Revision from sleeve to DS or RnY
- Thread starter Cat
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aaa
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Hi Cat. Welcome. I'm a traditional one surgery DS; 2005. All the weight is off and stayed off.
Re "Which surgery will help with reflux more? I have it pretty bad right now."
The RNY.... but I would seriously consider the advantages of the DS...
Greater malabsorption
Pyloric valve preserved
No dumping
"Simpler" revision from VSG
www.ncbi.nlm.nih.gov
.
Conclusions
Obesity is an important risk factor for GERD. While bariatric surgery is the most effective and sustainable treatment for obesity, GERD must be considered for all patients undergoing such procedures. LRYGB has shown superiority over LVSG for alleviation and management of GERD symptoms from the available literature. It has reported efficiency similar to Nissen fundoplication and is the options with refractory GERD post-fundoplication in obese patients. A patient’s preoperative status should be evaluated to optimize their choice of bariatric surgery: patient selection is key. In appropriately worked-up patients who have GERD, LRYGB could be considered as the first option. In patients with HH, this should be evaluated, and treatment should be considered during their bariatric surgery. While LVSG continues to become more commonly performed, it is important to monitor these patients for the long-term risks of developing GERD and its sequalae. In case of troublesome GERD symptoms following LVSG and LAGB, revisional surgery with LRYGB seems to be the best option.
The RNY.... but I would seriously consider the advantages of the DS...
Greater malabsorption
Pyloric valve preserved
No dumping
"Simpler" revision from VSG
Bariatric surgery and gastroesophageal reflux disease
With the rapidly increasing prevalence of obesity globally, the practice of bariatric surgery is being adopted routinely to prevent the development of chronic conditions as well as some forms of cancers associated with obesity. Gastroesophageal reflux ...
www.ncbi.nlm.nih.gov
Conclusions
Obesity is an important risk factor for GERD. While bariatric surgery is the most effective and sustainable treatment for obesity, GERD must be considered for all patients undergoing such procedures. LRYGB has shown superiority over LVSG for alleviation and management of GERD symptoms from the available literature. It has reported efficiency similar to Nissen fundoplication and is the options with refractory GERD post-fundoplication in obese patients. A patient’s preoperative status should be evaluated to optimize their choice of bariatric surgery: patient selection is key. In appropriately worked-up patients who have GERD, LRYGB could be considered as the first option. In patients with HH, this should be evaluated, and treatment should be considered during their bariatric surgery. While LVSG continues to become more commonly performed, it is important to monitor these patients for the long-term risks of developing GERD and its sequalae. In case of troublesome GERD symptoms following LVSG and LAGB, revisional surgery with LRYGB seems to be the best option.
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Welcome!
I wouldn’t get an RNY period. I don’t want dumping or vomiting if I eat something I am not supposed to or if my belly decides to do it. But I have chronic pain and vomiting hurts my back a lot. Vomiting can throw my back out and repeated stuff can cause my back to hurt so bad that I can’t walk. Chronic pain is also why I chose the DS because I am better able to keep the weight off with it. Also I would see if my surgeon could make my sleeve a little bigger than usual to reduce the chances of GERD. But they would need to be the surgeon who actually does what they say they are going to do and not do the whole switcheroo and make decisions you Plus do as Southern Lady said about the hernia. I would rather be on a couple prescription GERD medicine than to have to be concerned in the back of my mind that I am going to vomit.
My primary insurance would cover the sleeve and the bypass at 100% (if I had diabetes which was a matter of time) but I didn’t want that. I wanted the DS to make sure I would lose most of my excess weight and keep it off without having such an awfully restrictive and miserable low calorie diet for the rest of my life with vomiting. My friend had this and was happy with her choices and was successful. But I am unlucky and just knew I would be the one who didn’t lose it all, keep it off and then also would be hugging the toilet. Most of the time with the DS I kept waiting for the DS to not work.
