Please help

[Joyouslyme]

Hello everyone,

My surgeon is requesting my band removal and revision to DS w/o sleeve. I got info from others and don't want that. The band screwed up my esophagus and I will not get RNY. How should I word my request to my surgeon to include a larger sleeve?

Thanks!

 

[chevtow]

I'm confused. Your surgeon wants a DS without a sleeve? Is that a DS at that point?

 

[DianaCox]

Who is your surgeon?

If you are having such problems, I would consider going to one of the best revision surgeons and at LEAST getting a second opinion.

 

[southernlady]

Sounds like you need a different surgeon.

 

[Joyouslyme]

Dr. Prachand. His concern is the sleeve when I'm having esophageal issues. Can't I ask for a larger sleeve opening or something to that effect?

 

[DSRIGGS]

Dr. Prachand. His concern is the sleeve when I'm having esophageal issues. Can't I ask for a larger sleeve opening or something to that effect?

I don't understand what exactly you are saying? Are you saying that he think the sleeve will cause reflux do the geometry of the sleeve and that will cause more esophageal issues?

Prachand trained my original DS Surgeon in Peoria on the DS (Dr Marshall who frankly messed me up). Marshall was concerned with reflux for me as well and I told him I would have nothing but a DS. I had the DS.

Fast forward nearly two years after my DS with Marshal when I was taking 400,000 IU of creon a day to keep slightly below range on my nutritional lab values...FYI - 400K IU of CREON Is a shit ton. Marshall kept putting things off so at that point I knew it was time to fly to LA and have Dr K (one of the worlds top, if not top, Revision Surgeon) extend my CC & AL limbs.

I suggest you get on the horn to Dr Keshishian in Glendale, CA His contact information is on his site dssurgery.com or Dr Rabkin in the bay area. They are the two best in the world. They can give you a great second opinion and if Prachand won't do the DS revision , these guys will do it if it can be done.....they revise band to DS all the time.

You already said you aren't getting an RnY, which is very smart because you wouldn't be happy, so if Prachand won't do a sleeve then you won't be getting a DS from him.....so you need to talk to the people who will do it right and won't play games. Prachand like Marshall is a good cutter but their mindset on the DS is puzzling to me.

Please consult with Dr K or Dr R as you will get the straight scoop and will know your options.

Good luck

 

[Joyouslyme]

Yes. That's exactly what he said. I've been reading so much lately, but I believe that there's anot her version of the sleeve that wouldn't cause esophageal issues. Can you consult over the phone with those guys?

 

[DSRIGGS]

Yes. That's exactly what he said. I've been reading so much lately, but I believe that there's anot her version of the sleeve that wouldn't cause esophageal issues. Can you consult over the phone with those guys?

Absolutely. I sent Dr K an email on Saturday morning about 7 am my time and he didn't know me from Adam, and he called me back in ten minutes and talked to me for 45 minutes. That was actually about my son who had severe gastroparesis that Dr K fixed.

Email his office and they will set up a call, Skype or whatever works. I guarantee you that you have never met a surgeon who is more interested in your well being, attentive to your needs, and is so approachable. Since May I have talked to Dr K over the phone and traded emails countless times... Not to mention my sons surgery in May and mine in August. I feel so very lucky to have found him.

He will want to your imaging and such but will give you the straight scoop
And for a point of reference he has done over 2,000 ds surgeries and 500 revisions.... The man is the best and will give you what you need to know.

 

[Joyouslyme]

Thanks! I sent him an email.

 

[Larra]

A DS without a sleeve is not a DS, as I'm sure Dr. Prachand knows, since he does do the DS. He is probably meaning he would do an ERNY to give you more malaborption. As you may have seen in recent posts to others here, that is not a DS and has potential problems with a combination of increased malabsorption without the benefit of use of the pyloric valve.
I do understand his concern about (I presume) GERD, given that your band has damaged your esophagus. One of the few, maybe the only, advantage gastric bypass has is that it's the most effective bariatric surgery for fixing GERD. However, the sleeve of the DS can, to some extent, be customized by making it not too narrow. Surgeons doing the sleeve as a stand alone tend to make very narrow sleeves because if they don't, weight regain is almost guaranteed. But with a DS that is less of a concern, and a wider sleeve can be made for you.
I think Dr. K will give you a very different response than what you've had thus far. He tends to make larger sleeves in general and I will be very surprised if he doesn't think he can customize a sleeve that will work for you. Let us know as soon as you hear anything.

 

[DSRIGGS]

Thanks! I sent him an email.

Good deal. Sylve or Kristina on his staff will probably get back to you especially if Dr K is in surgery today. They will probably want your imaging and records for Dr K's review.

Don't be surprised if Dr Prachand gets his ego bruised but you want this done right and I just don't think he does many revisions (could be wrong) so you are wise to seek a second opinion. You definitely want the DS and not an RnY and there are many Band to DS folks on this board, so it should be able to be done.

Btw if you dig around on Dr K's site I bet he has a video of band removal and maybe even sleeve creation. He does all kinds of blogs and such so there is S ton of information on his site

 

[DSRIGGS]

A DS without a sleeve is not a DS, as I'm sure Dr. Prachand knows, since he does do the DS. He is probably meaning he would do an ERNY to give you more malaborption. As you may have seen in recent posts to others here, that is not a DS and has potential problems with a combination of increased malabsorption without the benefit of use of the pyloric valve.
I do understand his concern about (I presume) GERD, given that your band has damaged your esophagus. One of the few, maybe the only, advantage gastric bypass has is that it's the most effective bariatric surgery for fixing GERD. However, the sleeve of the DS can, to some extent, be customized by making it not too narrow. Surgeons doing the sleeve as a stand alone tend to make very narrow sleeves because if they don't, weight regain is almost guaranteed. But with a DS that is less of a concern, and a wider sleeve can be made for you.
I think Dr. K will give you a very different response than what you've had thus far. He tends to make larger sleeves in general and I will be very surprised if he doesn't think he can customize a sleeve that will work for you. Let us know as soon as you hear anything.

As usual I agree with your astute comments Ms Larra. Dr Marshall was concerned because I had Barrett esophagus but he went forward and made a pretty good sized sleeve and obviously I did okay with losing plenty of weight. I think Dr K would probably do something similar with the sleeve.

 

[DianaCox]

Walter Albert had a "pork chop" stomach sleeve, with a wider top, because of esophageal issues (he had a Nissen fundoplication). Dr. Anthone came up with that one for him (Omaha NB).

 

[DSRIGGS]

Walter Albert had a "pork chop" stomach sleeve, with a wider top, because of esophageal issues (he had a Nissen fundoplication). Dr. Anthone came up with that one for him (Omaha NB).

Yeah I think they can leave a little of the funds when slicing/stapling with their tool.

Did Walter have a nissen pre-ds and they took down leaving a pork chop or did the actually do a wrap with the DS? With Cameron's history with that f$$$$ing thing I wouldn't recommend a wrap to anybody. The weight loss itself should help with reflux assuming any hiatal hernia is repaired, at least to the points PPI will be effective in managing....

Although dr k posted a study today showing increased risk of MI for those of us on PPI.... Yay us!

 

[Txkat]

I had a Nissen fundoplication as part of my surgery as well because of a previous injury to my diaphragm. The hole in it was larger than normal and with a bad cough, I was literally coughing my stomach up my throat. It sounds like you have a good surgeon based on DSRIGGs experience with one of her colleagues. If it were me, I would ask her to draw what she is proposing, so you know what your digestive tract will look like after the surgery. Then make your decision about whether you should look for another doctor. I suspect there might just be a misunderstanding.