Gastric bypass after sleeve

M. Walker
on 1/11/12 6:44 pm
DS on 02/12/13
Anyone have UHC? And wanting to go ahead and get the gastric bypass? Just wondering the criteria they want or if there is a time limit as to when they will authorize the bypass?




        
MsBatt
on 1/11/12 7:08 pm
May I ask why you want to turn your fully-functional Sleeved stomach into an RNY pouch???

Seriously, if the Sleeve hasn't produced sufficient weight-loss for you, the RNY probably won't, either---studies are showing that these two procedures have VERY similar long-term results.

Have you researched the DS? (Duodenal Switch) The DS is basically the Sleeve (which you already have) plus an intestinal bypass which produces dramatic, permanent changes in metabolism and permanent malabsorption of calories. (The malabsorption of calories stops about 24 months after the RNY.)


MARIA F.
on 1/11/12 9:10 pm - Athens, GA

I concur with Msbatt on that. It would make much more sense to complete the DS rather than convert a VSG into a RNY. Better long term results, and much safer surgery too Iwould assume.

Btw..........would you happen to know what size bougie they used on you???
Amy Farrah Fowler
on 1/11/12 9:44 pm
Change the sleeve into a pouch, then do the intestinal part?? Why not leave the superior sleeve alone, and ONLY do the intestinal part of the DS?? It's the most effective surgery there is, and you have half of it.

I know why - the surgeon doesn't know how, so you have to pay the price with lots more surgery, to give you a lesser procedure. I'd fire that surgeon and hire one that knows all the surgeries instead of selling me a Yugo. Honey, I'm not being pissy at you, it's at your unethical surgeon.
M. Walker
on 1/11/12 10:01 pm
DS on 02/12/13
Please only respond to my question. This has nothing to do with my surgeon's ability, or if I even decide to do this or if my surgeon is willing to do this. I did not post for these answers. Don't respond if it is not for the answer to the original question. Thank you.




        
Sharyn S.
on 1/12/12 6:31 am - Bastrop, TX
RNY on 08/19/04 with
On January 11, 2012 at 10:01 PM Pacific Time, Melissa W. wrote:
Please only respond to my question. This has nothing to do with my surgeon's ability, or if I even decide to do this or if my surgeon is willing to do this. I did not post for these answers. Don't respond if it is not for the answer to the original question. Thank you.
I guess you didn't like my first answer. Whatever.

As someone who has beenvery successful with the RNY for over 7 years,I ask you "Why would you trade in a fully operational sleeve with pyloric valve for a pouch???Dumping and reactive hypoglycemia are no walk in thepark. You are alreadyhalf way to the DS.

If I knew then what I know now, I would have had the DS. That is 7 years ofliving with the RNYtalking. Don't get me wrong, I don't regret havingRNY. But, if I had a do-over, I wouldget the DS.

Sharyn, RN

RIP, MOM ~5/31/1944 - 5/11/2010
RIP, DADDY ~ 9/2/1934 - 1/25/2012

NanaB.
on 1/12/12 6:41 am, edited 1/12/12 6:47 am
Strange, you mentioned that you would get the DS if you had to do it all over again due to dumping and hypoglycemia that many long term RNYs have...but what I just discovered many Sleevers dump too, just do a search on the Sleeve board and you will come up any MANY that dump or have adverse reaction to carbs and sweets SAME as gastric bypass folks, not sure why this is downplayed. I have a friend with the Sleeve and she had NO IDEA that they dump, she can't eat full fats and carbs at restaurants her life is a total nightmare.

My sister had stomach stapling surgery about 25 years ago, and SHE DUMPS too, I think it has to with stapling off the stomach and she suffer quite frequently from stomach issues also.

I researched it and found that Sleevers have rapid gastric emptying, I guess people need to do their research outside of OH prior to surgery prior to making a life altering decision.
Are you overall Happy with your Band and want a postive environment to stay on track? Join us and become a member of our Happy Lap Band Group Keep it bookmarked!http://www.obesityhelp.com/group/Happy_Successful_Banders/



Sharyn S.
on 1/12/12 7:03 am - Bastrop, TX
RNY on 08/19/04 with
On January 12, 2012 at 6:41 AM Pacific Time, NanaB. wrote:
Strange, you mentioned that you would get the DS if you had to do it all over again due to dumping and hypoglycemia that many long term RNYs have...but what I just discovered many Sleevers dump too, just do a search on the Sleeve board and you will come up any MANY that dump or have adverse reaction to carbs and sweets SAME as gastric bypass folks, not sure why this is downplayed. I have a friend with the Sleeve and she had NO IDEA that they dump, she can't eat full fats and carbs at restaurants her life is a total nightmare.

My sister had stomach stapling surgery about 25 years ago, and SHE DUMPS too, I think it has to with stapling off the stomach and she suffer quite frequently from stomach issues also.

I researched it and found that Sleevers have rapid gastric emptying, I guess people need to do their research outside of OH prior to surgery prior to making a life altering decision.
Yes, there is still SOME who dump with the VSG, but not nearly as many as with the RNY, and even that's only 30%, or so.

