Revision Question Roux En Y

Jessica M.
on 11/2/19 5:06 pm - Midlothian, TX

I had gastric bypass (Roux en Y) in 2007. I want to have a revision but not sure what options are available. Can they redo my original gastric bypass?

"Winning at a Losing Game"

hollykim
on 11/8/19 10:14 am - Nashville, TN
Revision on 03/18/15 with
On November 3, 2019 at 12:06 AM Pacific Time, Jessica M. wrote:

I had gastric bypass (Roux en Y) in 2007. I want to have a revision but not sure what options are available. Can they redo my original gastric bypass?

no, they can tighten the stoma if it is stretched but that is about all.

The ppl we have seen here who have that does usually lose about 20# max and then loss stops.

Why are you wanting a revision?

often going back to basics helps restart weight loss along with not drinking and eating, high protein low carb diet and logging your intake every day helps.

 


          

 

Leiteb
on 11/10/19 5:17 pm

The previous comment is not true. I just had a consult and they can do a formal surgical revision. Risks are anywhere from 18-40% for a complication, so it is risky, but can be done if anatomy is favorable. They can do a Tore surgery, which is a tissue stitch surgery which narrows the stoma if that is what is stretched. This may only last a few years, as it is not standardized yet and has room for improvement. There is also the option to do a band over bypass which narrows the stoma and pouch size. This is a pushed a lot because it is a familiar procedure to many in the bariatric community and is lower risk. You can also look into pouch reset diets, seek counseling or other dietary aids. Whatever you do, make sure you are dealing with certainty of your options as discussed with your surgeon, before weighing things too much.

Sparklekitty, Science-Loving Derby Hag
on 11/12/19 12:19 pm
RNY on 08/05/19
On November 11, 2019 at 1:17 AM Pacific Time, Leiteb wrote:

The previous comment is not true. I just had a consult and they can do a formal surgical revision. Risks are anywhere from 18-40% for a complication, so it is risky, but can be done if anatomy is favorable. They can do a Tore surgery, which is a tissue stitch surgery which narrows the stoma if that is what is stretched. This may only last a few years, as it is not standardized yet and has room for improvement. There is also the option to do a band over bypass which narrows the stoma and pouch size. This is a pushed a lot because it is a familiar procedure to many in the bariatric community and is lower risk. You can also look into pouch reset diets, seek counseling or other dietary aids. Whatever you do, make sure you are dealing with certainty of your options as discussed with your surgeon, before weighing things too much.

"Band over bypass" is a terrible option. Bands have a miserable track record in terms of scarring, adhesions, and other complications. Many surgeons will not place lap-bands at all because of the risks.

The "pouch reset" is complete bunk. Going back to liquids will not shrink a pouch that has stretched; it's just another fad diet. You're much better off going back to basics and eating a limited amount of lean, dense protein.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

rocky513
on 11/13/19 3:26 pm, edited 11/13/19 7:27 am - WI

There is no way to actually redo your original RNY surgery because there is only so much stomach that can be used to create a pouch, and the stomach has already been resected. They can convert to a distal RNY (longer channel) from proximal RNY which is a terrrible option because of the side effects of severe vitamin malabsorption, chronic diarrhea, and foul smelling stool and gas. You can revise to DS, but it is a very complicated surgery with very few qualified surgeons that can perform it in the U.S.

Pouches do not stretch out. They are created from a section of stomach that has very little pliability. Stomas are what stretch, usually from overeating and drinking with meals. What happens is the stoma stretches to about the same size as the pouch and food flows freely into the intestines, which means you feel no restriction and you never feel satisfied. They can try to stitch the stoma to make it smaller, but those procedures usually fail.

HW 270 SW 236 GW 160 CW 145 (15 pounds below goal!)

VBG Aug. 7, 1986, Revised to RNY Nov. 18, 2010

(deactivated member)
on 11/27/19 4:33 am

My ex husband had a distal RNY going back ten years . Though he was a world class ass .. he never farted in my presence ... there was zero social complications from his distal ( or any other ) ... actually the a- hole was pretty much healthy as a horse despite ( what I would call ) deplorable eating habits : restaurant meals twice a day .... " low-fat snax like cookies all the time ... no excercise whatsoever .Even his type 2 diabetes remained under control ... despite his lifestyle issues.

