Open VS Laparoscopic RNY to DS Revision

[cboone]

Hi All,

This is Tee. Happy New Year!!!!!!!!!!!!!!!

Can I get your prospective on open VS laparoscopic RNY to DS Revision? I am very worried about longer time to heal, the scarring on my belly, and keloids. I have a huge very unattractive keloid from the RNY to the immediate left side of my belly button. Dr. K says he will try laparoscopic first but would like permission to do open if he needs too. But I can tell he does not want to really try, he prefers to perform the procedure open. If there is a conversation to read ton his if already thoroughly discussed elsewhere please point me there and you all have a blessed day. Thanks in Advance. Tee......

 

[brooklyngirl]

I had my DS done laparoscopically, but I consented for it to be done openly if needed. I would much rather have woken up with a successful surgery than forbid an open incision and woken up without my surgery completed. That's my 2 cents!

 

[SHales]

An RNY to DS revision is the most difficult WLS there is and if one of the top docs in the field is more comfortable doing it open, there is probably a reason, like your health and well-being. I actually think I would insist on having it open to mitigate chances of complications. I realize I am not the average but I had an open DS, did a 19 hour flight home (with layovers) at under 2 weeks out and was back to work (desk job) at just under 3 weeks out.

 

[jillc]

The thing is that with revisions 99% of the time there are adhesions from previous surgeries. The surgeon clears the adhesions during your surgeries. Many times, the surgeon will have to open you up fully to clear these adhesions.

I had my revision open and most of the revision surgeons in the US do theirs open. Open surgery isn't the most fun to recover from, but it's better than not getting the surgery itself.

I had a major fear of open surgeries because my first WLS was open in 1988. The pain meds weren't as nice then as they are now. You will have a pump to administer yourself meds. It's not a walk in the park. but it's well worth it.

 

[revisionDS]

Tee I understand your concern. If you are going to use Dr K he typically does revisions as open, and I don't know any rny to DS that were lap by Dr K, doesn't mean there are none out there, I am just not aware. I would suggest that you give Dr K permission to convert to open, because you don't want to wake up and not have your rny to ds done because it could not be dont lap, especially if you have chosen Dr K and you said he " I can tell he does not want to really try, he prefers to perform the procedure open" I think you answered your own question, you can't and shouldn't force a surgeon to do something they are not comfortable with, you will wake up with no surgery. As you know Dr K has a stellar reputation.

 

[Larra]

You are so very fortunate to have found Dr. Keshishian! He is far and away one of the best DS surgeons around, and known for doing a lot of these very difficult revisions. As someone else already said, RNY to DS revision is the toughest bariatric surgery of them all.
Most of these revisions are done open. Dr. Rabkin, also someone who does a lot of revisions, does all of them open. I understand your concerns about scarring given that you already have a bad scar, but the important part of the surgery is what's done on the inside and getting you through it with the lowest possible risk of serious complications. Let that be your focus.

 

[JackieOnLine]

Hi, Tee

Happy New Year back at ya!

 

[Munchkin]

No big deal. Take the scars. And here's why. The after effects of massive weight loss are not pretty anyway. Just go look at the before and after plastics pictures! What you will end up with is NOT what you are picturing in your head. Sorry!

Just do what you have to do to lose the weight. If you opt for and can afford plastics down the road they will remove or revise the scars anyway!

 

[cboone]

Thanks everybody. I got approved last week and it has been three weeks now since I went to get scoped by Dr. K. He is so thorough. We are setting a date for possibly the end of this month. I expect Kristina to call me back next week with some possible surgery dates. Now I am nervous about so many things. I am just as equally excited. Dr. K does not prefer to give me any measurements such as whether I will get a big or small sleeve, what length limbs might be etc. Actually he says that the size of the sleeve does not really matter or something like that. I a,,ready to start purchasing things such as protein shakes, vitamins etc.

 

[revisionDS]

@cboone congratulations he moves fast. Dr K won't give you limb lengths since he uses the Hess method and he adjusts also with your health, age, gender, etc. You will get that information in your operative report. I would have some protein shakes on hand, don't worry about the vitamins right away, you can get them when you get back from your trip.