Help ....revision getting sleeved for a second time

For months now I've been really undecided what surgery I'm having done again, do to a stretched pouch, I gained all my weight back... I've decided I'm gonna do a re sleeve... I haven't been on oh for some time to get more info from people.... my coordinator already told me I can't talk to Dr almanza over the phone to ask him how the procedure is done the second time around... has any one there gotten re sleeve... what is it like?  Do you loose quick? Is the recovery the same? How much do they cut out? And most important, do they just staple the pouch or do they remove the original staple line?  Any one out there??????????? I'm planning on having surgery in the next few weeks.. I'm self paying

Staples are not removed when re-sleeving. Your surgeon will need to re-staple. The fundus needs to be completely dissected ( liberated) and the excess needs to be removed. A too large fundus will lead to weight regain. This is the problem I have found numerous times when doing resleeves, fundus’ are too big.  Dissecting the fundus takes time and skill, but in order to have a sleeve that will really aid the patient in reaching their goal weight and keeping it off it needs to be done, always.

I would encourage you to ask what your surgeon’s success rate is for primary and revision sleeves.  Not only doing them safely but are  patients losing enough weight?    This will ensure you do not need to go through a third surgery.   In my experience resleeving, I find that the problem is not the stretched sleeve, it is that the sleeve was not done efficiently the first time around.  Sure it does stretch, but when a patient regains all their weight back I have invariably found that the problem was the initial sleeve. A revision sleeve is more difficult to do than a primary sleeve  so experience is important for your safety.

Of course you need to continue to check your caloric intake and food choices as with any weight loss surgery.

Best of luck.

Thank you dr.aceves.. what does dessecting the fundus mean?

It means totally separating the upper part of the stomach, the upper part is the fundus which is also the most stretchable part of the stomach. It is usually bound with  tissue, so some surgeons will just go around it.  I have encountered this in numerous revisions I have performed.  Separating it in order to staple uniformly is very  important for you to have a sleeve that is an effective tool for weight loss. 

Dr. Aceves, 

I would love to ask you a question.  I had the sleeve performed March, 2007.  I  have developed severe acid reflux and have gained 60 pounds.  I think the weight gain is due to the fact that I am so uncomfortable that I will eat something to get relief.  I have barretts esophagus and take dexilant 30 mg twice a day.  My question is, would resleeveing the original sleeve help with the acid reflux?  I was just thinking about your response above and removing the fundus and reshaping the stomach may make a difference with the reflux.  I do have a small sliding hernia that the drs say is not a problem.  

Looking forward to your response.  Thanks, Cindy 

Cindy, resleeving or reshaping  will not take care of the the reflux, it might even make it worse.  Having Barrett's puts you at a higher risk for esophageal cancer (this does not mean you will get it you are just at a higher risk)  so I would encourage you to convert to a bypass. The bypass will help you with the acid reflux and will take care of your weight. Please look into this, if medication is not  giving your relief from the reflux it will not get better on it's own. Sooner is better than later since you already have Barrett's.  

Good luck 

Thank you Dr. Aceves, what would be the best way for me to contact your office to get more information?  And, is this a risky revision, or will it be pretty routine?  

Could you please explain to me why the bypass will help or cure the reflux and would you repair the small sliding hernia? 

Thank you for your reply, Cindy 

All revisions entail more  risks than a first time surgery. In regards to the complexity of this  revision in particular  I would say that it is not the most difficult to do, there are other revisions  that are more complex than this one making them more risky. 

The bypass helps control the reflux in 2 ways. First here is no pressure on the lower part of the pouch, the union is not closed and 2nd the pouch on the gastric bypass is smaller and has less surface and produces less acid. 

The surgeon that does your revision will need to fix the hernia you have at the time of surgery.

You can reach my office through our webpage and we can provide more information. My OH profile is here below. 

Take Care,

Only a qualified surgeon can tell you if a resleeve may help. 

I cannot recommend strongly enough that you do some research on surgeons. You need to do research at sites other then this one, as only good reviews seem to stay up here, and there have been some that were anything but.

Please, if you do not mind, let me know, how you are coming along after the resleeved for a second time.. I am considering going back,  since i have regained around 45 % of lost weight in the first one. Also, the stomach pouch, has enlarde due to the fact that I can eat more than compare with first 2 years. I have the first one done 5 years ago.

Do you have a surgeon for second one? please let me know his web pages to see results

Awaiting your soonest response, and hoping everything goes fine with you.

Regards 

Pedro F