Need info on banding over old JIB bypass

Hi, I had the intestinal bypass, (my stomach not touched in any way) and understand I am one of the few who have survived. My Doctor was Dr. DiNella in Muscle Shoals and he did something which he referred to as a "modified bypass". This is probably why I have had as few complications as I have. My primary complication has been bypass arthritis but I have some control over that. I have regained 3/4 of my weight. I am considering getting a band. 3 Mexican doctors have offered to do it, stating it will be perfectly safe. My local banding group will not even return my phone calls. I am searching on all boards for someone who had the intestinal bypass (not RNY or VGB) and have added or are considering adding the band. If you know of anyone, or if you know anything about this issue, please reply.

I also had the old JIB back in 1981. I also had the "modified bypass". It was invented by my surgeon, Dr. Howard Dorton. He also fashioned a "reflux valve" in my intestines that he had gone to Italy to learn how to do. I also am thankful to be a survivor. I suffered many complications thru the years, the worst being the arthritis which left me disabled. It is actually called "Blind Loop Syndrome". Hardly anything helps it. I was on several arthritis meds and also 800mg. Motrin four times a day for years and got very little relief. We know now that is was because I was not absorbing much of it. I had a really strange case. I would be fine, then break out in a red rash and within three or four hours be totally parilyzed for about twenty four hours or at least couldn't walk or lift my arms to feed myself. Still, I fought with my doctors that wanted me to have a takedown. it all came to a head in 2002 when the "reflux valve' caused a major blockage that was only partial for three years, so went undiagnosed until 2002. I had an emergwency takedown and removal of the blockage to save my life. the surgeon who did it had turned me down for a reversal a year before because it was so serious and he had not seen any printed material that it would help the blind loop syndrome. Anyway, he does not do bariatric surgery and didn't think I would gain any weight back. Within six months, I had gained 85 poubnds so he referred me to a bariatric surgeon. I then had RNY. I did not know anything about the band, but would not have chosen it anyway from what all my research was showing. If you want to talk further, you can send me an email. I will be glad to talk with you. Oh, and don't count on being able to have it done laproscopically.

Placing the band is in general very safe. Banding over the JIB bypass to my knowledge is neither recommended and is not described. The American Society of Bariatric Surgery recommends that all JIB bypasses be converted (not adapted) to one of the other standard operations i.e. RNY, VBG although VBG is now falling out of favor when compared to primary(first time) banding for morbid obesity. Due to the long term complications of severe arthritis and possibility of liver failure. You are also venturing into territory where there is little information. I cannot make recommendations over the internet but I would be happy to discuss the issues with you if you wish. Be careful. Sincerely, Dr. Selwyn 513-558-4787.

I don't think you will find any information to my knowledge. The ASBS recommends that when a bariatric surgeon finds someone that has a JIB that they be converted to a standard operation such as a RNY or a VBG. The VBG is falling out of favor due to the introduction of the band. The band in general is very safe but "adapting" a previous JIB with the band is still unproven/unknown. I would be concerned banding a JIB because of the severe malabsorption caused by JIB and I don't think anyone can tell you what a restrictive procedure will do to your nutitional status. As you probably already know servere limiting arthritis is a side of effect of the JIB. The recommendations for reversal vs conversion (not adaption as you are questioning) came about due to the incidence of liver failure noted in the JIB group. If you wish I would be willing to discuss the issues with you. Good luck and be careful. Sincerely, Dr. Selwyn UC Center for Surgical Weight Loss 513-558-4787

Sorry about the repeat post. I wasn't sure that it went through. I also wanted to add that I do revisions laparoscopically, so don't count laparoscopic surgery out if your surgeon has the necessary intensive training (full fellowship). Sincerely, Dr. Selwyn UC Center for Surgical Weight Loss [email protected]

Hi dr. Selwyn!!!!!!!!! No disrespect intended but I would like to ask you if you are familiar with the old JIB and exactly what it entails? I ask because some of the newer, younger doctors don't really know much about the JIb. It would be extremely difficult for even the most experienced surgeon to do a takedown or revision laproscopically. I am not a doctor (nor do I play one of T.V.) I am just a JIB "survivor". If you are familiar with it, then you know why I am a survivor. yep!!!!! I am fortunate enough to be in that fifteen percent still alive today (unless they had a reversal). I only had my reversal in 2002 and felt very fortunate to be alive that long. Had my takedown as emergency surgery a few months after some of the best surgeons in this state refused to do it because it is such a major undertaking. Needless to say, the most experienced of the bunch ended up doing it as part of an emergency bowel obstruction surgery. Again, no disrespect intended but your words that this might be possible as a lap just jumped out at me and I wanted your thoughts. thanks

I am. I realize that one, persons with this surgery not only have a great deal of adhesions to deal with but two, also have a long defunctionalized limb that is atrophic (shrunken). No surgeon looks forward to dealing with the JIB patient because the limb is sometimes very small and very difficult to put back together with normal size bowel. So again, yes I am familiar with this surgery and no disrespect taken. I am used to the shock that patients have as to what can be done laparoscopically. I never said it would be easy, but with the newer technology and even with robotic assistance much more is possible than we thought just a few years ago. Sincerely, Dr. Selwyn UC Center for Surgical Weight Loss [email protected]