MarinaGirl
on 12/14/19 1:58 pm, edited 12/14/19 6:00 am

There are very few surgeons in the US capable of doing successful RNY revisions so if you are really serious about one, you may need to travel out-of-state for surgery. I recommend you contact Dr Ara Keshishian in Pasadena, CA (suburb of Los Angeles) for a virtual consult to hear what he has to say about your situation. Even if you do not go with him, he can provide great info to aid in your decision making. Deciding to have revisional surgery is a big deal so it is imperative you choose a procedure and surgeon that will actually address your weight loss/anatomy issues for the long term. I had complicated abdominal surgery with Dr K in 2018 and could not be happier with my care and follow up. I was an out-of-state patient too.

DS80
on 12/30/19 2:14 am, edited 12/29/19 6:47 pm

I just had my revision on the 19th. I had RNY in 2005. The procedure is called "Partial Gastrectomy with Gastrojejunostomy".

They would need to perform a EGD to find any complications. I had many frequent nausea and horrible dumping. They confirmed dumping and found a hiatal hernia. I also gained the weight back. Also my stomach was very large compared to RNY surgeries today. The surgeon said the Roux-en-y was still in its early stages so many surgeons made the pouch much larger then. They are seeing many early RNY patients are needing revision.

You can revise a Roux-en-y Gastric Bypass. You need to do your research and weigh the options. The distal approach is a bad choice I recommend a YouTuber "Experiencing Nirvana" She had a Distal and I a few years back I emailed her and she has had pretty harsh effects. Also watch another YouTuber "Dear Bria" Cambria Harris has inspired me from day 1 through my revision journey. She had the Sleeve Gastrectomy nonetheless her story is so personal and will inspire you.

Now, the best option for me was the Partial Gastrectomy with Gastrojejunostomy. I was in more pain than the first procedure but it's worth it. I have already lost 30lbs. Listen to your heart and do what's necessary to get your life back on track.

My surgeon was Dr. Harvinderpal Singh in Tomball, Tx. Also Dr. Matthew St. Laurent also in Tomball, Tx does this type of revision but you would need to have complications with the first procedure.

I want to stress that a revision to a Roux-En-Y Gastric Bypass holds a much higher complication rate. Do your research.

Many Blessings,

Diana

bmbutler2
on 12/31/19 9:25 am

Thank you for your response and especially the YouTube video suggestions. I am just beginning my journey after RNY in 2007. Kept the weight off for 6.5 years and then had back surgery......

DS80
on 12/31/19 10:04 am, edited 12/31/19 2:06 am

Your very welcome. Whatever you do just do not give up. I was going to have my revision to a Distal in California 2 years ago and decided it would not be right for me. I felt so compelled to respond to this because I could never find anything about revision to a RNY other than to convert to a DS or Distal. Well the only way a surgeon would even consider converting a RNY to DS is if your BMI after RNY is over 50. It's a two step process. Much, much more complicated.

The Partial Gastrectomy with Gastrojejunostomy is when they remove the lower portion of stomach or pouch kind of like the Sleeve Gastrectomy only instead of making it banana shaped it's more like a little ball. Your remnant stomach is still there (The part of the stomach cut from pouch that remains in RNY'ers) So basically it's pure restriction. After my surgery RNY in 2005 I had 2 kids gained everything back and some. Got up to 230. I could eat like a normal person without surgery. A whole footlong subway sandwich. That is not normal. If you can eat that way then your pouch was probably made much larger. Also the suchers they were using back then were different. Today they use a stapler that provides better healing and is just better as far as success long term.

One thing I will say is your initial procedure is still working because without it we would have all probably been much larger. Although many gain back it is not as much as you would have without it because of malabsorption.

Oh and when I was in California and started my revision journey I was super sick with nausea and vomiting the surgeon did a barium swallow and found nothing wrong! I was like this is not right. I knew something was wrong. He still wanted to do a Distal. I would have had to do a diet for 6 months in order to get an approval from insurance.

When I came to Texas and seen the surgeon here he was very concerned and set me up for an EGD. That's when he found all my issues hiatal hernia, dumping and he said my pouch was 4 times the size RNY Gastric Bypass pouches are today and no one who's pouch that is created that large will have long term success. The revision was approved the next day because of his findings. So if you feel something is not right don't stop until you find answers. The Bariatric surgeons out here in Texas got it together and know what they are doing.

Good Luck!!!

I'm here if you have any more questions.

Smiles,

Diana

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