum Teres. He did say that RNY could be done if his sleeve preservation surgery didn't work.

I also read (somewhere,sorry i can't remember) that there are pyloric preservation style RNYs where the intestines are rerouted and connect just below the sphincter.

Perhaps that's an option also, IDK

[Foxbins 516]

22 minutes ago, GreenTealael said:

I also read (somewhere,sorry i can't remember) that there are pyloric preservation style RNYs where the intestines are rerouted and connect just below the sphincter.

Perhaps that's an option also, IDK

I don't think it's an option in my case--to cure my GERD the vagus nerve would have to be cut, and then the pylorus won't work right without the acid. That's why we're looking a fix higher up. I think he's going for a modified Hill repair.