Search the Community

Does anyone regret having a band to sleeve revision? Can I ask why??

American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in 2015 and surgeon workforce in the United States The ASMBS Bariatric Numbers task force is reporting the 2015 estimation of the number of bariatric surgery procedures in the United States. This is a yearly report numbers estimation, and the task force followed the same methodology as in previous years [1]. A comprehensive review of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was performed, which included 100% of the primary and revisional bariatric cases performed within accredited metabolic and bariatric surgery centers. It was noted that during the 2015 calendar year, 89 new centers submitted data in comparison to 2014, and these centers submitted data on 8110 cases. These new accredited centers led the estimation of the number of cases performed in inpatient nonaccredited facilities to drop to more than half of what was estimated in 2014. Bariatric Outcomes Longitudinal Database (BOLD) and other data- bases were reviewed as well. To capture outpatient procedures performed at centers that do not submit data to MBSAQIP or BOLD, device maker companies were surveyed to obtain the total number of gastric bands and intragastric balloons sold per year; however, an estimation was made to deduct devices purchased but not used. Large outpatient centers performing stapling procedures, mainly laparoscopic sleeve gastrectomies, also were surveyed. The 2015 numbers listed in Table 1 show stability in the total number of bariatric procedures compared with 2014. The sleeve gastrectomy continues to be the most common procedure. Continuing the same trends as previous years, the gastric bypass decreased slightly, and the gastric band continued to decrease significantly. Numbers of revisions now are close to 1 out of 7 cases performed, predominantly gastric band conversions to stapling procedures. According to the 2015 projections from the U.S. Census [2] the total population of the United States was 321,418,820, of whom 247,773,209 were adults aged 18 years or older. Using the obesity prevalence data (body mass index Z40; 6.4% of adults) [3] 15,857,485 estimated individuals qualified for bariatric surgery. Thus, the rate of bariatric surgery in the qualified population based solely on body mass index criteria in 2015 is estimated at 1.24%. When analyzing only the numbers of primary procedures compared with the number of “eligible” candidates, the penetration rate of surgery in the candidate population in 2011 was .976% and increased to 1.068% in 2015. Over the 5-year period between 2011 and 2015, these data suggest that the penetration rate of surgery in the “eligible” population increased by an annual average of only 1.9% (number of primary procedures per eligible candidate). Regarding the bariatric surgeon workforce in the United States, it is difficult to estimate the number of surgeons performing bariatric procedures. The following calculations assume that practicing bariatric surgeons in the United States are active surgeon members of ASMBS. This assumption likely underestimates the number practicing by an unknown number. However, other available estimates of the number of practicing bariatric surgeons provide lower numbers. For example, the American College of Surgeons’ directory includes 1271 surgeons who self-identify as performing bariatric procedures [4]. A search of the MBSAQIP directory identified 1300 surgeons who perform bariatric procedures [5]. If these lower numbers are more accurate, then the following calculations would require proportionate adjustments downward. ASMBS has 1810 active surgeon members. Regarding gender of active members, 1643 are male and 167 (9%) are female. Similar to statistics regarding the dramatic growth in numbers of female surgery residents in the United States [6], female active members comprise 20% of the member- ship between age 30 and 39, but only 4% of the member- ship age 50 years and older. ASMBS reports 54 surgeons currently comprise the candidate group for membership, although in recent years this number is more typically 75 surgeon candidate members per year. This number of annual