I had mine July 2019 and have lost 110 ish and have met my surgeon’s goal weight. I am glad I chose it but also glad I was at the point in life where I was willing to eat a certain way and take quite a few vitamins. I don’t have any regrets about my decision
I wouldn’t get an RNY period. I don’t want dumping or vomiting if I eat something I am not supposed to or if my belly decides to do it. But I have chronic pain and vomiting hurts my back a lot. Vomiting can throw my back out and repeated stuff can cause my back to hurt so bad that I can’t walk. Chronic pain is also why I chose the DS because I am better able to keep the weight off with it. Also I would see if my surgeon could make my sleeve a little bigger than usual to reduce the chances of GERD. But they would need to be the surgeon who actually does what they say they are going to do and not do the whole switcheroo and make decisions you Plus do as Southern Lady said about the hernia. I would rather be on a couple prescription GERD medicine than to have to be concerned in the back of my mind that I am going to vomit.
My primary insurance would cover the sleeve and the bypass at 100% (if I had diabetes which was a matter of time) but I didn’t want that. I wanted the DS to make sure I would lose most of my excess weight and keep it off without having such an awfully restrictive and miserable low calorie diet for the rest of my life with vomiting. My friend had this and was happy with her choices and was successful. But I am unlucky and just knew I would be the one who didn’t lose it all, keep it off and then also would be hugging the toilet. Most of the time with the DS I kept waiting for the DS to not work.
I had mine July 2019 and have lost 110 ish and have met my surgeon’s goal weight. I am glad I chose it but also glad I was at the point in life where I was willing to eat a certain way and take quite a few vitamins. I don’t have any regrets about my decision
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Spiky Bugger
Well-Known Member
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- Jan 5, 2014
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I wouldn’t get an RnY.
If you already have the sleeve, you already HAVE half the DS. And as for reflux? I had the LapBand which caused my reflux. With the DS, it’s better, but not completely gone.
Who is your surgeon?
If you already have the sleeve, you already HAVE half the DS. And as for reflux? I had the LapBand which caused my reflux. With the DS, it’s better, but not completely gone.
Who is your surgeon?
Oops! You have the sleeve! Well since you have the sleeve there’s no way to make it bigger really without some riskier surgery and that wouldn’t help your GERD. I would go on with the BPD unless I knew my GERD would lead to Barrett’s disease or something like that which could lead to cancer. But this is decision you have to live with and I can only offer my rationale for why I made this choice.
hilary1617
First time at the rodeo.
- Joined
- Jan 6, 2014
- Messages
- 3,870
I have had GERD for many years, including Barrett’s Esophagus, and I have a family history of esophageal cancer (all died from it). I had gastric bypass and have never experienced dumping or vomiting from it. Thankfully, my GERD was greatly reduced with GB and I no longer have Barrett’s Esophagus (or ulcers, gastritis & esophagitis), so for me I believe it was the right surgery.
I am not recommending you get RNY; it’s a difficult decision to choose it over DS but in some situations it may be the better choice.
Note that my GERD was not due to a hiatal hernia nor was it improved after HH surgery. And it’s something my identical twin sister also suffers from.
Lastly, I am a patient of Dr Keshishian; he didn’t do my WLS but he has corrected some other abdominal issues I’ve had. He has never recommended a revision to DS for me. Dr K also does not recommend long term or permanent acid reflux medicine for me (and some others) because it only quiets the symptoms but doesn’t stop acid from damaging cells, which can lead to esophageal cancer.
I am not recommending you get RNY; it’s a difficult decision to choose it over DS but in some situations it may be the better choice.
Note that my GERD was not due to a hiatal hernia nor was it improved after HH surgery. And it’s something my identical twin sister also suffers from.
Lastly, I am a patient of Dr Keshishian; he didn’t do my WLS but he has corrected some other abdominal issues I’ve had. He has never recommended a revision to DS for me. Dr K also does not recommend long term or permanent acid reflux medicine for me (and some others) because it only quiets the symptoms but doesn’t stop acid from damaging cells, which can lead to esophageal cancer.
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I know this, but haven't gone back to trying to get off omeprazole. I need to.