But, I will NEVER recommend the CrapBand.

Sharyn, RN

RIP, MOM ~5/31/1944 - 5/11/2010
RIP, DADDY ~ 9/2/1934 - 1/25/2012

NanaB.
on 1/12/12 7:19 am, edited 1/12/12 7:20 am

Yea...but I did not know Sleevers dump, the way people on this board portray it, it is the best thing since sliced bread, and that was a new on me.

I am glad I learned this in case my band ever slips, or need to come out, I would look at the Sleeve as an option, but now I would NEVER look at it as option.. and thank god so far so good with my CRAPBAND, my life is smooth with no side effects at 7 years post op .

Are you overall Happy with your Band and want a postive environment to stay on track? Join us and become a member of our Happy Lap Band Group Keep it bookmarked!http://www.obesityhelp.com/group/Happy_Successful_Banders/



(deactivated member)
on 1/13/12 6:40 pm
NanaB.
on 1/14/12 4:10 am, edited 1/14/12 4:35 am
Here ya go...a brand new study on Sleeve gastric emptying.....aka dumping, some develop it early and some develop it years out.


Sorry, I am not spreading misinformation about the Sleeve, I have no reason to do that, that is done a lot about the lap band though. I make sure I thoroughly research a surgery and its side effects before making a life altering decision, you need to do the same thing and not base your research on what people say on the Internet.

Also many people do not know or realize they dump with the Sleeve, some just think they can no longer eat some carbs, fats and sweets unless they get sick, some people do not even know what they are getting into until after they've removed their stomach. If anyone wants to learn more about DUMING with the VSG, they can just go the Search box at the top of the forum and TYPE IN VSG and DUMPING and they will get several posting of people complaining about dumping on the VSG forum.

Here is recent studies indicating Dumping aka gastric emptying with Sleeve patients.



What is rapid gastric emptying?

Rapid gastric emptying, also called dumping syndrome, occurs when undigested food empties too quickly into the small intestine.

[Top]

What are the symptoms of rapid gastric emptying?

Early rapid gastric emptying begins either during or right after a meal. Symptoms include nausea, vomiting, bloating, cramping, diarrhea, dizziness, and fatigue. Late rapid gastric emptying occurs 1 to 3 hours after eating. Symptoms include hypoglycemia, also called low blood sugar; weakness; sweating; and dizziness. Experiencing both forms of gastric emptying is not uncommon.

New Study and FINDINGS ON DUMPING AKA...GASTRIC EMPTING WITH THE SLEEVE AS OF January 10, 2012

SAGES Annual Meeting

Tomorrow is All About Today

Search

Main menu

Skip to primary contentSkip to secondary content

Post navigation

COMPARISON STUDY OF GASTRIC EMPTYING AFTER PERFORMING SLEEVE GASTRECTOMY WITH TWO DIFFIERENT TECHNIQUES

Posted on January 10, 2012

Saed A Jaber, MD, Basma M Fallatah, MD, Abdel- Aziz Shehry, MD, Mahmoud Abdelmoeti, MD. King Fahd Medical Military complex

BACKGROUND: Sleeve gastrectomy (SG) has been became a primary surgical treatment for obesity. This operation could be associated with motor gastric dysfunction and abnormal gastric emptying. The purpose of this prospective study is to present a comparison study of gastric emptying to solids after performing sleeve gastrectomy with two different techniques using scintigraphy. METHODS: Prospectively; twenty morbidly obese patients were submitted for laparoscopic SG. After excluding patients with gastro-esophageal reflux disease and diabetes mellitus for the sake of avoiding having a preoperative gastric emptying, patients were divided into two groups. One group (3 males, 7 females) had sleeve gastrectomy started 7 cm from the pylorus and then vertical gastrectomy a long a 40 french size tube and the other group (3 males, 7 females ) has the sleeve started at 4 cm from the pylorus and then vertical gastrectomy a long a 40 french size gastric tube . Gastric emptying of solids was measured by scintigraphic technique. RESULTS: At 4 cm from the pylorus: Nine of ten patients had delayed gastric emptying with t1/2 >50 min (55-133 min).Mean BMI decreased from 42.1Kg/m2 to 36Kg/m2. All female patients were complaining from significant nausea and vomiting postoperatively that persisted for 6 months. At 7 cm from pylorus: Ten patients had rapid gastric emptying with t1/2<30 min(17-29 min) . BMI decreased from 42.1Kgm2 to 37.1Kg/m2. From these cases one female patient developed nausea in a chronic manner. Conclusion: Gastric emptying after SG is variable according to point of starting sleeve gastrectomy from the pylorus. At 4 cm it is associated with delayed emptying and at 7 cm it is associated with accelerated emptying for solids in the majority of patients. These results could be in consideration to select the appropriate technique according to gender and preoperative foregut condition.

From WBMD...about the Sleeve and Dumping

Gastric Sleeve Surgery

Restrictive operations like gastric sleeve surgery make the stomach smaller and help people lose weight. With a smaller stomach, you will feel full a lot quicker than you are used to. This means that you will need to make big lifelong changes in how you eat-including smaller portion sizes and different foods-in order to lose weight.

