14 years out from RnY - considering revision to DS

CherriesInTheSnow

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I’m 14 years out from what was a very successful (in terms of complications, compliance, etc) RnY surgery with Dr Nusbaum in NJ.

My surgery weight was 345 and I lost down to 199 and stabilized around 210 (I’m 5’10” and that was an amazing weight for me – I looked and felt GREAT). I’ve had some pretty hard challenges in the past 14 years; I maintained that weight until around 2013 when I started regaining. I’m back up to 300.

Dr Nusbaum’s former partner, Dr Bilof, has his own practice now and apparently does RnY to DS revisions. I’m getting married next month and my new husband has a very excellent insurance plan through his school system employer, so I feel that now is the time to try again (I’m 57).

I look forward to learning from you all and if anyone has an input re: Dr Bilof, I’d appreciate that.

CitS
 
Hi and welcome!

I have been in the DS community, here and elsewhere, for over 12 years now and have never heard of Dr. Bilof as doing the DS at all, let alone as a revision from RNY gastric bypass. This is a very complicated operation with significant risk, that, IMHO, should only be done be a very experienced DS surgeon. It requires taking apart your entire gastric bypass, restoring everything back to the original anatomy, and then doing the DS (the sleeve gastrectomy plus the rerouting of the small intestine). I'm saying this not to discourage you from pursuing this option, but to explain why I would not recommend going to any but an experienced DS surgeon who does these revisions - not just an experienced bariatric surgeon, which I'm sure he is, but specifically an experienced DS surgeon. At the very least, you should ask him how many of these he has done (not just "revisions", but specifically this revision), and his complication rate, again for this specific operation.

Even among the well known DS surgeons there are only a handful who take on this challenging operation. In NJ, there is Dr. Greenbaum, who does them on a case by case basis. It depends on how your gastric bypass was done; he would have to review your operative report to decide. Others are Dr. Rabkin in San Francisco, Dr. Keshishian in Glendale (near Los Angeles), I think Dr. Boyce in Tenn, Dr. Ayoola in Denton, TX, Dr. Simper in Utah. Other people may have other suggestions, but bottom line, you really, really need to have the right surgeon for this specific operation.
 
Even among the well known DS surgeons there are only a handful who take on this challenging operation. In NJ, there is Dr. Greenbaum, who does them on a case by case basis. It depends on how your gastric bypass was done; he would have to review your operative report to decide. Others are Dr. Rabkin in San Francisco, Dr. Keshishian in Glendale (near Los Angeles), I think Dr. Boyce in Tenn, Dr. Ayoola in Denton, TX, Dr. Simper in Utah. Other people may have other suggestions, but bottom line, you really, really need to have the right surgeon for this specific operation.
Slight correction: Dr. Keshishian is in Pasadena, CA not Glendale, CA. I had surgery (complex hiatal hernia repair and Nissen Fundoplication) with him 4 weeks ago and had a GREAT experience. I live out of state and his office staff was wonderful to work with, to make all the arrangements and confirm my insurance coverage.
 
I’ve heard of Bilof doing DS’s but not as a RNY to DS surgeon.
Ask him where he proctored for that. Ask him to tell you exactly what he will do and compare it to this description:
Take your remnant stomach and reattach it to your pouch recreating your original stomach. Then create the sleeve from the put together again stomach.

I’ve heard of surgeons performing a distal RNY and telling people it’s “just like the DS”. And all it does is adjust your small intestines to a much shorter absorption area.
 
Hi and welcome CherriesInTheSnow! Definitely go to a vetted RNY-to-DS-revision doctor, as suggested by Larra. While worthwhile, it is very difficult procedure and you need to be in very experienced hands. I'm hoping some revisionistas who've been through the procedure will be able to chime in. All the best!
 
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Hello CherriesInTheSnow We have similar stories. Rny in 2003, lost 130lbs but gained it all back (enlarged stoma so no restriction then giving up)I just had this procedure done this past February. I reiterate what everyone else has stated, do your homework, ask questions, then make your decision. My revision was done by Dr. Steven Simper in SLC he did a fantastic job. I have had no major complications and have lost 76lbs. Be prepared for the recovery I know this will vary from person to person, but I am not going to lie it was rough.
Best of luck to you and keep asking questions here this is a good place to be.
 
I’m 14 years out from what was a very successful (in terms of complications, compliance, etc) RnY surgery with Dr Nusbaum in NJ.

My surgery weight was 345 and I lost down to 199 and stabilized around 210 (I’m 5’10” and that was an amazing weight for me – I looked and felt GREAT). I’ve had some pretty hard challenges in the past 14 years; I maintained that weight until around 2013 when I started regaining. I’m back up to 300.

Dr Nusbaum’s former partner, Dr Bilof, has his own practice now and apparently does RnY to DS revisions. I’m getting married next month and my new husband has a very excellent insurance plan through his school system employer, so I feel that now is the time to try again (I’m 57).

I look forward to learning from you all and if anyone has an input re: Dr Bilof, I’d appreciate that.

CitS
 
I spoke to Dr. Bilof four or five months ago. At that point he had done about 10 RNY to DS. He hadn’t had any complications thus far.

I kept up with two of his patients for awhile and they were doing great. Both were losing about 10 lbs a month. One thing to know, you probably can’t use him if you have BCBS. He doesn’t operate at a BCBS Center of Excellence and therefore they won’t pay for it.

You could look into Dr. Bonnani and
Dr. Antanavicius in PA. According to their staff, they’ve both done a few 100 of RNY to DS.

I was scheduled to have surgery with
Dr. Antanavicius in PA but have since decided to go to Dr. Keshishian in CA. Since I’m a revision, I wanted someone who uses the Hess method vs standard lengths. Might as well give myself the best tool I can get : )
 
Hello CherriesInTheSnow We have similar stories. Rny in 2003, lost 130lbs but gained it all back (enlarged stoma so no restriction then giving up)I just had this procedure done this past February. I reiterate what everyone else has stated, do your homework, ask questions, then make your decision. My revision was done by Dr. Steven Simper in SLC he did a fantastic job. I have had no major complications and have lost 76lbs. Be prepared for the recovery I know this will vary from person to person, but I am not going to lie it was rough.
Best of luck to you and keep asking questions here this is a good place to be.

Yay... congrats on your weighloss! Has it been getting easier?
 
Thanks for input, I too am going to SLC with Dr Mackinlay, cuz they said Dr. simper was not available. I’m just starting the process through insurance. Have consult in November at RMAP!
 
Thanks for input, I too am going to SLC with Dr Mackinlay, cuz they said Dr. simper was not available. I’m just starting the process through insurance. Have consult in November at RMAP!
CherriesInTheSnow Dr. McKinley assisted Dr Simper with my revision I dont think you will be dissapointed. I had mine done at St.Marks Hospital which is where RMAP offices are located. I loved St. Marks it is a great hospital and the care was exceptional! Best of Luck and keep us posted.
 

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