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Bypass (RNY) to ESG (Endoscopic Sleeve Gastroplasty)??



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Posted (edited)

Hi all,

I had the RNY (revised from gastric band) 7 years ago and had amazing success. I got to my goal weight in 5 months and kept the weight off for over 5 years. In the last 18 months, I've had some medical issues that have resulted in me regaining almost all of the weight. Now that I have resolved those issues, I am maintaining my weight, but finding it impossible to lose again like I did before. There has definitely been some stretching of my pouch, which my surgeon has confirmed.

So I guess my question is, has anyone out there had the Edoscopic Sleeve Gastroplasty done? I have an appointment with my surgeon next week to discuss non-surgical options and I think this will be one of them. All of the research I've done shows it's a great option for regain after bariatric surgery but I'd love to hear from someone who has had it done.

If you have had it, how did you recover? Did you lose as much weight as you did with your initial surgery? Did you keep it off? What was the post op diet like?

Any and all feedback and comments welcome!

P.S: I'm in Melbourne, Australia

Edited by Amy*

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Is your surgeon doing a standard ESG (reducing the size of the stomach) or a TORe - Transoral outlet reduction?

The Facebook group ESG failures has a high number of Australian users, it seems that there is a higher rate of failure for the standard ESG in Australia, perhaps because ESG hasn't been in Australia as long as it has been in USA and some other countries, so the doctors (majority are not surgeons) are not as skilled/experienced as those doing ESG in other countries. There have been some very successful Australian ESGers but for some reason the facebook groups have gone quiet, perhaps new members have been reduced because it is not covered by medicare so not so many questions on the groups (there has been an application pending for it to be covered, but it seems to be in limbo at the moment) http://www.msac.gov.au/internet/msac/publishing.nsf/Content/1555-public

Standard ESG is not covered by medicare or private health insurance in Australia, you are probably looking at least being about $14k to $17k out of pocket.

I looked at some of the outomes for TORe which is an ESG revision on bypass when the gastric outlet is reduced by endscopic stitching. There seems to be a better success rate for that (none of the studies I read were for Australia). It doesn't like like this is covered by medicare or private health insurance either.

Some questions to be asked of your doctor - how many ESGs have then done? Or TORe if that is what is intended for you? Success and failure rate? If a standard ESG if they have done less than 50 I would consider finding someone who has done at least 150/200 ESGs or more. There are some out there who have done at least 250 or 300.

In general, weight loss from an ESG is typically lower the surgical options.

https://www.facebook.com/groups/238431870408750

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As you can see from my signature I had a surgical sleeve conversion from an ESG. My ESG failed, an endscope showed that all but one or two of the sutures had come undone or significantly loosened. This meant the restriction was no longer there.

The pre-op and post-op diets were the same as the surgical diets, volumes are particularly important initially as the anchor points and sutures are healing, the scarring caused in the healing process are what helps them to hold better. If volumes are exceeded and the healing/scarring process is still underway it may compromise the anchor point/sutures.

After the procedure I had a bit of stomach cramping but buscopan helped with that, a heated pad may help too. The cramping lasted a day or two from what I remember. Recovery was pretty good.

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Thanks so much for your reply. You’re right, it could be the TORe that my surgeon is planning on doing, he had mentioned an endoscopic procedure so I made an assumption about the ESG but I could be wrong. I’ll find out on Tuesday when I have my appointment.

I’ll definitely ask those questions. Hopefully it’s a good option for me.

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Hope it goes well for you, but if TORe isn't for you there are other options.

Ps another question to ask, should the suturing fail within a one or two year period does the surgeon offer a redo at nil cost or substantially reduced cost?

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I don't know about this particular surgery, but I know I've read mixed reviews of revisions like TORe, overstitch, etc. Some people don't lose much weight - but some do, but it's almost always slower than it was with the original surgery.

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11 hours ago, Amy* said:

Hi all,

I had the RNY (revised from gastric band) 7 years ago and had amazing success. I got to my goal weight in 5 months and kept the weight off for over 5 years. In the last 18 months, I've had some medical issues that have resulted in me regaining almost all of the weight. Now that I have resolved those issues, I am maintaining my weight, but finding it impossible to lose again like I did before. There has definitely been some stretching of my pouch, which my surgeon has confirmed.

So I guess my question is, has anyone out there had the Edoscopic Sleeve Gastroplasty done? I have an appointment with my surgeon next week to discuss non-surgical options and I think this will be one of them. All of the research I've done shows it's a great option for regain after bariatric surgery but I'd love to hear from someone who has had it done.

If you have had it, how did you recover? Did you lose as much weight as you did with your initial surgery? Did you keep it off? What was the post op diet like?

Any and all feedback and comments welcome!

P.S: I'm in Melbourne, Australia

I don't have a revision of the Bypass but this Information fell into my hands a while ago : Consider researching and asking about other methou such as sclerotherapy of the stoma and plication of the stoma or pouch using Endoscopic Operating System (EOS USGI)

Good Luck ♥️

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