Considering revision

[Revisionist 1]

I received a gastric sleeve back in June of 2016 so I'm coming up on my 5 year anniversary. I at one time weighed nearly 500 pounds and got the surgery at 380 as I lost 120 pounds on my own prior to surgery. I was down all the way to 160 pounds. My doctor even said I could stand to gain a few pounds. Problem is, I gained more than a few. I currently weigh about 330 pounds now. I have developed a hernia that will probably need to be surgically repaired. Given that, I'm considering a revision. Can a hernia be repaired while doing a revision? Has anyone gone from a sleeve to bypass? What are the differences you experienced with a sleeve vs bypass? I will also add I'm in the process of seeing a psychiatrist. I've learned I have social anxiety and the weight loss wasn't a cure for that anxiety. I'm almost looking at it as a do over and continuing therapy after surgery. Anybody have success doing a revision?

[catwoman7 10,922]

I haven't had a revision, but I just wanted you to say that lots of people have revised from sleeve to bypass (mostly due to GERD). There are a few current BP members who have, so hopefully some of them will respond.

[Tina Leo 14]

Hi! I'm revised Bypass to Bypass. I would only recommend a revision if your surgeon is 100% knowledgeable about bariatrics. As I understand it there are some unique challenges to a revision surgery - but maybe that is more in my case since I had a Bypass already. When they do a sleeve, do they distallize any of the connection to your intestines?

In any case, if you do have the revision - weight loss appears (8 weeks out) to go much slower than before, but steady. I feel better this time around - and as you say, I'm treating it like a do-over as I'm older and wiser now - and much better able to keep up with the costs of Vitamins and Proteins. And - there are a million bypass friendly things on the market now - so many more shake choices - high Protein Snacks and things.

I suspect the hernia can be repaired at the same time if your insurance will approve the bypass - that's the trickier part.

Good Luck!

[GreenTealael 24,905]

Hernias can be repaired alongside a revision (or separate). It’s up to the surgeon if they believe it’s worth repairing at the same time as it may prolong the surgical time.

IMHO choose a surgeon that has done plenty of complex cases with great outcomes.

I’ve gone from sleeve to bypass albeit for GERD. Outcomes can vary greatly but discussing optimal roux limb length for the best weightloss possible with your surgeon may help. It’s entirely possible to maintain or even gain after revision to RNY.

Some revision patients also experience a loss of VSG restriction because the pyloric sphincter is bypassed. food might feel like it goes right through you if you are used to the strong restriction of VSG.

Another option to inquire about is a revision to SIPS or Duodenal Switch especially if you don’t have GERD and have a significant amount to lose.

Good Luck!

[Revisionist 1]

I don't have issues with GERD. My surgeon is pretty respected and has been doing this for a while. Patients travel from out of state to see him. Even patients who are too large to walk and need medical transport see him. I'm interested in the differences of living with say a bypass vs sleeve? Maybe that's best to look over the bypass forum. If I need to have the hernia surgically repaired, I think I would want to have a revision done as well and hopefully do it in one surgery. I think I got the hernia because I gained so much weight.

[Coexister 114]

On 5/13/2021 at 7:45 PM, Revisionist said:

I received a gastric sleeve back in June of 2016 so I'm coming up on my 5 year anniversary.Can a hernia be repaired while doing a revision? Has anyone gone from a sleeve to bypass? What are the differences you experienced with a sleeve vs bypass? I will also add I'm in the process of seeing a psychiatrist. I've learned I have social anxiety and the weight loss wasn't a cure for that anxiety. I'm almost looking at it as a do over and continuing therapy after surgery. Anybody have success doing a revision?

I had a revision from sleeve to a bypass and a hiatal hernia repair at the same time and so "yes" they repair hernia's at the same time. In fact I had the initial hernia repair while having the sleeve which failed and had to be repaired during the bypass - doing great after bypass. I lost more weight after the bypass as the body doesn't absorb as much and it is definitely a different "feel" than the sleeve was. The restriction is completely different for me. Foods again changed in flavor and things I liked after the sleeve, I no longer like after bypass. I am not one on those that throw up from overeating and am able to tolerate everything and so I have to be careful and "watch what I eat". The experience is different for everyone. If I eat too much it is more painful then it was with the sleeve and I don't know if it is because of the hernia repair that I can't throw up but it hurts extremely hard. Recovery seemed easier and maybe it's because I had been through it before? Fluids are much easier for me to drink. I too have an anxiety disorder and no the surgery does not fix that. I work with a psychologist continuously on my issues for the anxiety along with other issues I am dealing with and so yes you will need to continue therapy. Good luck in your journey. You got this!

[Starwarsandcupcakes 1,898]

I’ve had VSG to RNY revision because a hiatal hernia caused me to develop hiccups from the GERD.
Compared to VSG it was much easier to drink liquids after RNY. The lack of pyloric valve was great in that regard. I do have more restriction with foods than I did with sleeve. I’m 9months out from my revision and just now able to eat chicken. It’s different for everyone but definitely listen to your body and any cues that you might be getting full, even after just a few bites.

