Gastric Bypass 18 Years Ago

[The Lynster 2]

Hi, I'm new here. I'm actually looking to connect to veterans of the surgery. I had my surgery 18 years ago and at the time it was great.

Doctors said I should of lost more weight. Starting weight 407 and lowest was just under 300 but I'm now up to 340 and I'm looking to get another procedure because I just can't seem to find a diet (way of eating) I can stick with. My knees are shot so I need to lose weight to get knee replacement surgery.

I had my gallbladder taken out.

Has anyone had pain in the upper abdomen when your bend over for about a minute? What about a side pain (my right) almost feels like I bruised a rib.

Thanks gang. Look forward connecting with someone that is going thru the same thing I am. I appreciate it.

[RickM 1,747]

Unfortunately, revisions tend not to do all that well for regain problems - I like to think about it as your stomach started out being able to hold 32-64 oz, and after WLS it can hold 1-4 oz typically; even after it stretches some and/or adapts, its capacity of maybe 4-8 oz is still just a fraction of what it was, and we have gotten used to living with that. So, going with a "do over" revision just doesn't have the same power as the first time around. Further, the bypass is difficult to work with, so typically the best they can do is to either put a band around the pouch to restrict it, or tighten up the stoma, neither of which have a great track record of success.

Probably your best shot at getting on track again and losing a substantial amount in a revision is to look into a duodenal switch (DS) which has much better regain resistance than the RNY or sleeve. Unfortunately, that is a very difficult revision, that maybe a half dozen or so surgeons around the country can do. Fortunately, two of them are here in CA - Dr. Ara Keshishian in the Glendale/Pasadena area, and Dr. John Rabkin in SF. I have seen several patients come through our support group over the years that have had quite reasonable success with that revision, so it is definitely worth a look.

The other approach that you might find is to convert your (conventional) proximal RNY to a distal RNY, which basically involves moving the pouch much farther down the intestine, bypassing more of it. It does not have a great reputation for being trouble free (from what i have seen, most insurance will not cover it as a primary WLS procedure, but will consider it for a revision.) I suspect that a big problem with it is that the surgeons don't really appreciate the nutritional/supplement differences with it, (it is much closer to a DS than an RNY in supplement needs) and the patients suffer as a result as they may not get the aftercare that they need over the years. The DS tends to be much less of a problem in this regard as the surgeons who do it do so as their primary or preferred procedure, so they know all of its subtle needs by experience.

Good luck in finding a solution to your problems,

[Tomo 1,135]

Hi, I'm new here. I'm actually looking to connect to veterans of the surgery. I had my surgery 18 years ago and at the time it was great.
Doctors said I should of lost more weight. Starting weight 407 and lowest was just under 300 but I'm now up to 340 and I'm looking to get another procedure because I just can't seem to find a diet (way of eating) I can stick with. My knees are shot so I need to lose weight to get knee replacement surgery.
I had my gallbladder taken out.
Has anyone had pain in the upper abdomen when your bend over for about a minute? What about a side pain (my right) almost feels like I bruised a rib.

Thanks gang. Look forward connecting with someone that is going thru the same thing I am. I appreciate it.

Hi. Revisions on gastric bypass are usually successful and more effective than original surgery. 60 to 80% excess weight loss, but you would have to follow your surgeon and team advice.
https://anmedhealth.org/services/surgery/weight-loss-surgery/revisional-bariatric-surgery#:~:text=Gastric%20bypass%20revision%20surgeries%20tend,their%20medical%20team's%20advice%20closely.n

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