Revision -- Where to Begin?
I had Lap RNY in 2005 and lost just over 100 pounds. I've regained about 40 and don't want it to go any further, so I'm considering revision. I've done a little research, but am finding it's difficult to even decide what might work for me. Some people hate the band, some love it. Some believe that DS is the way to go and some have done the Stomaphyx. I can't even figure out where to start. I've had a brief discussion with my doctor, but nothing detailed...sorta just "I'm interested".
If it matters, I have confirmed that my pouch has stretched to three times post-surgery size. Any and all (non-judgemental, please) comments are welcome. Thank you!!
If it matters, I have confirmed that my pouch has stretched to three times post-surgery size. Any and all (non-judgemental, please) comments are welcome. Thank you!!
Hi Dawn,
I just came back to this site recently but good thing you are taking the pro-active approach about the matters. I don't know much about the Stomaphyx but many on the board say it is a waste of time and money. I am pursuing DS myself and you will find there are only a few surgeons in the US that do revisions. After someone mentioned it on the board I did some research and thought this is the best for me. Are there doctors in your area that do revisions and what are they suggesting. Ultimately it is up to you and I don't think anyone is going to judge you. That is not what this website is about.
I just came back to this site recently but good thing you are taking the pro-active approach about the matters. I don't know much about the Stomaphyx but many on the board say it is a waste of time and money. I am pursuing DS myself and you will find there are only a few surgeons in the US that do revisions. After someone mentioned it on the board I did some research and thought this is the best for me. Are there doctors in your area that do revisions and what are they suggesting. Ultimately it is up to you and I don't think anyone is going to judge you. That is not what this website is about.
Are you still morbidly obese? You may find it hard to get insurance to pay if you are not.
As far as the stomach stretching, that is to be expected. What you need to check is if your stoma has stretched. If that is the case then food just goes right into your intestines leaving you hungry. You need to be scoped to find out. If you have mechanical failure for many insurance companies that is enough. Also make sure you insurance doesn't have a one WLS per lifetime clause.
I wouldn't waste my time on the Stomaphyx. Never heard of anyone having success with it. I have seen a few do well with the BOB (band over bypass) that that is pretty rare, too. You really are limited in your choices. Either a redo of your pouch (if there is mechanical failure) or a DS. As was said, it is very hard to find a surgeon that is qualified to do that revision but it would give you your best shot at losing weight and keeping it off.
As far as the stomach stretching, that is to be expected. What you need to check is if your stoma has stretched. If that is the case then food just goes right into your intestines leaving you hungry. You need to be scoped to find out. If you have mechanical failure for many insurance companies that is enough. Also make sure you insurance doesn't have a one WLS per lifetime clause.
I wouldn't waste my time on the Stomaphyx. Never heard of anyone having success with it. I have seen a few do well with the BOB (band over bypass) that that is pretty rare, too. You really are limited in your choices. Either a redo of your pouch (if there is mechanical failure) or a DS. As was said, it is very hard to find a surgeon that is qualified to do that revision but it would give you your best shot at losing weight and keeping it off.
WLS 10/28/2002 Revision 7/23/2010
High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.
I am no longer morbidly obese -- a great blessing. I have had a UGI that tested the size of my stoma and pouch. The stoma is still small, just the pouch has expanded. I understand that it would stretch, but three times the post-surg size?! I'm very angry that this has happened and that my stomach is as large as it is at this point. But I guess I'll have to deal with the anger and move past it somehow. I read very bad things about the band as a form of revision and have also seen where the Stomaphyx just isn't a longterm solution. The DS seems like it could be a good option, however, it seems like a more serious surgery than the RNY, so I don't think I'm up for that...nor would my doctor recommend it, I believe.
Not sure what to think at this point...maybe throw myself into support groups? Find a good nutritionist?? Not sure.
Not sure what to think at this point...maybe throw myself into support groups? Find a good nutritionist?? Not sure.
I understand how you feel. After my first surgery, whi*****luded a sleeve, I read my operative report and found that the surgeon only removed about 50% of my stomach. Not nearly enough and I know that I could very soon eat as much as I could before surgery. One of the many reasons I believe I failed with my first surgery.
However, with the RNY the pouch starts out very small. Mine was made 30cc, which I was told is about an ounce. You cannot live with a one ounce pouch so it needs to expand. I heard that a mature pouch is about 8 oz, which would be 8 times the original size, so I don't think it is a recipe for disaster. Considering most people's stomachs are the size of a two liter bottle it is still much smaller then it was.
Do you know how big your pouch is currently?
You are lucky your stoma is still small. That is the biggest problem. Stomaphyx wouldn't help you anyway because it is supposed to make the stoma smaller, not the pouch, not that is works anyway.
Even if you had a DS your stomach would still be pretty large. The DS stomach usually starts out at around 4 oz from what I understand and of course it will expand over time, too.
If your stoma is small and your pouch pretty intact you can still use your tool. It won't work if you eat all the time or a lot of carbs or you keep pushing the limits of your pouch you will still gain weight. With a small stoma you can still be satisfied with a smaller amount of food, probably less then you think.
