Bypass revision after sleeve? 8 years post op Sleeve

[Tink22-sleeve 528]

Hi All,

I am about 8 years out from a sleeve. Overall, happy. But often in the middle of the night I wake up, literally chocking on acid from GERD that developed immediately after the sleeve surgery.

I am looking to talk to people who have had a sleeve and then converted to bypass.

Would you please share with me:

1) Your reasons for conversion from the sleeve to bypass.

2) What was the post op period like compared with sleeve?

3) What is the best and worst part of having the bypass?

4) Any dumping issues?

Thanks so much!

[Tufflaw 463]

I was sleeved in Dec. 2016 and did extremely well at first - I dropped about 120 lbs in about 6 months, reaching my goal weight.

I had some personal/professional issues including losing my job, starting and losing my business, health issues with my kids, etc. and I slacked off and just started eating like crap again and gained almost all the weight back. I had GERD both before and after the surgery but was maintaining it with esomeprazole.

I got the revision to bypass in Nov, 2021 and as of today am down a little over 65 lbs. and the GERD is gone. As for your questions:

1) Your reasons for conversion from the sleeve to bypass. - My doctor said I was eligible for a second surgery and that he needed to do an endoscopy to see if the sleeve was dilatated (enlarged). If it was, I could resleeve or switch to bypass. If it wasn't, I'd have to go with bypass. They checked and it was enlarged so I could get either one but he recommended the bypass due to the GERD and potential future complications with long term use of the medication or effects to my esophagus from the GERD.

2) What was the post op period like compared with sleeve? - About the same. I think I felt a little worse right after the surgery because it was longer. My sleeve surgery was 26 minutes, the bypass was about 3 hours. It was supposed to be a little over an hour but there was an issue with one of the stapling devices not being able to reach a certain area so the doctor had to suture by hand which took longer. I believe I felt much groggier and a little more nauseous, but after the first day it was pretty much the same as the first time.

3) What is the best and worst part of having the bypass? - Best part is losing weight again and feeling healthier. Worst part was having to go through the surgery again due to my own screw up. Also this time they put a drain in my stomach for a week which wasn't fun.

4) Any dumping issues? - Not even once.

[GreenTealael 24,866]

Hi! I was sleeved in 2017 and converted to bypass in 2019.

1) Your reasons for conversion from the sleeve to bypass.

I wish I did the revision as soon as my symptoms started (GERD) Instead of waiting couple years but I didn’t understand that I was actually experiencing GERD. I just kept trying to rework my diet to see if the symptoms never occurred to me it was something that I could not fit without surgical intervention.

2) What was the post op period like compared with sleeve?

It was a easier than when I was sleeved, I don’t know why but I’m grateful

3) What is the best and worst part of having the bypass?

To me the bypass is almost exactly like having sleeved, I can’t tell the difference Until I remember the difference in restrictive feelings during eating. With a slave restriction was high in my chest almost near my throat. With the bypass I feel the heaviness disinterest in food.
Some days if I eat and dryer Proteins source (like grilled chicken breast) I can feel both types of restrictions.

4) Any dumping issues?

Yes I do experience dumping although it’s well managed now. I do have a few additional food restrictions than I did it with the sleeve. I cannot eat really sweet things. Or if I do it is literally one bite and I’m done. I rather not feel terrible over food if I can prevent it.

[Tink22-sleeve 528]

Thank you Greentealael and Tuffla for you responses. I so appreciate it. I have been trying to tolerate the discomfort after eating anything and the GERD for years now. I didn't have insurance for quite awhile, but now that I do I will make an appointment with a bariatric surgeon this afternoon to get checked out.

Thank you again!

[shriner37 249]

I was sleeved in 2015 and just went through the revision from sleeve to bypass about 3 1/2 weeks ago. So as I'm still in recovery mode I can't really provide a full answer all of your questions.

1. Reason for conversion: I developed a hiatal hernia where part of the sleeve had slipped up through the opening of the diaphragm into the chest cavity, which was causing chest discomfort and only allowing me to eat a couple ounces of food at a meal. After doing an EGD my surgeon was concerned enough to schedule my revision within a week. He said if they just fixed the hernia there was a high likelihood it would recur with the sleeve. If he converted to bypass he said there was a very low likelihood I'd have any further problems. I also had GERD issues from the sleeve which I wanted to address.

2. Post-op period: I'd say for me it was essentially the same. I had the same surgeon and facility which were both great. Recovery plan is the same for both surgeries (clear liquid, full liquid, puree, soft solids, etc.) I had a bit more pain with the bypass but I'm 7 years older than when I had the sleeve.

3. Best and worst part: Can't really answer this yet, except to say it's nice to lose some additional weight (I never hit my goal with the sleeve) but it's tough to have to start over with the recovery.

4. Dumping: Haven't experienced it yet, but I am just up to about 2 to 2.5 oz of soft Protein so I have not been able to even try anything that might cause dumping.

My thought on the revision is if you are experiencing significant GERD it is definitely worth considering. GERD can cause Barret's esophagus and ultimately lead to esophageal cancer if not kept in check. Having had a relative who died of that cancer in her early 50's I was concerned enough to want to solve it if I could.

[gabbykittyvsg 184]

I converted from sleeve to bypass almost 2 weeks ago due to severe GERD. My recovery has not been typical. My small intestine swelled almost completely shut at one of the newly created junctions so I had to go back in the hospital for a few days for a lovely tube down my nose and into my stomach, more steroids and forced rest in the form of nothing to eat or drink.

I'm fine now, fluids are moving through and my digestive system is fully back on line.

The swelling wasn't a big surprise since my sleeve swelled quite a bit when I first had it done 7 years ago.

Considering the severity of your GERD, absolutely get the conversion to bypass. The GI doc who did my first endoscopy was worried enough about the results of my second endoscopy (done by a different doc) that he called me to make sure I understood the severity of what could happen if it wasn't surgically corrected.

For what it's worth, I've not had any reflux since surgery.

Sent from my Z5157V using BariatricPal mobile app

[Tink22-sleeve 528]

Thanks so much for your comments...they are so appreciated. I have made an appointment to be seen by a Bariatric Doc here in Vancouver, WA. I have to wait a month to be seen, but that doesn't seem to long away. I will need to wrap my brain around possible surgery. Ugh.