This surgery can be done by making a large incision in the abdomen (an open procedure) or by making several small incisions and using small instruments and a camera to guide the surgery (laparoscopic approach). More than half of yourstomach is removed, leaving a thin vertical sleeve, or tube, that is about the size of a banana. Surgical staples keep your new stomach closed. Because part of your stomach has been removed, this is not reversible


Sometimes this surgery is part of a larger approach to weight loss done in several steps. If you need to lose a lot of weight before you have duodenal switch surgery, gastric sleeve surgery may help you.

What To Expect After Surgery

You will have some belly pain and may need pain medicine for the first week or so after surgery. The cut that the doctor makes (incision) may be tender and sore. Because the surgery makes your stomach smaller, you will get full more quickly when you eat. Food also may empty into the small intestine too quickly. This is called dumping syndrome. It can cause diarrhea and make you feel faint, shaky, and nauseated. It also can make it hard for your body to get enough nutrition.


Are you overall Happy with your Band and want a postive environment to stay on track? Join us and become a member of our Happy Lap Band Group Keep it bookmarked!http://www.obesityhelp.com/group/Happy_Successful_Banders/



RickyDee Sleever
on 8/1/13 3:37 am

Sleeve not sliced bread for those with IBS, certain medications, blown metabolism or Binge Eating Disorder. My surgery was excellent, I was virtually by the book for three years. My weight loss stopped cold at 1 year, was supposed to have 2ndyr. Have been Dr monitored every three months, my labs are excellent, but no more loss and I am at 1100 cals! Tried conservative maintenance, and began to gain, I would do the RnY in a heartbeat. DS can be very unpleasant, especially for those like me, who have IBS!

Phyllis C.
on 1/12/12 7:41 am, edited 1/12/12 7:41 am
VSG on 04/17/08 with
"Dumping" with the sleeve is not severe for thosewho experience it. It is very easy to avoid by not eating sugary fatty foods to excess. It is actually a very good deterrent to eating crap.

I can control that reaction with the sleeve. I couldn't control the damage and pain that I had with the band.

Phyllis
"Me agreeing with you doesn't preclude you from being a deviant."

Judi J.
on 1/12/12 7:09 am - MN
Even some people who have never had surgery have had "dumping" episodes. But the more research that comes out, it does appear to link reactive hypoglycemia to the lack of a pyloric valve. I'm fortunate, have rarely had it be an issue but it's a crap shoot as to who will get it and who won't.
NanaB.
on 1/12/12 7:24 am
Ihave a few friends that had RNY and never dumped, their lives are great, but as you say it is crap shoot, lap banders DO NOT get dumping syndrome, but people who;ve never had weight loss surgery can get hypoglycemia I think it is similar to a complication of diabetes.

This seems to be MORE COMMON than people report with the Sleeve and MANY are not happy that they dump since it was not clear to them this could happen with a restrictive only surgery.
Are you overall Happy with your Band and want a postive environment to stay on track? Join us and become a member of our Happy Lap Band Group Keep it bookmarked!http://www.obesityhelp.com/group/Happy_Successful_Banders/



Judi J.
on 1/12/12 7:28 am - MN
yep, that's why we all pick the surgery that has the potential consequences we think we can live with. I hate going to the doctor. The fill appointments would have driven me crazy with a band and I need the malabsorption. I knew I'd get to a point where I'd need to watch what I eat and I'm there. no surprises

have a good one NanaB
Nic M
on 1/13/12 4:33 pm
Ihad "dumping" episodes for years and years after gallbladder removal. I'd eat something that wasn't easily digestible and get all woozy and icky. "Explosive diarrhea!Outta my waaaay!"

Avoid kemmerling, Green Bay, WI

Judi J.
on 1/13/12 7:31 pm - MN
only you can make explosive diarrhea sound entertaining, you goof!
Nic M
on 1/13/12 7:34 pm
It IS entertaining!As long as it's happening to someone else!

Avoid kemmerling, Green Bay, WI

Krazydoglady
on 1/12/12 8:35 am - FL
Statistically, pproximately 16% of those with the sleeve experience reactive hypoglycemia based on studies actually done on the subect. It is some but not most VSG patients.

Having a blind stomach post stapling vs. stomachremoved are two entirely different animals.Removal of the cells that producethe hormone Ghrelin, for example. That blind stomach can still ulcerate, as well.

Gastrectomy is a common operation -- far more common than most people realize - for conditions like ulcers and stomach cancer. I've run into a number of folks since my VSG who have partial stomachs.There was an interesting article on Salon.com last year by a foodie who devleoped stomach cancer and had her stomach removed entirely.Her small intestines were basically attached to her esophagus.

The only food intolerance I have is poultry. Things like wings tend to be too dry for me.

Carolyn (32 lbs lost Pre-op) HW: 291, SW:259, GW: 129.5, CW: 126.4


Age: 45, Height: 5'2 1/4", Stretch Goal: 122