Have you tried measuring out your food and seeing if you are satisfied with a smaller amount?
Do you drink with your meals? That will cause you to be able to eat more, too. Drinking a lot of fluids and protein shakes will help reduce your appetite, too.
If you are having problems with food addiction then a counselor may help, or OA. If you just need help knowing how to eat then a nutritionist is the way to go.
If you still want a revision then you may have to pay for it because I don't see insurance paying for one.
The DS may be a good choice because it does allow you to eat more food and is more forgiving of imperfect eating, although no surgery will help if you eat a lot of simple carbs since those are absorbed 100% no matter which surgery you have.
However, with the RNY the pouch starts out very small. Mine was made 30cc, which I was told is about an ounce. You cannot live with a one ounce pouch so it needs to expand. I heard that a mature pouch is about 8 oz, which would be 8 times the original size, so I don't think it is a recipe for disaster. Considering most people's stomachs are the size of a two liter bottle it is still much smaller then it was.
Do you know how big your pouch is currently?
You are lucky your stoma is still small. That is the biggest problem. Stomaphyx wouldn't help you anyway because it is supposed to make the stoma smaller, not the pouch, not that is works anyway.
Even if you had a DS your stomach would still be pretty large. The DS stomach usually starts out at around 4 oz from what I understand and of course it will expand over time, too.
If your stoma is small and your pouch pretty intact you can still use your tool. It won't work if you eat all the time or a lot of carbs or you keep pushing the limits of your pouch you will still gain weight. With a small stoma you can still be satisfied with a smaller amount of food, probably less then you think.
Have you tried measuring out your food and seeing if you are satisfied with a smaller amount?
Do you drink with your meals? That will cause you to be able to eat more, too. Drinking a lot of fluids and protein shakes will help reduce your appetite, too.
If you are having problems with food addiction then a counselor may help, or OA. If you just need help knowing how to eat then a nutritionist is the way to go.
If you still want a revision then you may have to pay for it because I don't see insurance paying for one.
The DS may be a good choice because it does allow you to eat more food and is more forgiving of imperfect eating, although no surgery will help if you eat a lot of simple carbs since those are absorbed 100% no matter which surgery you have.
WLS 10/28/2002 Revision 7/23/2010
High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.
Lady,
I just received my op report and reading it. Where do I look for how much of my stomach was removed? Not to take over OPs posting but I am still considered morbidly obese. My initial doctor told me bc I was big boned I should never expect to get down to a "normal" weight but I now I think I take exception to that bc is there really such a thing as "big boned". But back to op report. I see where it says pouch measured 15 cc in capacity and a total of 60 cc were instilled after dilating the puch to maximal stretch but noting about how much stomach was taken away.
I just received my op report and reading it. Where do I look for how much of my stomach was removed? Not to take over OPs posting but I am still considered morbidly obese. My initial doctor told me bc I was big boned I should never expect to get down to a "normal" weight but I now I think I take exception to that bc is there really such a thing as "big boned". But back to op report. I see where it says pouch measured 15 cc in capacity and a total of 60 cc were instilled after dilating the puch to maximal stretch but noting about how much stomach was taken away.
They do the sleeve differently then they did in 2002. Now they use a bougie.
They shouldn't have removed anything if you had a RNY. They just section off the pouch but the remnant stomach is still there.
If your pouch measured 15cc in capacity that seems pretty small. Mine was made 30cc and I was told it was about an ounce so if yours started out at 15cc that is 1/2 an ounce, however I don't know how they measure it ultimately, meaning is it measured after dilating the pouch or before? Do they make all pouches 15cc and then dilate them to their maximal stretch? In any case even if it were 60cc that is still around 2 ounces, plenty small.
Have you been scoped to see what it is currently? Usually when there are mechanical failure it is more likely the stoma has stretched then the pouch.
They shouldn't have removed anything if you had a RNY. They just section off the pouch but the remnant stomach is still there.
If your pouch measured 15cc in capacity that seems pretty small. Mine was made 30cc and I was told it was about an ounce so if yours started out at 15cc that is 1/2 an ounce, however I don't know how they measure it ultimately, meaning is it measured after dilating the pouch or before? Do they make all pouches 15cc and then dilate them to their maximal stretch? In any case even if it were 60cc that is still around 2 ounces, plenty small.
Have you been scoped to see what it is currently? Usually when there are mechanical failure it is more likely the stoma has stretched then the pouch.
WLS 10/28/2002 Revision 7/23/2010
High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.
Ohh you had the sleeve. Sorry thought you had RNY as well. Nope haven't had a scope done but my consult is on 10/20 and I know I have to have an upper GI done. I actually had one of those doen a few years ago bc I was anemic even though I was taking my pills and they said due to my bypass my body wasn't absorbing my iron pills but that was about 4-5 yrs ago. I don't know how they do the RNYs now but yeah back in 2004 thats what my op report reads if I am reading it correctly. I know I cant eat without stopping and not be in any type of pain at all. While probably 2 yrs ago I couldn't eat a whole happy meal.
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