membership candidates would expand the active membership by 4.1% per year. This corresponds closely to the number of fellowship training positions offered each year by the Fellowship Council in the United States [7]. Currently in the United States 61 postgraduate fellow- ships provide training in bariatric surgery for up to 77 trainees on an annual basis. Of these 61 programs, 29 are classified as bariatric fellowships, 31 as minimally invasive surgery/bariatric fellowships, and 1 program is categorized as minimally invasive surgery/bariatric/flexible endoscopy. The bariatric surgeon workforce is also influenced by the number of retiring surgeons. Williams and Ellison studied the general surgeon workforce in 2008 [8]. They suggested that the typical surgeon practices for 30 years, and therefore it is reasonable to estimate that 1/30th or 3.4% of surgeons retire each year. An annual retirement rate of 3.4% would translate into 62 ASMBS active surgeon members retiring each year. Another method to estimate the number of retiring surgeons is to examine the age distribution of current ASMBS members. Thirty active members (1.7%) are over the age of 70 years and could be considered imminent candidates for retirement, while 142 active members (9.4%) are over the age of 60 years and may retire in the next few years. Assuming ASMBS members age 60 and older will retire at an equal rate each year over the coming 5-year period would suggest that 34 surgeons will retire annually over the next 5 years. Thus, using these 2 approaches to estimate the number of active bariatric surgeons retiring each year, one would estimate that between 34 and 62 bariatric surgeons will retire each year. Conclusions There has been a 24% increase in the absolute number of procedures performed annually in the United States since 2011. However, surgery is chosen/achieved as a treatment option by only 1% of candidates as defined by the estimated number of patients with class III obesity. The penetration rate of surgery in patients with class III obesity is estimated to have grown by only 9.4% over 5 years for an annual growth rate of 1.9%. Thus the increased number of procedures may simply result from the ongoing growth in the U.S. population. The bariatric surgeon workforce is difficult to estimate, but there appears to be similar small growth in the number of bariatric surgeons based on ASMBS membership data and assumptions regarding surgeons retiring from practice. The active surgeon membership of ASMBS appears to be increasing by between 13 and 41 surgeons each year, or .7% to 2.3% per year. This growth in surgeon workforce appears reasonable given the growth noted in absolute procedure numbers. Bariatric surgery, as the only successful long-term treatment for obesity, continues to be under- utilized in treating the obesity epidemic in the United States. References [1] Ponce J, Nguyen NT, Hutter M, Sudan R, Morton JM. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in the United States, 2011-2014. Surg Obes Relat Dis 2015;11(6):1199–200. [2] United States Census Bureau. American FactFinder website. Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2015 [cited 2016 Aug 15]. Available from: http://factfinder.census.gov/faces/tableservi ces/jsf/pages/productview.xhtml?pid=PEP_2015_PEPANNRES&src=pt. [3] Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011-2014. NCHS Data Brief 2015;(219):1–8. [4] American College of Surgeons website. Searching for surgeons [cited 2016 Aug 15]. Available from: https://www.facs.org/search/find-a-surgeon. [5] American College of Surgeons website. Metabolic and bariatric surgery accreditation and quality improvement program [cited 2016 Feb 15]. Available from: https://www.facs.org/quality-programs/mbsaqip. [6] Association of Women Surgeons website. Why AWS is important [cited 2016 Feb 15]. Available from: https://www.womensurgeons.org/ about-us/why-aws-is-important/. [7] The Fellowship Council website. Directory of fellowships [cited 2016 Feb 15]. Available from: https://fellowshipcouncil.org/directory- of-fellowships. [8] Williams TE Jr, Ellison EC. Population analysis predicts a future critical shortage of general surgeons. Surgery 2008;144(4): 548–554; discussion 554–6.

