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Hi SleeveGirl88. Having GERD isnt' the same thing as having reflux every once in a while because you ate some food that disagrees with you. When they are discussing GERD as a contraindication for VSG, they are talking about people that have it regularly at least one or two episodes a week that don't necessarily have anything eating greasy food. You also don't seem to have any co-morbidities and a relatively low BMI of 40 (the average bariatric patient has a BMI of 42.5). If you're goal is weight loss, I would probably go with the VSG. While RNY may have slightly better total weight loss numbers and slightly lower regain rates over 5 years, the differences aren't really statistically significant--particularly for someone with your BMI. You'll do great with either the sleeve or the RNY and you're not going to get much of a weight loss advantage going with an RNY. There have been a lot of comparative studies that have been published over the past two years that support this conclusion. In terms of weight regain, some people start to see it earlier in the process with the sleeve but in the limited number of long term studies that track people beyond 5 years--there really isn't a long term statistical difference. What does seem to make a difference your starting BMI. Whether you're a sleeve or an RNY, if you start the journey with a BMI of 40 or less, the chances of you having BMI below 30 after one year is 95% and the chance of you maintaining a BMI under 30 after 5 years is over 75% with either procedure. The numbers for both procedures drop considerable the higher your BMI is at the time of surgery. The other thing to think about, particularly if your young (under 50), is that you're going have to live with this surgery for a long time. While RNY may have slightly better 5 year outcomes on the whole, the differences aren't really statistically significant. For someone like you, it might only mean a 5-8 pound difference (maybe)--but ultimately, it's probably not much of a difference at all. Ten or 15 years post op, you could be at a point where you have had significant regain with either procedure (hopefully not) and then you have think about revision (since obesity is a chronic condition). With this in mind, you should consider which procedure gives you the most and best options for revision. With RNY, you're revision possibilities are currently limited. In some cases, the pouch can be made smaller. Surgeons can also increase the length of the biliopancreatic limb to increase malabsorbtion or convert you to a distal bypass. The weight loss benefits of these procedures are disappointing for the most part, but these procedures can help treat co-morbidities. A more aggressive or radical approach would be to reverse the RNY and switch to a totally different procedure, but this is a very complicated and risky procedure that most bariatric surgeons aren't comfortable performing (at least not in 2018). In truth, your options of revision from and RNY are limited and may not be very effective for weight loss/regain. Options for revision from a sleeve if there is significant weight regain or re-occurrence of co-morbidities are numerous and more effective. Resleeves are common, easily performed and can help get you back on track. Since holds more volume to begin with and the pyloric valve is preserved with a VSG, resleeves seem to be more effective than revisions to a RNY pouch for treating weight regain. A sleeve also can be easily converted to an RNY down the road, but this is usually done to treat severe GERD--not so much for weight loss (although it can be used for this too). The most exiting option with a sleeve is that it can easily be converted to a BPD-DS or modified duodenal switch (also called a loop DS, SIPS, SADI-S), which is still considered an investigational procedure in the United States, but is probably the future of bariatric surgery. This is essentially a VSG with a single long limb bypass that attaches midway down your small intestines (roughly speaking) and has only one anastomosis (one connection point). It gives you most of the benefits of a BPD-DS (which is by far the most power bariatric surgery, but also the most risky), with approximately the same risk factors as an RNY. More studies are needed for the modified DS before it will be widely adopted in the US, but it's being adopted by many surgical centers and long-term RCTs are being done as we write (with excellent short and mid-range results). As a revision from a VSG, the SIPS procedure will be an easy upgrade that will only take about 30-60 minutes and will mostly likely be performed on an outpatient basis in the future (The SIPS bypass is much less complicated and less invasive that the VSG part of the procedure). In the end, both the RNY and VSG are excellent options that are very effective for weight loss. You can't go wrong, with either one. However, if you like and trust your surgeon and if he or she has been gently nudging your towards the sleeve, you should probably take his or her advice.

