RNY revision to more extensive RNY. ANY EXPERIENCES?

 Hi, This is my first time posting...

I found out during my 6 year RNY anniversary that my surgeon is recommending a revision. She told me I was a candidate last year, but I wanted to try to just deal with it with sheer willpower. The problem is that it is a "mechanical failure" so willpower is powerless. I just didn't want to go through another surgery. I've been steadily gaining, and getting progressively more discouraged, so if my insurance covers it, I'll be having it done mid June. It is much more extensive that I had realized. This is how I understand it...

Create a new smaller pouch and stoma, shorten the channel so I will have greater malabsorption, and remove about 1/2 of my upper stomach. This is the area that creates the hunger hormones. She will leave a tube, that will be exposed for about 3 weeks. This will be used as a feeding tube if there are any complications. (That part gives me the creeps) I guess this mechanical failure is pretty uncommon, but it does happen.

DOES ANYONE HAVE ANY EXPERIENCE OR KNOWLEDGE OF THIS TYPE OF REVISION?

I know it is a more lengthy surgery and carries more risks, but I have great confidence in my surgeon. Still I feel a bit ill when I think of the months ahead... Honestly, I should be grateful that I can still have help getting the weigh off, since it is really bad for my osteoarthritis.

Upcoming revision date is June 14th.
Highest: 268. Lowest 168. Currently: 194

Hangin' in with my claws,

Jory

Hi Jory,
I had an RNY in 2002, lost weight, than gained weight.  What sort of mechanical failure did you have?  They really aren't all that uncommon, I've seen lot of stretched stomas. Also curious as to why you'd consider doing a more extensive procedure of the surgery that failed you once. I recently had an RNY to DS revision and there is NOTHING I miss about the RNY, I don't miss the pouch, dumping, dirreahea, etc, feeling like I"m dieting all the time.  It works for some people, please don't misunderstand me but I think you should really think hard about going down that path again. Revisions are a tough surgery and I hope you'll weigh all options that are best for you and your lifestyle and not limit yourself to your surgeons surgical abilities.
Best of luck,
Debbie
P.S.  I had a feeding tube in for 6 weeks, had to flu**** 3 times a day, couldn't wait to get rid of it. But it's a great peace of mind in the event you can't get enough liquids/nourishment in.

I think that depending on how much your channel is shortened determines if it is a distal rny or and extended rny (erny). I was changed to a distal. My pouch size was reduced and I supposedly have a 150 common channel. My reason for distal was lack of weight loss from initial surgery. It did not help much for me and I'm now looking into being revised to a duodenal switch (ds) which is supposed to have the best success rate out there in getting the weight off and keeping it off.

Define distal. If it is just bypassing another 100cm, it isn't worth the cut.

If she is talking in terms of common channel, what numbers?

 Hi! I just had the same op done 8 days ago.  I know ppl are always asking me why didn't I go with a ds or something different bu this is all my doc offered.  I had to travel 1 1/2 hrs to find one to take on a revision like this. I feel good.  Alot of pain in the beginning but it is subsiding. I have lost 15lbs between the preop diet and now.  Good luck!

I would think about this long and hard before you make a decision.

I am just preparing to revise from the RNY to the DS.  Check out the DS board here and talk to the people there.  Lots of Men and Women on that board who are revised from RNY to DS and they can share lots of information and help you weigh the facts

As well, check out the website www.dsfacts.com

Good luck in your decision

Cutting out your stomach in the area where the hunger hormone (grehlin) is produced is done in the sleeve and the DS surgeries, but there is NO pouch or stoma left.   The pouch is reattached back to the stomach and THEN the greater curvature of the stomach is cut away.   

If your surgeon is planning on leaving you with a pouch and a stoma, you will not be getting the modern DS surgery.   It sounds like some kind of version of the old Scopinaro surgery (on which the modern DS is based) which was less than successful.    The modern DS surgery has a sleeve stomach - the older Scopinaro procedure involved making a larger pouch than the RNY and then completely removing the remainder of the stomach (which differs from the RNY in that in the RNY the stomach is just left floating inside you), but the patient was still left with a stoma and pouch, NOT a sleeve.

You may want to go over to the DS forum and ask them about this surgery that your doctor is describing.   Something doesn't sound right ...

Jory,
I read your post quickly this morning and it's been haunting me all day!  I think you should describe this on the DS Problems yahoo group site. http://groups.yahoo.com/group/DS_PostOp_Problems/join
It sounds a lot like the old DS procedure in which many have suffered over the years.  I think you'd find that the surgeons on the DSfacts.com list find that surgery you're describing to be a medical dinosaur that harms more than it helps.

I hate to diss anyone's choice for surgery because we're all in the same boat as far as desiring better health through weight loss,  but....having gone through a revision of my bad Rny to an even worse Rny (ERny).....I HATE to see anyone make the same mistakes!!!  I'm about to have a very high risk revision this next week to a DS.....hoping to undo some of the damage that the ERny has caused my body!

Please get another opinion.  Email a couple of the surgeon's on the DSfacts.com list with your issues.  Don't be in a hurry to go down such a drastic path without turning over every possible stone along the way to the O.R.!

Take care friend! 

To answer one question, during an endoscopy (that was done when I had to have a food bolis removed) it showed my stoma and pouch were both distended. So the food does not remain for more that 10-15 mins and I want to eat again.

Thanks to all those who took the time to respond but I am pretty disheartened by most of the posts that basically say follow their surgeon's method of the DS and not to follow my surgeon's plan. I actually have great faith in her. I just wanted to know if anyone else had had this type of custom/hybrid RNY revision and what their experience was? I really don't need more doubt and fear right now.

Jory,
I just reread my post and am thinking I just directed you to a place to find a "list" of highly successful Revision surgeons.  I realize there are several amazing revision surgeons so I try not to push mine on anyone unless asked.  I'd send friends to the best places to buy jeans too! 

Coming on this board is a good thing and certainly we all have our opinions and personal experiences to draw from.  I'll submit that this is what you were after?  Hearing the reasons others have made certain choices and their experience after they made it is valuable as you weigh your options.  What you describe as a result of your endoscopy is actually typical of many Rny'ers.  Wide open stomas with stretched (or distended) pouches is the #1 reason most seek revision.  It is VERY difficult to have any kind of satiety when food just rushes through!  I know that some can do OK with it if they strictly eat dense, lean protein and withhold liquids at LEAST 1 hr after eating.  It's a huge struggle though and no wonder we gain when we're running on "empty" all the time!

Please just consider the responses as people who are hoping to help someone from making mistakes that they wish they wouldn't have had to learn from.  Take it all with a huge grain of salt but if nothing else; please just consider getting other opinions.  Once your surgeon cuts away any stomach then you have ruined your chances for a revision to a true DS if that fails or makes you deathly sick.  Maybe ask your surgeon if you may have misunderstood and if they are really taking down the Rny, reattaching the stomach and then making a sleeve?

I"m not sure if it's the exact same as what you are defining as a "hybrid revision" but you may check out research on the Scorpinaro (I KNOW I spelled that wrong!!!) duodenal switch.  If that is indeed what you'll be ending up with then you're going into something that has basically been ditched by the world because of the complication rate.

Don't be discouraged!  Just dig in and keep researching.  If, you find that your medical cir****tances will only allow for the "hybrid" surgery then you'll go into the O.R. at least feeling confident that there were not ANY better options available for you!

Hang in there!  Research either changes your direction or confirms your present journey!  Both are worth it!