Same here went to a new bariatric surgeon they did the scope with in a week of my appointment and found I had a hernia and slipped band I wish I wouldnt have waited so long to go to the doc waited 2 years, I am having revision surgery band to sleeve;) Good Luck to you!!! Sent from my SM-N910V using the BariatricPal App

I had the band since 2009, and they unfilled me for 3 or 4 months so I felt "free" hehe. I had a couple before pre-op diet for my revision but I didn't go crazy. I had a prime rib steak at Fuddruckers (steak always got stuck in my band), and what's really funny is... I can eat steak now whenever I want. Go figure. lol

That seems like a very long time. The barium swallow does give them information though and from that they can tell if it slipped or not. Did they unfill you completely? That's what they did to me, and they said to come back in 3 months. The unfill takes most of the pressure off your stomach so it can heal again. I recently had a revision but I had the band from 2009-2016.

I'm so sorry that you are in pain Denise - I can relate, though the knee is much more stable, it better be since it is made out of metal lol! It still hurts quite a bit, and as does everything else it seems. I was at my final pre-op appt with the new surgeon whom I really like (Dr. Srikanth in Federal Way, WA) and I was pretty stunned at the results of labs that were done on Hallowen...normal Iron level should be at least 100 - mine is 11, I am peri-monopausal, so some months I will have a normal cycle, some times it will be light, then I will miss one and then its like those elevator doors opening in The Shining. I also have frequent nosebleeds. So I have a few more hoops added - doc wants a colonoscopy, that took a bit to get on short notice, and have that Thursday afternoon and I see an ear, nose, and throat doc on Friday morning, then more iron infusion after that. So after I get a call from the hospital to clear everything in ab out an hour, I drop off my post surgery scrips and pick up the fun stuff so I get to sit on the toilet for the next two days haha! I guess my gallbladder is packed full of stones - I will be very happy to get that out. The stricture and hernia are pretty serious - doc says some mesh may be involved to anchor my esophagus in place and keep that stomach where it should be. A dear friend found out he was showing signs of Barrett's esophagus in June - she lived until mid September - that one gets you fast. This doc is super comprehensive and it is cool to find out all the things inside that I did not know about - my husband and I have matching cysts on our livers lol. The last bone scan revealed arthritis just about everywhere - my hands have been bothering me and sure enough it showed up between the carpals and metacarpals. I'm an inch shorter than I used to be too - so that mea I need to lose even more weight haha. I am hoping that the surgery will help with the reflux so I can get off of PPI's - I worry that my bones are just going to turn to dust. You guys don't even what to know what the Vitamin req's are with the surgery - its pretty intense - 4500 mg of Calcium a day, 150g of Protein (2 scoops of Optimum Nutrition chocolate mixed with 4 oz. of Water three times a day gets me to 144g with only 12 oz. of liquid) this is good since I am also to drink an ocean of liquid a day I wont go into the other supplements the list is long. I honestly cant quite believe that insurance approved a revision - I got denied round one and was ok with the decision either way. Round two they said yes. I will keep you guys posted with how it all goes. I am sorry I have been so bad at keeping in touch with the board. I have only recently started reading other forums again - I hate drama and get upset when everyone else seems upset. I asked how long the procedure will take - this one is going to be a humdinger - 6-9 hours of surgery. Wish me luck! If for some reason I don't make it - its been a good ride

Had my revision surgery on 10/18/16 from LapBand to sleeve due to esophagus issues from the band. I was banded in 2010. If I can answer any questions, just ask away. Recovery wasn't easy, but it wasn't terrible either. I haven't had any problems with drinking or getting my Protein in. Still off work but that's only because I want to make sure I've got a good handle on food before I return to my job. Sent from my iPhone using the BariatricPal App

I'm having the revision surgery cuz I've had nothing but complications with my band i have it for about 4 years I never could find my sweet spot is either over filled under-filled I just thought I would go about my business and deal with it! sometimes I can eat and sometimes I cant eat most the time I am vomiting because my food gets stuck I finally made an appointment with a new bariatric surgeon and found out that it slipped and is at the top of my stomach and bottom of my esophagus which means I don't have a pouch anymore so when I am able to eat without any problems I totally over it because I never know when I'm going to be able to eat again which sucks!!!!also I have a hiatal hernia I gained all my weight back plus a couple pounds and I also have slowly and gradually been getting heartburn more frequently I believe that is due to the hernia I was just approved by my insurance and hopefully get a call today to get my surgery date.. for the revision. I wish I would have went in a couple of years ago and caught it in time but I didnt there is no way that I would want to be re banded just to go through all of this again I want the damn thing out and I want a permanent change it is definitely scary though but in the end I'm sure it'll be well worth it!!! In facts my surgeon and a lot of Surgeons are not doing the Lap Band anymore because of the complication rates I'm happy for the people that have not had any problems or complications:) Sent from my SM-N910V using the BariatricPal App

As long as we put our faith in the Lord and hold his hand I believe he is gonna guide me threw this Sent from my LGLS992 using the BariatricPal App What is revision surgery? Sent from my SM-G903W using the BariatricPal App What is revision surgery? Gastric bypass? Sent from my SM-G903W using the BariatricPal App It is where they have to revise something with your bypass. Basically go in and fix something that is wrong with your bypass. Sent from my LGLS992 using the BariatricPal App

They have already done 2 revision surgery's fixed a obstruction as well. I feel better but I still can't stop loosing. My body won't retain any nutrition. Sent from my LGLS992 using the BariatricPal App

Hi all! I'm hoping for some insight/advice/encouragement. I was banded in 2008 and lost a total of 67 pounds (there was more to lose). Through the years I've gained back about 20 pounds. I have severe heartburn and am on Nexium. I'm looking into a band/sleeve revision. It scares me that the sleeve is permanent. Can someone give me a revision success story to ease my mind? I admire all of you!!

