Hi Kathy,

Any updates on this thread about Dr Schuster or others in the metro Phoenix area who specialize in revision from RNY to traditional DS?

Typically they would put your stomach back together and then sleeve it (or maybe sleeve the remnant stomach and then graft it into the pouch - I would figure that techniques vary,) and undo the bypass, basically doing a total reversal of the RNY and sleeving it. Then they would do the switch part, which your surgeon seems to be doing as a second phase procedure - not a bad plan considering the length and complexity of the surgery; virgin DS's are still sometimes done in two stages in complicated cases.

I remember reading on Dr. Keshishian's site a few years ago he gave a detailed description of how he performed the procedure; look around in his backlog of blog posts to find it:

https://www.dssurgery.com/weight-loss-surgery/revisional-wei ght-loss-surgery/

https://www.dssurgery.com/?page_id=145

His revision page gives a brief description, but there was a much more detailed description in one of his blogs.

Hey, yes so in Ontario, they have changed it tonan2 part procedure Because of how long it takes.

Hey, going through the revision process and wondering if anyone's gone through it. My bypass has to be made into a sleeve first and then a few months later they complete the DS. I would love to know of anyone has gone through it.

I think that this all depends upon what your original surgeon meant by "no longer have a stomach just a pouch". A nominal RNY can be said to not have a functioning stomach, as the pouch is more of a flaccid funnel between the esophagus and intestine with a bit of restriction via the stoma to slow the food flow into the intestine, but it lacks a lot of the function of a normal stomach (hence the alternate term of a "gastric bypass". The remaining functioning stomach is left aside and sewn shut but is otherwise intact but non-functional. If that is what he meant, then you should be good to go to revise it to a DS.

If, however, he removed the entire remaining stomach, which happens occasionally, then there isn't anything left to restore the original stomach configuration to sleeve for the DS. Some other configuration may be possible, such as a distal, or long limb. RNY. Dr. K would certainly be able to tell you what is appropriate for your needs with what you currently have in you. If you have, or can get a copy of the surgical report on your original procedure, that would document exactly what was done; they are commonly available from the surgeon or hospital if done in the US, though not sure about if it was done in Mexico. That would save some scanning/probing to find out what you actually have.

Good luck, Dr. K is great to work with