Need your thoughts on revision Dr's for complicated revisions

OrganicLife

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Jul 22, 2015
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Hello everyone. I was on here last December reading up on revisions. Some may remember me, most may not. I am an unusual case. I had a band erosion into my stomach, and a severe infection around the port site. This was in 2009. I'll try to cover everything quickly as to not bore anyone with all the details. Went to a bariatric surgeon in NJ (I live in NJ), and he was able to remove the port, the band and suture back my stomach together. A sleeve at the time was not advised, because the stomach had to heal from being cut in half basically and the infection. He said at least 6 months to heal before anything can be done. So, I started doing research, and found the surgery that I thought would be the best option for me from a life long history of ups and downs with my weight losses and gains.

I found a surgeon that could perform the DS by lap. I wanted lap, because 20 years prior I had open surgery on my thoracic cavity, and didn't want to go through that pain and recovery again. Sent the surgeon my operative reports from 20 years ago, and from the surgery to remove the lapband 6 months prior. Fast forward....I had the surgery, BUT, didn't get the DS. I received a bipartition in 2010. Was told because of the severe adhesions all through my insides, the surgeon felt, for my safety, the DS could not be done by lap safely, especially concerning the duodenal and I said I didn't want to be opened. Plus there was the surgery time. My surgery was for over 4 hours to get all the adhesions out. So, I cried and was told that I should be able to loose weight with this. I was devastated.

Last year, I started looking into having a revision. Gained almost all my weight back (almost 6 years later), there is hardly any restriction at this point with this sleeve. I can't overeat, but I can eat my dinner. So, I Called and contacted several surgeons. With my insurance, I would only be able to have it done in NJ. The NJ revision surgeon said he would not be able to do this for me. So, I contacted another surgeon in California, based on recommendations. I sent him my operative reports from my surgeries, and he said it would have to be done open because he's never revised anyone with my type of plumbing. Murphy's law. I came to terms with the fact that in order for me to fix me, it will have to be done open, and I will just have to deal with the recovery to make myself healthy and for the surgery to be done safely. What's another scar anyway...can't be any worse then what I have now. Insurance was a huge issue. Was not able to use my insurance at all. It would have to be self pay. Don't have that kind of cash to self pay at that time. So, another hurdle I will have to get over.

Now, almost a year later, I have refinanced my homes, and have the funds to self pay to finally have this done. I am now researching 3 top revision surgeons.

My angel devil on my shoulders that are talking into my ears are telling me to go back to the surgeon who performed the bipartition, because he would know how to reverse it. He is also an excellent revision surgeon and a DS surgeon as well. Since it will be done open, then he would be able to do the DS. He said open was the only way to go with my adhesions safely. Then the angel devil again says to me, go to either surgeons in CA for the revision. They have the experience in complicated revisions as well, however, they have never done anything with a bipartition. All three will be expensive. One surgeon I can drive to, the other two I will have to fly to and possibly stay in CA for 2 weeks. One note, I was told in CA, if my hospital stay is longer then 4-5 days (if there are complications), then the hospital bill starts going up. I'm not worried about that at this point. If it happens, then I will deal with payments. I mean, what can they do, toss me onto the street if I don't pay right then and there for the additional days?

I am waiting to hear back from the original surgeon, to see if he will do this. I believe he is away on conference right now. I know the other 2 can perform this, although I would have to contact them again, and start the paperwork again (which ever one it will be).

Has anyone on here had a revision of a bipartition? If so, which surgeon did they go to for it? And what were their results? I know I am probably one of just a handful of people that have this. I feel like I don't fit in to any forums or boards anywhere. Odd ball. I KNOW that the DS is the only surgery that will give me the best chance at having a healthier life, for the rest of my life.

Thx for reading this post. What are your thoughts?
 
Was your potential NJ revision surgeon David Greenbaum? If not have you contacted him?
 
"I received a bipartition in 2010." Gagner, right? I don't personally think I'd give him another chance.

The other two are Rabkin and Keshishian. I would use one of them. And if they say it needs to be open, it does.
 
"I received a bipartition in 2010." Gagner, right? I don't personally think I'd give him another chance.

The other two are Rabkin and Keshishian. I would use one of them. And if they say it needs to be open, it does.

Yes, to Gagner. Yes, it would be open....i've come to terms with that fact. It is, what it is. But they have not done anything with a bipartition reversal. I'm not a surgeon, I have no idea what needs to be done to break it all down, and put me back together and to give me the DS without risking my life. All of them have great skills. The ONLY reason I was thinking of Gagner, he did the surgery, he knows what is required. He said the only way I can have the revision to DS safely, is open. I am torn, yet leaning towards Rabkin. I would be doing this alone. No one would be coming with me no matter where I get the revision done.
 