I was to go in and revise my sleeve to bypass...call it change...lol but with all the test the doctor stated that he would only have to move my sleeve or straighten it out as it was twisted , and attach to my liver and my diaphragm. Sent from my SM-G928V using the BariatricPal App

As long as we put our faith in the Lord and hold his hand I believe he is gonna guide me threw this Sent from my LGLS992 using the BariatricPal App What is revision surgery? Sent from my SM-G903W using the BariatricPal App What is revision surgery? Gastric bypass? Sent from my SM-G903W using the BariatricPal App

To the poster above...i had those symptoms. It turned out i had an obstruction. Along with a hiatal hernia. Just had revision surgery on October 19th 2016 and I feel so much better. I had acid reflux could barely swallow could barely drink I feel 200% better now. Sent from my SM-G928V using the BariatricPal App

Hello! Sleeved on 11/8. Did any of you with a band to sleeve have a hiatal hernia?? Mine was fixed and so was my dilated esophagus. I needed to wait a year to get my esophagus back to the way it was. I know my insides are still a bit swollen from everything, but did any of you have a hard time keeping things down at first like when you had the band? Yesterday was fine, but today I was having trouble in the morning and now I am good again. I'm PRAYING / HOPING it's from me downing my drinks to fast. I never want to go back to not being able to down anything as I did with the band. Any positivity would be great right about now. As I feel scared and a bit down. Thank you!! Sent from my iPhone using the BariatricPal App

55 and have the revision from sleeve to bypass on 11/7 feel great. Port removal tomorrow nervous about that and of course constipated. Sorry TMI but so happy about new life. Sent from my SM-N900P using the BariatricPal App

I am a band to vsg revision 2 years ago. The acid remains to the point I take 40mg nexium daily and still have break through. Dr has told me recently that I may have to revise to rny to fix the problem. He also told me that he no longer revises band to sleeve only band to bypass because of the acid issue. Good luck. Sent from my iPhone using the BariatricPal App

I have been approved for my consultation so that means the surgeons have reviewed my revision packet and my benefits have been verified and I have an appointment next Wednesday I am so excited Sent from my SM-N920T using the BariatricPal App

My husband has had his sleep apnea for many many years. He fought about using it for many years. It drove him crazy. But...he has it so bad now that he sleeps with it every night. Before he could peel the paint off the walls with his snoring plus he had Restless Leg Syndrom!! Not a good night's sleep for me for many years!! LOL Now he wears his every night, except when he gets a real bad cold because it makes him feel like he can't breathe. When he had a failed revision from the Band to a RNY it made him feel like he was smothering. But that was a whole different thing. He went to Mexico last June and had a Sleeve done but so far with his 65# loss he still needs his CPAP. One thing that helped him was a full face mask. It helped him breathe without coming undid. Thank You DR's!!!

@@FDclerical Good luck! I had to revise to RNY from VSG because of severe reflux. Like you, I din't regret my sleeve at all. It allowed me to lose 130 lbs and I mourned its loss. RNY has been fine! I had gained about 12 lbs prior to my conversion and those pounds are gone and I'm continuing to lose. Getting off PPIs was worth it 100%!!!

@bearhugs1975 I revised from VSG to RNY on 7/1/16. I haven't had any problems eating foods. If I eat too much fruit, I get heart palpitations that are annoying but don't affect my daily life. I just don't eat fruit. My surgeon advised that this reaction will mellow with time and I'll be able to eat fruit like I could with my VSG. I didn't find the recovery to be more difficult at all. In fact, it was much easier. I spent an extra night in the hospital (my choice). Once I was home, I was able to drink with no issues and at my 1 week appt, my surgeon advanced my diet early. I had gained about 12 lbs prior to my conversion because the only thing that helped the acid was crackers. I've now lost that re-gain and am within a pound of my lowest weight. If the acid is bad enough, I wouldn't hesitate to convert to RNY

