What is the 'work up' for VSG to RNY revision??

on 8/20/17 2:16 pm
VSG on 06/01/14

I still have severe GERD 3 years post VSG and have regained a lot of my weight. My surgeon says that he really wants to revise to RNY to eliminate the GERD. I have fully resisted this idea for the past year but at this point i'm open to any idea that will work to get rid of the GERD and help me take the weight back off.

I already checked with my insurance and they will approve revision on a case-by-case basis but stated that if all my testing shows GERD it would very likely go through. I already called ahead and scheduled an EGD with him to get the ball rolling.

I'm wondering what is the typical work up for revision? Do you have to go back through all those months of NUT visits, psych, support groups, etc? I know it's probably insurance specific but i'm just trying to get a generalized idea. Especially since this is a medically necessary revision?

I have an appointment with the surgeon but not for almost a month and i'm just trying to think ahead because I am in the midst of a Doctorate program and classes start again next week.

I'm also going to 'try' a shake/small meal type reset starting tomorrow and see if I have any sort of luck on my own, but I can already tell that it will be VERY VERY hard because i'm eating fairly normal sized meals at this point, I can't imagine how a shake will fill me up at this point in the game.

on 8/20/17 4:59 pm
VSG on 10/14/15

Def depends on insurance. What is your insurance?

on 8/20/17 5:13 pm

I was revised last year to RNY because of severe GERD. I didn't have to go through any of the pre wls testing because it was a medical necessity . I did however; have to have several tests to prove to the insurance company that I did have GERD severe enough to require surgical intervention.

I don't remember the names of the two main tests, but I know others on this board who have had the same testing done. It seems to be pretty universal. If your insurance company requires them, and they probably will, they will let your surgeon know before authorizing the surgery. In addition to those two tests, I had a swallow with tilt table test and an upper endoscopy.

After having the revision, you won't have to worry about one shake filling you up. You won't even be able to get a full shake down for a while. You will be concerned mainly with staying hydrated. Remember, with a revision you will be going from a sleeve to a tiny pouch.

If I can be of any more help let me know. Good luck to you!


Original surgery: VSG Feb. 2009

Revised to: RNY Feb. 2016.

Height: 5'7"

Start weight: 252. Current weight: 120

on 8/22/17 3:55 pm

on 8/22/17 4:04 pm

Hello, I had VSG, about 7 yrs ago and was so happy with my loss, I have changed jobs, went through chemo, and moved in one yr. I found myself eating I have gained 70 lbs back. I feel aweful about it. I have started the revision process, I have an apt, for revision consultation, I'm scared to death, Ive never had throwing up, diarreah, and all that I do have gerd really bad, I still am limited on how much, but not what I can eat. Is anyone sorry they revised to RNY? is there a way to fix it another way? if I go on a liquid diet and start all over and get focused, I feel like My sleeve might work. any input is appreciated. thank you


on 8/22/17 4:55 pm

I'm not sorry at all that I had the revision done. It really took care of the GERD when nothing else worked. I found the revision easier to go through than when I had the original sleeve done. I've noticed that others have found it easier too.

In so far as another way to fix it, monitoring your diet, elevating your head in bed, ppi therapy and other standard treatments that are available are the only ways I know of. By the time you are looking at revision, the other methods have failed.

Going on a liquid diet, getting focused and starting all over again will more than likely not fix your GERD, but it will show you that your sleeve can and will still work.

I'm sorry you are having to go through this rough time. Severe GERD is no fun and I really get what you are going through.

When you go in for your consultation, have all your questions written down so you don't forget them. Hopefully everything will be clearer to you and you'll feel more comfortable about having the revision.

Keep in touch and let us know how you are doing!


Original surgery: VSG Feb. 2009

Revised to: RNY Feb. 2016.

Height: 5'7"

Start weight: 252. Current weight: 120

on 8/21/17 8:15 am
Revision on 05/17/17

I had the revised done may 19 2017. I'm having a very hard time losing any weight. Please help

Gwen M.
on 8/21/17 6:02 pm
VSG on 03/13/14

Are you weighing/measuring and logging everything you put into your mouth using something like MyFitnessPal?

What, exactly, are you eating each day? How much liquid are you getting?

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 41 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

on 8/22/17 1:09 pm - Alexandria, VA
RNY on 11/10/04 with
On August 22, 2017 at 1:02 AM Pacific Time, Gwen M. wrote:

Are you weighing/measuring and logging everything you put into your mouth using something like MyFitnessPal?

What, exactly, are you eating each day? How much liquid are you getting?

I had mine on the 9th of August. I have had virtually no issues, but my daily calorie average has been 500 calories. That includes at least 1 protein shake, but lots of simple soft foods like cottage cheese, tuna and canned chicken. I track all my food and liquids on Fitbit. I am down 10 pounds pre-surgery and 10 pounds post. I can see how it would be easy to snack and overeat though.


RNY 11/2004 (lost 110 pounds, gained back to 284), revision 8/2017 (down 26 pounds)

on 8/23/17 10:55 am
VSG on 05/12/14

I revised last year due to GERD. I had a barium swallow, an EGD, and a pH and manometry test. The last test determined how severe my reflux was. My revision was approved the day it was submitted.