@OrganicLife I'm sorry it has come to this, but glad you have accepted the idea of open surgery. Open thoracic surgery is almost always very painful because it involves going between two ribs and the wound moves with every breath. Open abdominal surgery is generally much less painful - not no pain and I don't mean to make light of it, but nothing to compare with open thoracic surgery. I hope that helps a little.
While Dr. Rabkin may never have revised someone with your exact anatomy, he has done many revisions and seen lots of different anatomy in there, so he should be able to handle whatever he encounters. Same for Dr. Keshishian. And both are accustomed to working with patients from far out of town and they or their staffs will be able to advise you on travel, where to stay, etc.
 
While my RNY revision was pretty straightforward as far as that complicated of a surgery could be or so we thought... however I had a diaphormatic hernia repair (open) about 8 years ago and splenectomy about 9 months prior (lap with hand assist). I chose D Keshishian- he would only do it open. He said he could start lap but in his opinion we would end up open and it would only add more surgical time. He said there was a ton of adhesions, mesh and my whole thoracic cavity and insides was a maze and a mess. I was sore afterwards but everything was very smooth. I have had no complications and cannot say enough good about the support from Dr K. My surgery was a Friday and he was at the hospital to check on me both Saturday and Sunday. I had a j tube that came out at about 5 weeks of corse or was 10 at night and I was by myself- no gonna lie was a little freaked out. I text him and he called me immediately. I don't know dr rankin personally he has been vetted and is a great surgeon I can only tell you how complicated my surgery was and how amazingly dr k handled it.
 
I had a revision with Dr K but it was for malnutrition because my first DS surgeon made my Alimentary limb way to short. Now a revision to lengthen channels lime I had is the easiest surgery Dr K does and those are his words. He has done 500 or more DS revisions and is just the most incredible Dr and person you will meet. He did a major ventral hernia repair with an 8 x 10 hunk of mesh on me just in May. I am also getting ready to back out within the next month because I need a partial colectomy. I wouldn't think of another surgeon than Dr K. He is the best in the business and you wold love him. Rabkin also has grwat reputation for rny rods revisions I have just never met him.

Best wishes.
 
I had a revision with Dr K but it was for malnutrition because my first DS surgeon made my Alimentary limb way to short. Now a revision to lengthen channels lime I had is the easiest surgery Dr K does and those are his words. He has done 500 or more DS revisions and is just the most incredible Dr and person you will meet. He did a major ventral hernia repair with an 8 x 10 hunk of mesh on me just in May. I am also getting ready to back out within the next month because I need a partial colectomy. I wouldn't think of another surgeon than Dr K. He is the best in the business and you wold love him. Rabkin also has grwat reputation for rny rods revisions I have just never met him.

Best wishes.

I second everything Scott says. In my mind Keshishian is a surgeon God. If he cant figure it out No one can! I hear Rabkin is also but i don't know him. DR. K has taken excellent care of me.
 
Dr. K is a great choice.

There is a world of difference between abdominal surgery and cracking a chest. Promise!

I was very sick back then. Thoracic surgeon told me I would feel like I was hit by a truck when I wake up in recovery. It was awful. While he was performing surgery on me, he had to remove my gallbladder, and had to check my liver, pancrease and intestines. I was basically opened up like a sardine can. They had me standing up that night after I was released from the recovery room. I wanted to cry, but it hurt so much, crying made the pain worse. I thought I could tolerate pain....I did have a c section 4 years prior to that.

It is what it is, and I just have to handle it. It's all for the better and it will be worth it all.
 
I was very sick back then. Thoracic surgeon told me I would feel like I was hit by a truck when I wake up in recovery. It was awful. While he was performing surgery on me, he had to remove my gallbladder, and had to check my liver, pancrease and intestines. I was basically opened up like a sardine can. They had me standing up that night after I was released from the recovery room. I wanted to cry, but it hurt so much, crying made the pain worse. I thought I could tolerate pain....I did have a c section 4 years prior to that.

It is what it is, and I just have to handle it. It's all for the better and it will be worth it all.
I had thoracic surgery and it was not awesome - the recovery time was terrible combined with being pregnant so I didn't want pain killers. I think recovery from that was worse - other than I wasn't on a liquid diet. :-/
 

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