Hello everyone As I write this I am one month and three days post op. I've been doing some reading here on and off before surgery and since, and decided to join up and say hello. It took me years to get here. I have been overweight most of my life. I would have done this sooner, but we (my wife and I) had two friends who died from this surgery. It took us a while to get past that, but we did, and I started the process back in June. I lost about 65 lbs on the pre op diet, and struggled with the notion of going through with the surgery or just doing it the old fashioned way. But as the doc reminded me, it isn't the losing that is hard for a lot of us, it is the keeping it off. So I went ahead with it. Everything has gone exceedingly well for me so far. I am usually the person who is told "this never happens to ANYONE!" when it comes to complications or freak happenings. But so far no complications, no side effects, nothing but getting smaller as the days go by. To date I am 100 lbs down from where I started. I have about 80 lbs to go to get to my initial goal. I will revise that goal as I get closer and determine whether to push further or ease up. I do not want to lose muscle mass, of which I have lots. Tomorrow I get to start in on soft food. I have been eagerly anticipating the day. So far everything has gone down without a hitch, but with each changeover, I experience a little trepidation. Anyway, hello to all of you, and I am sure I will have some questions after I do some more reading.

SLEEVE VS BYPASS this is a personal decision in the beginning I was scared of having my intestines rearranged. Now I’m left with no choice!!! Even with my issues and recent complications I still don’t regret my sleeve. I never knew LIFE would happen the way it did AND didn’t know I’d be affected by GERD so terribly. I’ve wanted to be able to do this for a while and I thank God Bariatric Pal is STILL here 4 years later after my sleeve providing a community of release. Judgement or not it’s good to get it out! I hate a lot of text so I’ll try to get straight to the point lol HW-324 SW-312 LW-224 CW-250.3 Gastric Sleeve 11-6-2012 After my sleeve I was able to lose 100lbs in 10 months….Nov of 2013 my dad passed away from a sudden heart attack the day after his 60th birthday and at that time I fell into a SAD bad depression and instantly went from 224 to 236 and stayed there. I then had a divorce and my older sister passed away 9 months after my father to a heart attack as well. COMPLETELY DEVASTATED I was now at 258, I still decided I had to take my life back and I got back on track getting back down to 236. Fast fwd to 2014- July of 2015 a new relationship (got WAY 2 comfortable) and I ended up pregnant. Sadly having a miscarriage last year which has brought me to where I am now. After we lost the baby I was having horrible excruciating heart burn but no surgeon would give me a chance because I moved from Connecticut to South Florida they didn’t wanna mess with it. I finally found a surgeon who sent me for an UPPER G.I. on 11/8/16 to see that my sleeve is slightly twisted up top adding to the GERD and heartburn pain and he described it as “very big” and said almost looks like a normal stomach. The pain I feel is in my chest but also under my left breast and it is SHARP and ive avoided and cut out ALL trigger foods. Even with Water. It hurts.badly. I now have Cigna insurance whom requires nothing but a medically necessary letter and mental evaluation for revision surgery sleeve to bypass approval BUT I am still seeing a dietitian monthly and my last appointment is Dec 8th. We are submitting to insurance this Friday. HAD to get this out because seeing those xrays I knew something was wrong, I STILL DO NOT REGRET MY SLEEVE. I am thankful for this journey and how far I’ve come. And I know with the bypass I will be out of pain, my twisted sleeve will be fixed and I have confidence ill hit my goal!!! Anyone else looking into revision December of 2016? I have to share because NOT EVERYONE is vocal about their journey but I have nothing to hide. Im already bariatric For life!! People have been evil and critical but I choose to dismiss them because I will never be 324 again and that I have to be thankful for!

Surgery twin I'm December 1st lap band to bypass revision. Good luck to us both. Sent from my SM-G550T1 using the BariatricPal App

You are worrying too much. Make sure that they are aware you have sleep apnea but know that the people taking care of you are professionals. You won't be the first person that's had anesthesia and suffers from sleep apnea-I actually have it too and had my revision surgery done on 10/18/16. They will be monitoring you the entire time so don't drive yourself to crazy with worry. It won't help! Sent from my iPhone using the BariatricPal App