VSG to DS revision questions

[Megange1]

Hi,

I was just wondering if anyone has had VSG to DS revision surgery and if you could answer some questions. I'm considering having this surgery with Dr. Rabkin and he has said he'll need to do it as an open procedure and remove my gallbladder and appendix at the same time. I will need to be resleeved because my sleeve is 10 years old and too big. So, I have some questions for anyone who may have had a similiar surgery.

1) How painful was it? Are open procedures way more painful?

2) How long was your recovery really before you were up and about? How long until you could go back to work?

3) Are you happy you decided to do the surgery?

4) Any regrets?

5) Has anyone had this done laparoscopically and has a doc they recommend?

Any help would be great! Honestly, I'm terrified and just want to know if I'm making the best decision in the end.

 

[Larra]

Hi! So glad to see you here. Hopefully the folks who have had revisions will chime in soon.

 

[Clematis]

Why has he said he needs to do it open?

 

[Butterfly]

Hi there. Welcome! I'm scheduled for a revision from sleeve to DS next month so I don't have the experience of having completed surgery, but I can tell you that I *want* my doc to do mine open. I have an issue in my abdomen that he's going to have to fix anyway, but it was my choice before we knew that would happen to ask for it open and I realize it's not usually what people want.

Why did I want it? I had a few abdominal surgeries when I was younger and one of them was a gallbladder removal by a surgeon I can only describe as a butcher. When the nurses saw the size of the incision he made for me they were flabbergasted. One of them said "That looks like emergency surgery you would have gotten in the field in WWII by another soldier." For that reason, I wanted him to be able to SEE everything because I know I have scar tissue and probably adhesions in there.

Also, it seems that the mortality rate is somewhat better for open DS procedures vs laproscopic. As terrified as I am to die on the table, that helps my anxiety a touch: http://www.duodenalswitchdoc.com/duodenal-switch-faq.html

But, like Clematis asks, find out why your doc wants open. There may be reasons they've forseen that they can share with you. Keep us posted!

 

[Eztli]

I have not yet had the revision but am scheduled to have one, like you from vsg to D.S.
I did consult with 5 different D.S surgeons before choosing one so maybe I can provide some insight.
I am not comfortable with being re-sleeved (though I can really chow down, so maybe this wouldn't be a bad idea) but anyone who I asked about resleeving said it would have to be an open surgery. I am guessing that is why your surgeon is doing open. Re-sleeving is a delicate operation, and no one I talked to would resleeve laparoscopically.
My D.S revision will be performed laparoscopically, however, as I previously said, I did not want a re-sleeve, so I'm just getting the switch.
Anyways, although I did not consult with him, I have heard nothing but good things about your surgeon, so I hope that alleviates some of your nervousness. Good luck, and I hope there is someone on here who has had an open revision, and can provide some insight.

 

[Munchkin]

My surgery was open and it was not nearly as bad as I thought it would be. I was uncomfortable but not really in pain.

 

[Marquis Mark]

I had sleeve to DS. Prior to that I'd already had my appendix removed. Did not have GB removed during DS surgery. Mine was laparoscopic, but the Dr did have to make a 10 CM incision in order to address a bowel twist.

Having qualified my answer, here goes:

1) How painful was it? Are open procedures way more painful?

I didn't think so, but, again, it was only 10 CM. Not sure how it would feel had it been more extensive. Frankly, I don't remember the pain so much as I do the weakness and lethargy after surgery.


2) How long was your recovery really before you were up and about? How long until you could go back to work?

I tried to go back to work after 4. If I absolutely had to, I could have, but since I didn't I took and extra 2 weeks off. The main issue was that I had a very low energy level. I liken it to feeling like a narcoleptic tree sloth on Ambien.

3) Are you happy you decided to do the surgery?

Yes, even with a few unpleasant side effects and the worry (not evidence supported) that, as I get older, this may come back to haunt me, yes.

4) Any regrets?

Other than I couldn't get a handle on my eating and had to have surgery, no.

5) Has anyone had this done laparoscopically and has a doc they recommend?

Most people have it done laproscopically, including me. There's a list of vetted doctors somewhere on this site. I liked my guy but you wouldn't have access to him unless you were a Kaiser SoCal member. I'm sure you'll get lots of opinions/recommendations on this question.

Any help would be great! Honestly, I'm terrified and just want to know if I'm making the best decision in the end.
It's always scary when you're on your side. But once you get on our side you will just accept it and be fine with it. Before people have kids, fly in airplanes, etc., they feel nervous. Once it's happening, it's just what it is. And remember, except for the sleeve part, it's reversible so, worse comes to worse, you have that option. But few end up reversing.

Good luck. Odds are you'll do it and be glad you did.

Mark

 

[DSRIGGS]

I had my original DS revised as I was having bad malnutrition issues and Dr K needed to extend my absorbing intestinal path. He did this as what he called "hand assisted Lap". This meant that I had a midline incision from my umbilicus down to the top of my groin. It made measuring my small intestine easier and also gave him more room to do the procedure. He described measuring the small intestine via lap, which he does do often, like trying to pick up spaghetti with chip sticks. While inside me abdomen he found that a mesenteric defect (hernia in the mesentery) had reemerged so doing this open made it easier to find that defect.

As far as pain. I think I was a little more tender than the lap procedures I had before that one but it wasn't really bad. The most painful surgery I ever had was when Dr K laproscopically repaired a big ventral hernia and screwed into my abdominal wall a 9 x 11 inch hunk of mesh. Man that freaking hurt.

BTW here is a picture of my guts as Dr K had them out of me measuring and he is showing the mesenteric defect.

 

[Megange1]

Why has he said he needs to do it open?

He said that he feels it is much safer.

 

[southernlady]

He said that he feels it is much safer.

And it might be in your case. You and he will have to decide that.

I've had open abdominal surgery (1994) and I've had lap abdominal surgery (2011).
Open left a bigger scar but over 20 years later, I'm the only one who knows exactly where it is. It's faded into the normal skin color. Open felt like my insides were gonna fall out (they didn't but it sure felt it) for about 10 days. LOL.
Lap left much smaller scars and only one is noticeable at 6 years out. And that one was used a second time for my gallbladder removal. Scars healed very quickly. BUT good God Almighty, the gas they used to pump me up was miserable and that took about 2 weeks to go away.