VSG, RNY and swallow test results

[harrietvane]

My mum is currently in having her lapband removed after a decade or longer (jeez!). She's after a revision to something, but thinks the DS is 'too extreme'.

Her original lapband surgeon when she went in for a consult suggested the sleeve. A second surgeon she consulted with was pushing the RNY. I gave her my view on the latter, and the sense that for her (who the band worked decently well for) that maybe a sleeve is enough (though I do wish she'd travel and get a DS!). I showed her data on EWL and regain as well.

However, the second surgeon (the one doing the removal) is refusing to do a sleeve due to reflux and the results of her swallow test. The report from the test says:

'There is oesophageal dysmotility present with a sluggish primary peristaltic wave seen inferior to the tertiary contractions noted. This resulted in a hold up of barium in the distal oesophagus and within granularity of the distal oesophageal mucosa in keeping with oesophagitis.

Gross gastro-oesophagael reflux was seen during the study, reaching the pharynx.'
​

This surgeon stressed that RNY was 'more reversible' given the blind stomach (********) and that the sleeve 'has an equal chance of dumping too' (********), but I threw a bunch of links at her about dumping, pyloric valve and weight regain that got her to understand it's no small (or easily reversible) surgery.

What say ye, hive mind? She the sleeve be off the table given the above?

 

[southernlady]

All you can do is show her what you know. At the end of the day, it is up to her to make her own decision regardless of which way she goes.

You could mention to her that a slightly larger sleeve may help with reflux.

 

[harrietvane]

@southernlady: it's definitely her decision, but it should be a well-informed one. Just wanted to know if it'd be worth her getting another opinion on the VSG.

 

[Munchkin]

Worth a second opinion, yes! Honestly I believe there is a chance her dysmotility will improve once the lapband is gone!

 

[DianaCox]

DS, with larger sleeve.

 

[Larra]

I was thinking the same thing as @Munchkin. Those d*&m bands may be removable but they can cause permanent damage. It would be helpful to see how she does without and retest after a few months to see if the reflux and esophagitis improve or not.
And anyone who thinks gastric bypass is easily reversible is crazy. True, a sleeve is not reversible at all, but it can be made wider rather than narrower, and if that proved to cause problems a sleeve can be converted to gastric bypass. Converting from gastric bypass to sleeve or DS, or even just undoing it, is a big, big deal. Just ask any of the people here who have been down that rocky road.

 

[Spiky Bugger]

I have the same issues as your mom...also from the band. In fact, I was an example. The band surgeon removing the saline before I had the revision to the band was showing a new tech how he was going to see how the volume of food drastically increased when the saline was removed.

But it didn't. The barium bounced up and down. They all just stared at me. I just had an endoscopy which, 12 years later, shows the damage caused by the band.

Too large a percentage of my RnY friends have had significant weight gain. And I think that more than should be are living with MS or something that looks a lot like MS.

My sister, who just turned 69, got the sleeve about five years (5?) ago, and is steadily regaining her lost weight. She didn't want the DS because it was "too hard to live with."

I'm 70, my Revision to DS was 12 years ago. I never got thin. But I lost about 120 pounds and, as of this morning, I am still over 110 pounds down from my pre-surgery weight.

Please tell Mom that THIS old woman says she went to a guy who makes and repairs Chevys. He doesn't even understand the Bentley, so of course he badmouths it.