VSG revision to RNY

on 5/13/13 11:16 am

Hi, I posted this to the revision forum yesterday but haven't gotten any feedback. I'm hoping that someone on this forum may have a similar experience and can offer some advice/feedback. Thanks!

I had VSG almost a year ago and have been very successful regarding weight loss and hit goal at 9 months. I'm getting ready to revise to RNY due to refractory GERD. I'm constantly spitting acid out and have significant pain all the time from it. I've gone for multiple opinions and the opinions are all the same. Can anyone that's undergone this type of revision give me any feedback on recovery and pain levels? Also, how different is your diet vs. with VSG? I eat protein first then try to fit in a couple of veggies if I have room. I appreciate any feedback!




on 5/13/13 12:45 pm - MI


I was in your situation and had to have my VSG converted to a RNY due to serious GERD.  The good news is you will get another window in which to speed up your weight loss, particularly if you are not at goal.  You will have to start over just like with the sleeve with clears, then full liquids etc.  Functionally, there are not too many differences in terms of what and how you can eat.  My husband also had the sleeve and we eat very similarly.  The exceptions are just a few things like chicken breast and other dense meats which I have trouble swallowing.

The bad news is you become more prone to ulcers.  I am guessing you are already on a PPI and Carafate.  Given how prone you are to acid, you may want to consider asking your doctor to keep you on them for several months proactively.  I have had severe problems with ulcers but the doctors tell me I am one in a million.  I just had to have my rement stomach totally removed and my vagus nerves cut to prevent further ulcers.  That is VERY unlikely to happen to you but anything you can take to reduce your odds is a good thing.  Of course you will have to be very careful about no nsaids or smoking.

The surgery itself was a little harder than the sleeve for me but I went into it very malnourished (I had been living on iv nutrition which is just not as good as food). I also developed a big hematoma from the drain. I did not have a drain for the sleeve.  The incisions did not hurt as much because I was thinner so they had to cut through less tissue.

Figure 3 weeks off of work.  Most of the same post surgery advice is the same....drink and walk as much as possible.

I was totally freaked out at having the RNY because of the malabsorbtion and the fear of dumping.  I was very reassured by the statistcs that only about 30% of those with RNYs actually dump. I do not dump unless I consume far more carbs than I have any business eating.  I have to take a few extra vitamins than I did with the sleeve.  I need 4000 mg of Vitamin D daily and prescription iron twice a day along with a sublingual Vitamin B.   

Really, the RNY is not so bad.  Getting rid of the awful reflux will make you feel better and the jump start in weight loss is a really nice bonus.  I am sure you will do fine.  One gastro I consulted said he is seeing more and more sleeves converted to RNY because of reflux.  Hopefully this is something which surgeons will do a better job screening for in the future. 


Good luck with everything!






Jennifer ER   VSG 6/29/11  RNY 10/26/11   

on 5/13/13 4:19 pm
I had originally scheduled VSG, but my surgeon suddenly decided not to do any more sleeves or bands because of all the reflux problems people are having. So you are definitely not alone. I'm scheduled for RNY now --- with some reservations --- but WLS is not optional for me.

Angie in Missouri US

Allen Y.
on 5/13/13 7:57 pm - Garland, TX

I didn't have a VSG, I had the older VBG.  I did revise to RNY because I had learned to eat around the VBG and gain all my weight back.  The RNY is in fact much more comfortable than the VBG was. Much closer to feeling like you didn't have surgery at all. You just get punished for eating too fast, not chewing well or eating too much.

Overall I would say the RNY has been a real blessing for me.



Diana M.
on 5/13/13 11:33 pm - TX
VSG on 07/12/12

I had to be revised from VSG to RNY a little over a month ago because of reflux.  I had actually started aspirating, so it was done on an emergency basis.

Because of the weight I had lost already, the surgery was actually easier to recover from.  I had my doctor keep me in the hospital on heavy pain meds a couple of extra days, just as a precaution, because I am one of those that experienced complications after my VSG.  I figured it was better safe than sorry.

My diet progression was faster with the RNY than it was with the VSG, and there have been a couple of "different" things to get used to.  For example - Since you'll no longer create enough stomach acid to break down your food, if you don't chew enough, your body creates ridiculous amount of mucous to slide food through to your intestine...and frequently, you'll throw it up.  I believe most people call this the foamies.  It's totally disgusting, and you'll only have to do it once to learn your lesson.

I lost a ridiculous amount of weight in the first month, which has been nice.  

Just remember the same rules from your VSG - walk and sip, when you get to foods you can chew - chew lots and lots, same no eating/drinking at the same time rules, protein first always and forever.  Then add in the extra vitamins, and no NSAIDs.  You should be good to go.

Honestly, if I had to do it all over again, even knowing that I would have to have the revision, I'd do the VSG again, then revise to the RNY.  We have the advantage of having had most of our stomachs removed first, and losing most of the ghrelin manufactories in our body, so not only do we have the RNY and the advantages that come with it, we still have the extra advantage that came with the VSG.  It's like double stacking the deck in your favor.

Good luck!

on 5/14/13 7:37 am

Thanks so much to everyone that replied!! I'm nervous but feeling better knowing that others have successfully gone through this. Fingers crossed that everything works out.

on 7/21/13 6:15 am
RNY on 08/13/13 with

Can you update us on your progress?  I am having the same revision from vsg to rny because of reflux and I am hoping to achieve my weight loss goals, as it has come to a stop w/ the sleeve.  What has your weight loss progress been like thus far, since your revision? :) 

on 7/21/13 8:03 am



I'll be having my revision in August as I wanted to try some other medical management combinations first. One of the reasons I happen to be nervous abut the revision is I hit my weight loss goals with the sleeve and now have a normal BMI. Thus I am worried about losing too much but I have been to 3 different surgeons at Centers of Excellence and they all have the same feedback.....I need the revision and while I will lose more weight, my body will most likely bottom out and then rebound a bit. I will keep you posted after the surgery. Do you have a date for yourself yet?