I did follow all of the Dr's orders and had the best attitude and still my band has to come out! I'm scheduled for a revision on Wednesday, so it is the luck of the draw who keeps theirs and who does not. I don't want to rain on anyone's parade but the band is a great tool that comes with it's share of problems. I have talked to many people who have had no problems what so ever and then lots who have. I wish everyone could have a wonderful experience but if you read enough you will find that is not always the outcome. Good luck to all! Bernadette

I am being revised from a sleeve to bypass on the 23rd

I don't think there's really a difference in how much you can eat. At first you probably won't be able to eat as much because you'll be swollen from the surgery for awhile, but after that - I don't think so because I've known several people who've had revisions, and I don't remember people mentioning that.

Hello, I've also gotten a revision from sleeve to bypass. How much weight loss is expected when doing a revision? Sent from my iPhone using the BariatricPal App

Yes, I had my revision on Monday Nov 14th. This isn't as easy as the Sleeve and my incisions are bothering me more this time. I had a rough start in the hospital due to some complications but i think I'm getting much better. I'm supposd to go to work on Tuesday but don't think I am quite up to it yet. Thanksgiving was difficult.... I felt so left out, and hungry but I guess its worth it. I had the surgery to cure my severe GERD and it seems to have helped. Hope everyone else is doing well. Let me know when we get our own page.

Yes, I had my revision on Monday Nov 14th. This isn't as easy as the Sleeve and my incisions are bothering me more this time. I had a rough start in the hospital due to some complications but i think I'm getting much better. I'm supposd to go to work on Tuesday but don't think I am quite up to it yet. Thanksgiving was difficult.... I felt so left out, and hungry but I guess its worth it. I had the surgery to cure my severe GERD and it seems to have helped. Hope everyone else is doing well. Let me know when we get our own page.So good to hear you are doing well !!! I asked Alex 3 times for the forum.but no word yet. I'll keep you guys posted as soon as I get my surgery date. Submitted already just waiting for Cigna approval. My gerd is still out of control but I'm feeling hopeful!!! Sent from my Z981 using the BariatricPal App

Yes I had my revision done Monday. I will be following to hear other people thoughts on it Sent from my SM-N920P using the BariatricPal App

Hello all, I am 2 days post-op from a bypass and I just got home from the hospital today. Has anyone else had a revision from sleeve to bypass? Sent from my iPad using the BariatricPal App

This is one of my concerns with the "self pay" route. I completely understand that some insurance plans don't cover WLS and there needs to be a self pay option. On the other hand I have seen people: who are 50-60 pounds over weight getting WLS. getting questionable "revisions". choosing self pay because their insurance denied them or required them to "jump through hoops" Seems like some minimal requirements, like maybe a referral from your primary care provider, Should be required for getting major surgery instead of a credit card with a high spending limit. There is a thread here started a few days ago by a woman who went to a surgeon for a pre op interview who was told she could have surgery the NEXT DAY if she had the funds. Another case of greed trumping ethics.

Protein drinks are a way to get a lot of protein in with very low carbs and moderate calories. Back when I was banded, I was not informed of the benefits of a high protein/moderate carb diet and did not use Protein Drinks. There are still surgeons who don't want you to drink your calories. I dunno, I am maintaining a pretty massive weight loss (half my starting body weight) and I still have 1/2 or 1 premier Protein Drink daily... usually in my coffee plus a few sips and I call it Breakfast. I am 4 years band to sleeve revision. I am not wild about ANY of them. The ones I could tolerate where premier chocolate or strawberry. The vanilla is vile but works as a base for a smoothie or a fake latte. For ones that start as a powder, I found the nectar Syntrax the only ones i could BEAR to drink. My my main complaint is they weren't very "satiating" as a person with a mature sleeve. They have lots of crazy flavors - the best ones in my opinion was the vanilla bean and I think the chocolate was okay. I don't use it anymore but I did during the weight loss phase. The best way to try the syntrax product is get their sample pack. It used to be you could get it for the price of shipping which was a great way to try before you buy. I recommend calling the company and asking. I bought my big jug powder of the vanilla bean from Amazon as that was cheapest at the time.

