Revision from sleeve to DS or RnY

aaa

Well-Known Member
Hi Cat. Welcome. I'm a traditional one surgery DS; 2005. All the weight is off and stayed off.
 

southernlady

Administrator
Staff member
Which surgery will help with reflux more? I have it pretty bad right now.
First make sure it’s not caused by a hiatal hernia. If it is, they can fix that during the revision to the DS. Supposedly the RNY “cures” reflux but many discover it didn’t or it comes back with a vengeance between year 5-10.
 

Georgepds

Well-Known Member
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

.
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.
 
Last edited:

Webmommy

Well-Known Member
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
 
Last edited:

Spiky Bugger

Well-Known Member
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?
 

Webmommy

Well-Known Member
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
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.
Hi and welcome Cat ! I had a DS years ago and am pleased with the long term results. I don't have any GERD issues, so can't comment there but I do have a small hiatal hernia. No problems, no regrets on my end.
 

Georgepds

Well-Known Member
Fwiw...

I had the DS in 2 steps (VSG , then a year later, the BPD). The surgeon corrected my HH at the time of the VSG. I Never had a sign of Gerd.

As others have pointed out, it might be worth asking about fixing the HH, if you have one. If the Gerd disapears, then, IMO, the DS would be the better choice. For one, it would not involve resectioning the stomach
 
Top