RNY to DS

[Battenabrowngold]

Hello,

I am scheduled to have RNY to DS revision surgery on 11/21/2018. (Yes, I chose that date!). I meet with my surgeon tomorrow and I was wondering if anyone had any advice on questions to ask. I’ve noticed some lingo about 2 anastomoses (I’m sure I spelled that wrong). What does that mean? Will my surgeon undo my original surgery and then do the DS? I’m also having a hiatal hernia repaired and my gallbladder removed - which I assume is a proactive move since I don’t have any current issues with my gallbladder. Does anyone know what the “average” weight loss is with a revision like this? My surgeon said 55%-60% of excess weight loss. Whatever that means. There’s not a lot of information on the Internet about this type of revision and what I did read seems to conflict with what my surgeon’s office says. They say it will take 2-2.5 hours and I’ll be in the hospital for two nights barring any complications. My surgery will be done laporoscopically (I’m sure I’m spelling that wrong).

Thank in advance!

Amber

 

[DianaCox]

Make sure they’re not just giving you a distal RNY. That is the worst of both DS and RNY in terms of lifestyle and doesn’t work as well as DS long term.

 

[Battenabrowngold]

Make sure they’re not just giving you a distal RNY. That is the worst of both DS and RNY in terms of lifestyle and doesn’t work as well as DS long term.

They are prepping me like I’m having a DS and I had to buy the vitamins someone with a DS gets. I will be sure to ask this tomorrow. Thank you!

 

[Trilla]

Welcome and congratulations!

I strongly recommend asking the surgeon explain the procedure to you and what is an "anastomoses".

I recall seeing somewhere a list of questions to ask your surgeon, but I can't find it. a few questions were:
- how do you decide the length of the common channel? what will it be for me most likely?
- for my age, size, and procedure, what complications have your patients experienced?
- what are the risks of having a leak? if that were to happen what is done? what is the recovery time?

Excess weight = current weight - "ideal weight". take me for example

my current weight = 295
"ideal weight" = 140 [lots of calculators out there i use this one: https://healthyeater.com/ideal-body-weight-calculator ]
my excess weight is (295 - 140) = 155
if i lost 60% of my excess body weight... I would lose (155 * .60) = 93 lbs

The doctor I am working with told me the same thing- surgery ~2-2.5 hrs with 2-3 days recovery in the hospital.

good luck!

 

[Larra]

An anastomosis is a connection of one part of the intestine to another. A real, standard of care DS has 2 of them. However, there are some surgeons doing a different, experimental version with only one anastomosis and calling it the DS, or, if more honest, calling it SADI or SIPS or loop DS or some other name. The long term results of this version are not known. On other websites, I've seen some people happy with it, others with dismal results, some wishing they could sue their surgeons because they feel they were misled. So it's important that you ask your surgeon very specifically whether he's doing the true, standard of care DS or not, and if you aren't happy with the answer, find another surgeon.

Regarding does the surgeon undo the old RNY - if he's doing a revision to DS, yes, it's a big operation that requires totally undoing the old RNY, restoring everything to the original anatomy, and then doing the DS. It's a big operation, and unless your surgeon has a lot of experience with it, it may take longer than 2.5 hours. Which may be why DianaCox asked that you make very sure he's doing the DS and not just distal RNY, which would be much simpler and faster, but which has not been shown to provide significant additional weight loss.

 

[Battenabrowngold]

I just got home from my appointment with my surgeon. I asked if he could draw pictures and he did. He also suggested I view the DS procedure video on their website. Below are the questions I asked and the answers I received:

Q.Will the gastric bypass be "undone" and a standard DS performed?
A.Yes, we will put everything back to how it was before Gastric Bypass and then perform the DS.

Q.How long will the surgery take?
A.It depends on the individual and what things look like on the inside. It can be 3-4 hours up to 6 hours, but it rarely ever takes 6 hours. *Side Note - I'm scheduled for surgery at 7:15 and his next surgery is scheduled for 11:15 - not that that really means anything.

Q.How long is a normal hospital stay?
A.2 nights

Q.Will this be double anastomosis?
A. Yes.

Q.How do you decide the length of the common channel?
A.It's based on your BMI.

Q.What will it most likely be for me?
A.between 100 and 150 cm

Q.For my age, size, and procedure, what complications have your patients experienced?
A.There are no standard complications. Some experience nausea after they go home.

I asked other questions throughout the conversation and my husband asked questions, too. I feel better after speaking with the surgeon and feel better prepared. The surgeon told me these were good questions. So, thank you for the suggestions!

 

[Larra]

You did good! Got some good answers, too. I thought from the get go that 2 hours was not realistic for such an extensive operation, and he's giving you a much more realistic answer. If possible, see if you can have him make your common channel no longer than 100 - 125 cm. You've already struggled with one bariatric surgery, you need as much help as you can get.

 

[Battenabrowngold]

Hi Larra - I assume the shorter the channel, the less absorption? I sent my surgeon an email asking if it was possible to keep the length between 100 and 125cm per your advice. . Thank you! I'll let you know what he says.

 

[Battenabrowngold]

Make sure they’re not just giving you a distal RNY. That is the worst of both DS and RNY in terms of lifestyle and doesn’t work as well as DS long term.

I found out today that it is indeed a standard DS with double anastomosis. Thanks for the suggestion.

 

[Larra]

There is some absorption in the alimentary limb (before food gets to the cc) but the cc is the only area where the food mixes with digestive enzymes, which maximizes absorption. 150 cm isn't horrible, but it's really best to base the cc length on the Hess method, which measures how long your small intestine is and bases the limb lengths on that, rather than on your starting bmi. Too short a cc isn't good either.

 

[Battenabrowngold]

Larra, I heard back from my surgeon and he is going to make the common channel 100 cm long.

 

[JackieOnLine]

great news; I'm glad for you.

 

[Larra]

Excellent! And great job advocating for yourself.

 

[GrammyLuLu]

How did your surgery go? I am sure your still in the hospital. I had my RNY to DS revision in February. Recovery was tough for me but about week 6-7 things made a 360 turnaround and I finally started feeling better. I am down 100lbs and have gone from a 3x in tops to an xl and 28pant to an 18/20 pant. The weight loss has slowed down but I am losing inches like crazy.
Your recovery will be uniquely yours as well as your journey. Best of luck to you and I am wishing you a speedy recovery!

 

[DawnNYC]

How did your surgery go? I am sure your still in the hospital. I had my RNY to DS revision in February. Recovery was tough for me but about week 6-7 things made a 360 turnaround and I finally started feeling better. I am down 100lbs and have gone from a 3x in tops to an xl and 28pant to an 18/20 pant. The weight loss has slowed down but I am losing inches like crazy.
Your recovery will be uniquely yours as well as your journey. Best of luck to you and I am wishing you a speedy recovery!

I was thinking about you the other day and wondering how things have been going for you. Congrats on your weightloss! I'm excited that I got my insurance approval letter yesterday and in process of scheduling, mostly likely, in Jan. Can't wait to get going : )