Hi there, how are you feeling? Can you tell me about your experience with the revision? Sent from my SM-G935V using the BariatricPal App

I had sleeve in 2011 revision done Dec 22 I'm doing good walking and sipping Sent from my SM-N920P using the BariatricPal App

I get it. Went for band revision on 10/21/19 to do the sleeve. So until 11/30/20. I still found rare occasions for food sticking. Sleeve wasn't done last year due to scar tissue so that is why I had issues. Sent from my SM-J337V using BariatricPal mobile app

I'm only 4'11 and my HW was 233, I received the lap-band in 12/03/03. I received my revision on 5/28/13. SW: 180.4 CW: 161.7

I think it just shows that the band works for some and not all! I can relate more to people who've had issues with problems with the band more so than people who were successful that's for sure. I don't expect that people won't be successful because I wasn't but in that respect I don't think people should assume that just because they are successful that everyone can be or that it's some kind of character flaw if they're not! I revised to RNY and can honestly say I still experience hunger and hormones still play an issue. When I am hungry I know I should eat, it's my body telling me to do so but with the smaller stomach I can only eat so much so that is why I've been able to have success now that I never had with the band. I'm restricted in ways I couldn't be with the band and need that restriction. I wish all well no matter what procedure they choose but hope they make the right one the first time! Nancy.

PoPo, I agree with you 300%! My mother has had both hips AND both knees replaced due to arthritis and complicated by her weight. She is now 78 and a bit too old to get a band but I hope to not have the surgeries she has had to have due to her weight. Also she has high blood pressure and cholesterol... all of which could be made better by loss of weight. For me the risk of the surgery and any complications was far less than the risk of being overweight. I am 45, been overweight (or yoyo'd) for most of my life. It wasn't going to get better from here unless I did something drastic. If a revision is needed later on, so be it... I'm still better off! AND, if I do need knee/hip replacements like my mom I will be healthier to have those operations. My mom's weight made it more difficult for the surgeon to do the operations!

I think people say things like "you're not that big" because they're trying to be polite. Would you rather have them say, "OMG, it's about time you did somehting, you fatty"? WLS is something that's difficult for people who haven't had a weight problem to understand. They don't know how to react when you tell them you're having it. As you lose weight, people get so used to you having been big that they have a very warped perception of what you should look like, and a skinnier you looks "unhealthy" to them. I thought I might have a port leak and need a revision a few weeks ago, and several people asked "do you even need the band? Aren't you at or close to your goal?" I laughed and told them I needed to lose almost another 30lbs before even being on the upper end of the healthy BMI chart.

I had lap band. It slipped and could not go back into place. It eroded and I had to have revision too much scarring. In 2009 I was so scared and elected band. I've not had one complication after bypass and am kicking myself that I didn't do that surgery first. I was miserable w band. Never was restricted if I was too tight I would regurgitate in sleep. Sorry just my story. I went in so often to take fluid in and out regardless of what you do make sure you choose surgeon near by. Sent from my XT1254 using BariatricPal mobile app

I had the sleeve and then revised to RNY. I only had GERD woth the sleeve. I had rumbling noises with both surgeries but not loud enough for others to hear. And I have no GI issues with the RNY. No uncontrollable gas or poo

Hi everyone. Here's a bit of my background Lapband done April 2011 Only lost 40 lbs Went in for revision to sleep Nov 5, 2016 And they were only able to take my band out Since it had slipped I needed time to recover. Friday is my surgery, and I decided to go bypass instead of sleeve. I'm very nervous, about dumping and feeling like I'm starving. Plus I'm a very thirsty person and I can chug a bottle of Water lol, so the sipping is going to be a huge adjustment. Anyone else having surgery in January, what day? And what surgery you getting? I'd love to have some fellow BariatricPal friends to embark on this new journey with! Sent from my iPhone using the BariatricPal App

First, congrats on your weight loss. Yay! If you’re losing at a great pace why do you want to lose faster? We all lose at our own rate & what is right for us. And you’ll end up at a weight that is right for you too. Sure you may lose a little faster at the beginning with a bypass but it slows just like any other surgery as you progress. So at this stage you’d probably be losing at exactly the same rate. You also didn’t start at a very high BMI so your rate of loss wouldn’t be like someone weighing 400, 500+lbs. But their rate of loss slows too. In five months you’ve almost reached your goal. Can’t complain about that. As @RickM said the average weight loss at about 3 yrs post surgery is about the same regardless of whether the surgery is sleeve or bypass (about 65% of the weight you had to lose). I’m glad I got the sleeve. I exceeded my weight loss goal & happily sit at a weight I never thought I would weigh as an adult let alone to have basically maintained. And to me that’s the biggest win: maintaining. Generally I’m healthy. I don’t need to take any vitamins like you would with bypass. And while I have a malabsorption (protein) issue, which are possible with bypass, it occurred as a result of my gall removal last year & had nothing to do with my sleeve surgery 3 years ago. I had mild managed reflux before surgery & I still have reflux now. It manifests differently but again it’s managed through diet & meds. If it worsens & I need a revision in the future I’ll deal with that then. I have to be careful to eat slowly & to avoid dry or coarse food but that’s me & my sleeve. I had a bit of a fussy digestive system before anyway so there’s nothing that’s harder to manage or limits me in any way. Celebrate every pound you’ve lost & enjoy the life you can have now. Don’t worry or question how fast you’re losing.

