Question:
Long Limb gastric bypass revision

Vertical banded gastroplasty in 1985. Revised to gastric bypass with six ft bypassed in July of 2000. No positive results! Now my surgeon wants to revise me to a long limb gastric bypass. He says he can bypass down to within 3 ft. He says this is a very good option for people like me. Of coure he said and I already know that vitamin intake and protien supplements are an absolute critical thing at this point. Has anyone here had any expierience with this surgery or know of anyone who has to go extremely distal like this? Was it as invasive a surgery as the original gastric bypass? How long was the surgery? How has the wieght loss been since for you or this person? I need to know as much information as I can to be knowledgeable about the long limb gastric bypass revision. I am hesitant in that after my gastric bypass I was put back in the hospital with a pulminary embolis which was a total surprise to me because my surgeon inserted a greenfield filter which should have prevented this. It was a scarry thing and one that I don't need to happen again. I have been thru alot already but want to finally have some success. My surgeon is highly recommended and practices out of a very reputable medical college and university. I need lots of support and advice from anyone who could help me. Thanks so much.    — Sarah B. (posted on September 28, 2003)

September 28, 2003
Your profile says your surgeon doesnt transect. That makes me concerned. I suggest you get a second opinion from a surgeon who specializes in revisions like my surgeon Dr Philip schauer<P> Was the lack of loss understood? Refer you to a nutrotnist? Keep a food diary? How about exercise? I certinally hope your surgeon covers these before operating more. A dedicated grazer can out eat the surgery. I am not suggesting you did this but it should be reviewed.
   — bob-haller

September 28, 2003
I live with 40" of common channel, have for 9 years. What are your specific questions? I cannot address your own personal medical issues, of course. But I can descibre life with a distal.
   — vitalady

September 28, 2003
I am not a truly distal RNY but I have read about some and these are the cautions I can pass along. Protein supplements will become a life-long thing as it is impossible for an RNY with a tiny pouch to get in enough food alone to keep themselves healthy. Because you are malabsorbing so much and can only eat very small quantity it can be dangerous. Getting in your vitamins etc. will be even more critical. I would also be very concerned about developing osteoporosis as there is very little small intestine left to do any absorption. To me this is a very scary afterlife. There are very few in the world that are bypassed this long with an RNY. Personally I would look into a revision to a DS as at least that surgery is designed to function with a long bypass or short common channel - depending on how you want to look at it. While you may not end up with a functioning pyloric valve it still would be better to have a 3-4 ounce stomach which can break down things and help the stuff to be absorbed in that small section of common channel. <p>I'm with Bob. You need to be sure there isn't some failure in the anatomy of your existing surgery, especially if you are not transected. You do not indicate if you are eating large portions of food, which would make me think staple line disruption. When you say no results what does that mean? Not good results or literally you haven't lost anything? I sure wouldget a 2nd opinion. Just because this surgeon is great etc. doesn't mean he did great with your surgery. A 2nd opinion would not hurt. I sure would rather go in and have my stomach transected if that's possible than a short common channel with an RNY. If you haven't lost much weight from either surgery then I would try and figure out what it is because it would be horrible to go through another surgery and end up with the same result, especially with your high risk for clots now. Please do a lot of reading, consulting with doctors and thinking before jumping into this procedure.
   — zoedogcbr

September 29, 2003
You might also want to check out the Yahoo group for those seeking revisions: http://groups.yahoo.com/group/ossg-revision . I wish you the best.
   — Kay B.

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