Revision Surgery

tbsouthamboy
on 12/6/18 10:24 am

Looking for recommendations and advice on revision surgery.

chevtow41
on 12/6/18 12:37 pm, edited 12/6/18 4:39 am
DS on 11/11/14

There are very few qualified revision surgeons, RNY to DS is a VERY complicated surgery and I would 100% recommend doing lots of research, don't just assume because Dr. Joe Blow does bariatric surgery that he can handle revisions. Where are you located? If we know we can better advise you on best and closest option

Edit...just realized this wasn't in the DS board. What kind of revision are you looking for? More info is needed

tbsouthamboy
on 12/6/18 12:44 pm

Hi.. I live in New Jersey... I've just started gaining A LOT of weight now. I had my by pass in 2005. I've been doing a little research on the revision, just not sure yet.

tbsouthamboy
on 12/6/18 12:45 pm

I don't know much about the revision surgery. I hoping to get some advise

Kathy S.
on 12/6/18 3:51 pm - InTheBurbs, XX
RNY on 08/29/04 with

Hi and welcome to OH

Here is some basic information about revision/s. PM me and let me know what surgery you had before, where you are located and I would be glad to help you find a surgeon. Or you can call and or email me at 866-957-4636, [email protected]

Looking forward to hearing from you.

Kathy

Member Services

HW:330 - GW:150 - MW:118-125

RW:190 - CW:130

tbsouthamboy
on 12/7/18 12:26 pm

Thank you so much. I will definitely be in touch

califsleevin
on 12/7/18 10:07 am - CA

Effectively revising an RNY is a difficult thing; there are fairly "simple" fixes like tightening the stoma or placing a lapband around the pouch (band over bypass) that are often suggested, but neither has a particularly good success rate. Revising to a duodenal switch usually gives good results, but as chevtow indicated, it is a complex procedure that few surgeons can do. Fortunately, if that is the appropriate route, you are in a good location for it. Check into Dr, David Greenbaum in Moorestown or Dr. Mitchell Roslin in NYC as both have been doing them; there may be others in the area - check on the DS board to see if anyone else has gotten into it (there used to be only about a half dozen in US as a whole who were qualified.)

Along with looking into revisions, it is also helpful to really try to analyze why you have regained and start to correct what you can; it may be strictly a behavioral or habits thing, or there may also be some other physiological problem that is driving things, so it is good to get a handle on that before, or along with, revision considerations.

Good luck!

1st support group/seminar - 8/03 (has it been that long?)  

Wife's DS - 5/05 w Dr. Robert Rabkin   VSG on 5/9/11 by Dr. John Rabkin

 

MarinaGirl
on 12/7/18 12:12 pm
Revision with
On December 7, 2018 at 6:07 PM Pacific Time, califsleevin wrote:

Effectively revising an RNY is a difficult thing; there are fairly "simple" fixes like tightening the stoma or placing a lapband around the pouch (band over bypass) that are often suggested, but neither has a particularly good success rate. Revising to a duodenal switch usually gives good results, but as chevtow indicated, it is a complex procedure that few surgeons can do. Fortunately, if that is the appropriate route, you are in a good location for it. Check into Dr, David Greenbaum in Moorestown or Dr. Mitchell Roslin in NYC as both have been doing them; there may be others in the area - check on the DS board to see if anyone else has gotten into it (there used to be only about a half dozen in US as a whole who were qualified.)

Along with looking into revisions, it is also helpful to really try to analyze why you have regained and start to correct what you can; it may be strictly a behavioral or habits thing, or there may also be some other physiological problem that is driving things, so it is good to get a handle on that before, or along with, revision considerations.

Good luck!

Just be careful with Greenbaum and Roslin because they don't always revise to DS. They sometimes aren't comfortable with some pouches and will only do ERNY, which is not as good as DS. And some patients have unexpectedly been given the SADI (1 anastomosis), which insurance companies consider experimental, instead of getting the standard of care DS (2 anastomoses).

Do your research and make sure you're very clear with your surgeon on the type of surgery to be performed, and get it in writing.

tbsouthamboy
on 12/7/18 12:24 pm

Thank you so much. I truly appreciate your advise and will definitely do some research.

califsleevin
on 12/9/18 10:54 am - CA

I'm not as concerned with these surgeons who have the demonstrated skills to do these complex revisions, but may sometime exercise their judgement in recommending something different than what the patient originally envisioned. Sometimes a DS is not the appropriate course of action in a particular case, as desirable as that end point may be. Patients, particularly those getting revisions, can bring complicating factors into the equation that need to be considered. Perhaps the pouch as been damaged by prior revision attempts - Stomaphyx or band over bypass - that makes reconfiguring it to a sleeve inadvisable, or perhaps the remnant stomach is no longer viable for such reconstruction. This is a quite different cir****tance than the "bait but don't switch" surgeons who advertise doing the DS but don't have the skills to perform it and sell the patient on what they really do know how to do.

There was a thread on another forum a few years ago where the patient wanted their band revised to a DS, but Dr. Roslin wouldn't do it due to the amount of damage to the esophagus from the band, recommending the bypass instead in this case. It wasn't that he couldn't do a DS, but that it was his medical judgement that is wasn't the correct approach. Disappointed, the patient consulted several other of the "name brand" DS surgeons, and got the same response from them as well. Each time we go under the knife for one of these procedures, we back ourselves a little further into a corner, reducing future options, which is why one should research as extensively as possible these procedures before getting into them, and also seeking second or third opinions.

1st support group/seminar - 8/03 (has it been that long?)  

Wife's DS - 5/05 w Dr. Robert Rabkin   VSG on 5/9/11 by Dr. John Rabkin

 

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