On my invoice, the procedure is just called BRACHIOPLASTY. The side boob skin removal is not considered part of the arm lift/brachioplasty with my surgeon. It is part of a separate procedure invoiced as BILATERAL BREAST REDUCTION REVISION, which is basically a breast lift with auxiliary breast removal from flanks. My doc is awesome as he is charging me with a revision instead of a first time breast lift (which really is what I am getting but is about 5K less expensive) as I had a breast reduction several years ago, and he is already going to be there doing the arm lift anyway. With that said however, I did speak to another surgeon (who I didn't end up going with) who combined the arm lift and auxiliary breast removal (without breast lift) and he called it BILATERAL ARM LIFT WITH CHEST WALL EXTENSION. He wanted to do it as one continuous incision. Edited to add: Neither my surgeon nor the other fella I mentioned above post patient photos on their websites (I had to go in for appointments to look at their patient results books)

Is there anyone else out there dealing with what I am going through? I had my lap band done on Jan. 28th 2010 and it couldn't have gone smoother. I lost an astoning 71 pounds and felt like I became the person I should have been a long time ago. My nightmare started the day after my port revision. It had flipped in June of this year and of course was told is was a simple procedure...woke up twice on the table but I guess that can be common with a twighlight...ever since he did the revision it has been pure hell for me. He relocted the port, I have nothing but pain and none of my fills are working. I have had 3 fills since the surgery and nothing is working. I have expressed this to him and he did a CT Scan to see if there was anything going on around the port. Of coursenothing came up so why look into it anymore....he did a fill that day and I woke up at 4am in so much pain my husband had to help me out of bed. I laid on the couch for 24 hours with an ice pack and Tylenol. And cried a lot. I called the nurse and told her everything again and she has been very kind but kind doesn't help. She told me to make another money making appointment and have a heart to heart chat with him and write all my questions down. Not sure what else I can tell him!! When a patient has that much pain wouldn't you think your doc would look into this further or give you options. He told me it could soft tissue/scar tissue from the surgery or my body is rejecting it. Now I can't get in to see him for almost a month. Dec.21st!! Just in time to renew my deductable. I shouldn't worry so much about the money because my insurance does cover a lot of it, but I still have to pay some. So when I see him I am going to give him these options..either do a test to make sure the whole band is working, no leaks, port flips, or band slips. I have been poked so many times I feel like pin cushion. I don't even think he is getting the fluid in the port.. When I drink the water it does get stopped and then he does his thing with the fill. But then the next day I feel like there was nothing done. I think I have a surgeon who is not listening (not the first time), doesn't care or does't believe me. I am actually getting scared. Would've something is really wrong and he is missing it! So again, options are test, see a different surgeon or get the band removed which breaks my heart. It worked so well for me when it was just right. I am so sad about this right now. I thought I finally had found the answer to my obesity and its all messed up due to a flipped port. Gosh darn it! I also travel one hour to there. I go to Froedert in Milwaukee which is an awsome hospital. One of the best. People come all around from the world to go there. How did I end up in this mess. This time my husband is going with me....can someone please hlep me or support me in anyway. Give me any advice..I need something to keep going....I hear all these success stories and I want to be one of them. I was on my way too. Please, maybe just a pat on the back for me right now.Dec. 21st seems so far away. He is going to be gone I guess. There are two other docs in the practice whom i wish i picked now. I have met both of them and they are awsome. oh well...thanks for listening everyone...HELP!!!

It's nice to have you here April. I had a revision from Lap Band to sleeve about 6 days ago. The members of this forum are awesome and very supportive. They are also full of wonderful information from someone who has been there done that. Best of luck to you!