revision options limited

I had RNY in 1999 lost 200 pounds but have in the last 4 years have gained back 100 pounds.  My stoma has stretched out to be larger than my pouch.  I did restore last December it held for 6 weeks I lost 35 pounds and then it let go and now stoma is even larger than before restore.  I had RNY at DHMC in New Hampshire - they have no options for revision to fix the stoma so I am going out of state.  I was determined that I wanted RNY converted to DS.  I went to a surgeon who does many types of revisions including to ds.  He informed me he would do it but did not think it was a good idea.  My RNY was not done in the "normal" fashion.  One of the biggest things is four lines of staples that he would need to go through which would make greater risk of leakage.  Also pouch and intestines were done a bit different.  He gave me the option of doing DS but needed to understand he would give mortality rate 2 in 50.  Also because of intestines would have more BMs than normal DS patients.  He gave me a few other options and I decided to have him put the lapband at the bottom of my pouch to narrow the stoma and hopefully keep it at proper size. So I am having the lapband on Jan 29th.  I am excited but also nervous about if it will work and if I wil be disappointed.  Every time I read the message boards here I think the DS sounds great and am disappointed that it is not an option for me because of what was done back in 1999 with the RNY.  The surgeon I had then was an older surgeon- he only did open procedures but it was what was available and known back then.  Fortunately he doesn't even do surgeries anymore. Any feedback , particularly if anyone has had revision to stoma with lapband  or knows someone who has, would be appreciated. 

Hi, I am so sorry to hear about your trials.  I wish you the best of luck with the lapband.  I do have a question.  Where did you have the Restore procedure and what was the reasons it "didn't hold".  I am going down this road and would like to learn from your trials.  Thanks so much Kathy

I had the restore at DHMC in New Hampshire in December 2006.  I was one of the first 5 participants they did and was guaranteed to have the actual endocinch.  I spoke to two of the other first 5 at the 1 month check ups.  They were not having as much of a weightloss as me but they were also talking about eating chocolate and drinking with their meals and adding solid foods quicker than they were suppose to.  I think if you are going to go through any of these procedures or surgeries you need to follow the guidelines.  I did everything they said and lost 35 pounds in 6 weeks.  It was great and felt like it did when I first had RNY.  By the first week of February I did not have the feeling of fullness any more and knew that it was different.  They did a check and confirmed that it had was no longer intact.  My understanding is the doctor who did the restore has learned better techniques.  I am not sure how it is going now.  I was told that mine didn't hold and they weren't sure why but perhaps it wasn't strong enough.  I guess it could also be that it just wasn't a match for my body.  I think that it was lack of experience with the procedure and it was new and still being perfected.  I did vomit when I first tried to add beef to my diet and so went back to liquid and then slowly added again and was fine so I don't know if that one time of vomiting loosened something but that was before the first check and at the endoscopy check everything was great so I don't think that was the problem.  My understanding is that they have learned a lot and improved it since then.  It did however make me decide that it was not the procedure for me.  I don't know that it would not work and be great for others particularly with more experience.

Yes, do tell.  I'm curious what you mean by "it let go".  There are a number of us on this forum who are awaiting participation in the RESTORe trial. Betsy

Sorry  to hear that you can not get the DS but with those Stats on mortality it most definitly is not worth it. I to have gained back about 45-50 lbs. I am having the lap over RNY on 1/24/08. Make sure that your current surgeon has done alot of them because our anatomy is now very different. My surgeon is in NYC and is one of the most experienced. Best of luck to you.

I am accepting that there has to be a reason and that the lapband over RNY is the right choice.  My surgeon is Dr. Roslin who is also in NYC and experienced with both RNY amd lapband so I am comfortable with him.   It is the reason I am traveling from NH to NYC because although there are surgeons that do RNY and ones that do lapband in NH there are none that do both or that do lapband over RNY.   GOOD LUCK ON THE 24TH.   are you excited, nervous, anxious and all of the above. 

Best wishes with your revision to lapband!