[nbw1220 58]

I agree with what others have said. Going from VSG to RNY is definitely different in the restriction and feelings of fullness. I am almost 2 months out and when I am full I get pressure in my chest but no where else...so different from my sleeve. Now that I am able to start moving to solids...i am finding that liquids are much easier (than with VSG) to drink as well. I am grateful that I have had no nausea, gerd or acid reflux with this revision. I also had gained about half of my weight over 7 yrs but I am losing again which is nice. You can lose weight with revision, my surgeon told me from the beginning that I would lose since it was a different surgery...just don't fall back into old habits with your second chance! I know it will slow down but I am down 33lbs since surgery.

[Revisionist 1]

I think I got too caught up on the success. I went from about 500 pounds to under 170. Doctors were telling me to gain a couple pounds. I was eating about 900 calories a day with plenty of exercise. I would eat about two pieces of chicken breast tenderloins for dinner. Now I eat six and can probably still keep going. Just can't seem to shake these extreme shifts in weight.

[GreenTealael 24,905]

On 5/14/2021 at 7:13 PM, Revisionist said:

I don't have issues with GERD. My surgeon is pretty respected and has been doing this for a while. Patients travel from out of state to see him. Even patients who are too large to walk and need medical transport see him. I'm interested in the differences of living with say a bypass vs sleeve? Maybe that's best to look over the bypass forum. If I need to have the hernia surgically repaired, I think I would want to have a revision done as well and hopefully do it in one surgery. I think I got the hernia because I gained so much weight.

For me life is basically the same with RNY except there are more foods that will make me dump than with VSG. Immediately after surgery I had to deal with learning new bathroom habits (I had to urinate at the drop of a dime for months) but it has gone back to normal now that I’m almost 2yrs post op.

[Tracyringo 503]

On 5/14/2021 at 6:13 PM, Revisionist said:

I don't have issues with GERD. My surgeon is pretty respected and has been doing this for a while. Patients travel from out of state to see him. Even patients who are too large to walk and need medical transport see him. I'm interested in the differences of living with say a bypass vs sleeve? Maybe that's best to look over the bypass forum. If I need to have the hernia surgically repaired, I think I would want to have a revision done as well and hopefully do it in one surgery. I think I got the hernia because I gained so much weight.

I agree with greentealael and considering you dont have issues with GERD a DS may be better for you since you have more excess weight to lose. I would absolutely ask the surgeon his thought on it. No restriction on RNY for me after my revision but luckily I dump and cannot over eat without getting violently ill so it keeps me in check.

[StratusPhr 127]

On 5/13/2021 at 9:35 PM, catwoman7 said:

I haven't had a revision, but I just wanted you to say that lots of people have revised from sleeve to bypass (mostly due to GERD). There are a few current BP members who have, so hopefully some of them will respond.

Our BCBS Anthem doesn't cover WLS, any idea if insurance will cover a revision due to GERD and a hiatal hernia? First appointment next month so it has not been suggested or recommended. I'm ahead of myself, but would like to have an idea of what I'm in for.

[catwoman7 10,922]

12 minutes ago, StratusPhr said:

Our BCBS Anthem doesn't cover WLS, any idea if insurance will cover a revision due to GERD and a hiatal hernia? First appointment next month so it has not been suggested or recommended. I'm ahead of myself, but would like to have an idea of what I'm in for.

boy - I have no idea. Maybe they would if it was due to medical issues (which it sounds like it is) - unless there's another way to repair a hiatal hernia which doesn't involve a WLS revision. If there is, maybe they'd cover plan B. I hate to even guess, though. You might have to just call the insurance company and ask them (you might have to speak to a supervisor - yours would be kind of an unusual case - the person answering the phone may or may not know)

[StratusPhr 127]

3 hours ago, catwoman7 said:

boy - I have no idea. Maybe they would if it was due to medical issues (which it sounds like it is) - unless there's another way to repair a hiatal hernia which doesn't involve a WLS revision. If there is, maybe they'd cover plan B. I hate to even guess, though. You might have to just call the insurance company and ask them (you might have to speak to a supervisor - yours would be kind of an unusual case - the person answering the phone may or may not know)

Thank you! I will wait until after the appointment and see what the doctor recommends, then I'll call if they don't!! Have a great day!

[JEANMR1 25]

On 5/15/2021 at 10:11 AM, Starwarsandcupcakes said:

I’ve had VSG to RNY revision because a hiatal hernia caused me to develop hiccups from the GERD.
Compared to VSG it was much easier to drink liquids after RNY. The lack of pyloric valve was great in that regard. I do have more restriction with foods than I did with sleeve. I’m 9months out from my revision and just now able to eat chicken. It’s different for everyone but definitely listen to your body and any cues that you might be getting full, even after just a few bites.

I’m 3 1/2 weeks out from my revision. I’m jealous that you cannot eat chicken for nine months. I hate chicken and that’s all I’ve been eating. 🙂