Enlarged Stoma

Hello,

Yesterday I meet with the surgeon (Dr. Stephanie Vaimakis) who I consulted with re: revision surgery. Afteer the consultation, she ordered that I have a cat scan, upper GI and an endoscopy done. The tests revealed that my pouch is small but I have an enlarged stoma. The doctor went over the types of revisions available and the one that I would have to have done which is to revise the original RNY. She did discuss with me that it has a higher risk than the original surgery and that it would take about 3 to 4 hours. I have a tentative surgery date of 12/7 but if there is a cancellation, I will be rescheduled.

I'm very nervous at the risk factor, even though I know there is always risk involved.

Can anyone share their stories of having their original RNY revised?

I just had one done on this past Monday. I really cant comment a whole lot on the results since I am still bloated as a filled balloon. But I can tell you about the pre and early post op experience. 
I had nearly the same thing as you are facing except I had more of metabolic issue along with it. I went from 138 , my goal in my first surgery, to 235 right before my revision. My original surgery was July of 2002. About a year and a half ago I had both a upper GI and endoscopy done and they showed no problems. When my surgeon (now a different one from the one who ordered the test) did the revision there was actually a expansion of the stomach out past the stitch line. He reduced my pouch about a third of its size, putting me back to a normal pouch. He also felt that a revision overall was a better, more effective way to re lose my additional weight. So my surgery consisted of both a adjustment to the pouch as well as additionally as adjusting the length of the intestine so I have very little absorption in the entire process. I am pretty sure he did not touch the stoma itself because I have had absolutely no issues with drinking. I am not on softs yet, but can do liquid of any kind. I have spoken with him regarding this issue and he states it is because I am not on solid food yet. I am praying he is right, but it does make me nervous!. Recovery has been a breeze. I have had to take pain pills very infrequently and can, for the most part move around no problem. I try to do 4 walks a day. At least 10 to 15 minutes each. I kind of get a double workout since I also have ligament damage in my left foot that requires me to wear this huge and heavy (about 5 lbs) boot to help my foot heal. Makes for a hard walk sometimes. 

Risk- well my surgeon at least, said there was not a whole lot of risk for a eRNY which is what I had. Revising a RNY t a DS is considerably more risky, although you will see often here, way more pro DS and negative eRNY. DS is difficult and risky.My surgeon has about 18 years experience in WLS surgeries and due to the risks involved in a DS conversion he refuses to do them. What he told me was that the eRNY was much safer and the biggest risk was too much weight loss. I personally cannot even begin to imagine that being the case for me!!! There is a FB site for support for people who have had or are planning on having a distal (eRNY) revision. It is a great place to get a really good idea of how life is as a post op. Just do a search on FB for Distal revision. I discovered, that here, there seems to be (at least when I joined here about a year ago when I was considering this surgery, that there really wasn't much discussion at all nor a positive reaction to the consideration of a Distal revision. Nearly everyone supported conversion to a DS.

I will keep everyone posted as I move into the next few months, and have more experiences to share. 

My revision was done LAP, I did agree to have it converted to a open but he was able to do it by LAP. That I think is one of the biggest helps for recovery. I was up and walking about 8 hours after surgery and have walked at least three times a day, most days 4. Not really long walks but I do notice the difference in how quickly I am healing. 

Thank you for sharing, and I wish you a quick recovery!  I'm three days away from an RNY revision, and this was really encouraging to read.  I don't think there's a cute name for what I'm having... he's reducing the pouch, removing part of the remnant stomach, and reducing the stoma. He's leaving my intestines alone. I am pretty nervous about the actual surgery, but I suppose that is normal.

Thanks to the OP for posting the question.

How are you after surgery?

I just saw your post.  I had an enlarged stoma with the RNY.  I had a revision from the RNY to the DS on 7/28/15.  

I am just wondering what it is the Dr. called the surgery he did to you?  How are you doing with the recovery?

I'm healing well but still don't have endurance strength.

The last few days have been tough. I am exhausted, and up until yesterday I was still on narcotics for the pain.  Most of my pain is actually from a hiatal hernia repair he did at the same time.  I had no idea how painful that would be. 

Officially I had a "Laparoscopic Revision of Gastric Bypass with Partial Gastrectomy." Basically he just fixed what was broken rather than converting to a different procedure.  I definitely feel more restriction.  At the beginning, it was tough to just take my morning medicines without the water trying to come back up.  

I hear the RNY to DS conversion can be tough.  My doc has done a few, and some of them had to be hospitalized for several weeks.  Now he'll only do them in stages (i.e. multiple surgeries).

I saw the PA at my surgeon's office this past Wednesday and she said my carbs may be to low, and that might be contributing to my lack of energy.  I'm slowing trying to increase them, which is tough when you are limited to a liquid diet (my surgeon does 3 weeks of liquid).  I was getting about 25 carbs, 70-80 protein, and 3 grams of fat per day.  I am really hoping that increasing the carbs and the fat (she didn't ask about fat, but 3 grams can't be enough), and getting off the narcotic, I will start feeling better soon -- because as of now this really sucks.  

I hope you get your strength back soon too.  How's the pain with that procedure? 

I am sorry to hear of so much pain.  Yes, if they worked on a hernia at the same time... yes, you are dealing with almost 2 surgeries.  

I was in the hospital for 3 days an in extreme pain for the first two, only because I thought I would have a real bad reaction to Dilaudid like I did the last time I had it. So, I didn't take it and by the 3rd day, I was willing to try ANYTHING!!  Dilaudid worked and I was finally getting my pain under control.  I have been off all narcotics since 9 days out... but remember I didn't have a hernia repair at the same time.

I am still trying to learn about the DS diet.

Good luck to you and give yourself all the time you need to let your body heal.  It will help in the long run!

Many, many, MANY thanks to everyone for sharing their experiences it has been VERY helpful.  You all have helped to ease my worries about my upcoming revision. 

I'm really looking forward to fixing what is broke.  I have to tell you, being able to eat as much as everyone else is really depressing BUT not as depressing as regaining the weight.  It is really hard listening to others talk about losing weight and all you want to do is change the subject.