Looking for a revision doctor in Washington State

[BigClive 0]

Hi All, I've been watching this site for awhile now and have decided to look into getting the sleeve done. Both my wife and I were banded two years ago and she has done amazingly well, but I on the other hand have not. I am looking to possibly do a revision to sleeve, but wanted to know if anyone had a good local surgeon recommendation they could give me. We live in Olympia, but I would be willing to drive anywhere in the state. Any help you could give me would be greatly appreciated.

Thanks for your time,

Clive

[MINI-Me 196]

I did not use them personally, but do attend their support group meetings.

I have heard excellent things about them & personally know 3 people who used them. My three friends were very pleased with the surgery and after-care.

http://pugetsoundsurgicalcenter.com/sleeve-gastrectomy.html

[BigClive 0]

I had a consultation today and the surgeon recommended revision to gastic bypass over the sleeve. Did anyone else that has had a revsion get this same response? I'm more confused now than ever!

[MINI-Me 196]

Did he/she say why they recommended g-bypass instead of the sleeve?

[BigClive 0]

Did he/she say why they recommended g-bypass instead of the sleeve?

He said in revisions from band to sleeve are not as successful in keeping the weight off. He said that the few statistics that are out there show that people that have bypass have greater success and keep it off longer. The complications with the a sleeve revision are really high. He said that if I was going to do the revision and risk the complications I would have greater success with bypass. I have to be honest, bypass scares me! Actually any revision is making me nervous at this point, but just wanted to know if others had thought about bypass before they got the sleeve. I just don't want to make another mistake.

[MINI-Me 196]

Wow! I really don't know what to say to that. I know I only have 9 months of experience with the sleeve, but I can't believe that I have less chance of keeping off the weight longer than a bypass patient.

I don't know your surgeon or his/her experience, but I suggest maybe getting a second opinion. Revision is a major decision and having several expert opinions is definitely worth the time/effort.

[Oregondaisy 2,021]

Why don't you just read all the band to sleeve revision stories in here? I don't agree that gastric bypass is better. Weight loss is the same, and with gastric bypass you will be looking at diligently taking all sorts of supplements for the rest of your life . Plus the gastric bypass stomach stretches out and the sleeved stomach is made from the non stretchy part of the stomach.

[BigClive 0]

Why don't you just read all the band to sleeve revision stories in here? I don't agree that gastric bypass is better. Weight loss is the same, and with gastric bypass you will be looking at diligently taking all sorts of supplements for the rest of your life . Plus the gastric bypass stomach stretches out and the sleeved stomach is made from the non stretchy part of the stomach.

I have been reading this section a lot, but unfortunately it only has sleeve patients in it. So there is not a comparison and the people in it are definitely pro sleeve (which i totally get). It makes sense and I'm really happy for the people that it's working for. I didn't mean to say that it wasn't a great option. I was just posting what the surgeon said. I'm still not convinced one way or the other which one is right for me. I do know that the 2 surgeons (my band surgeon and the revision surgeon) both have told me that the sleeve can stretch just as much as any other surgery. It's just like in anything. It's all going to boil down to the choices that I make with what goes in my body. I don't think it will matter what surgery I have, I'll still be able to put 2000 calories down my stomach if I make the wrong choices.

The main driver Dr. Lauter said for going bypass over sleeve was that the complications in a revision are far greater than if I had just had it done that way the first time. He said that because there is no long term stats showing what the weightloss will be in 15 years or greater that it makes sense that it get done right with a proven method. He said the sleeve is essentially what the band was 5 years ago. That it has all this hype and does work for the right people. It's still someting I'm looking at. I've been given a name at a different clinic so I'm going to try and get in with them soon.

I appreciate all your advice on the forum. I keep reading everyday and am excited to be right here with you guys soon one way or the other.

[Oregondaisy 2,021]

I don't agree with that. My daughter had gastric bypass and she can eat about 4 times what I can eat. I would think if my stomach was going to stretch, it would have stretched by now at 18 months post op. It has stretched some, but nothing compared to my daughter. I can eat one piece of pizza and I am stuffed. She can eat 4 pieces of pizza easily.

[MINI-Me 196]

Clive - sounds like you are doing the right things. Talking with various surgeons and looking at the best options for YOU. You are right, we are pro-sleeve here because it worked so well for us. But, you have to do what is right for YOU.

Best of luck with your research and consultations. If we can be of any further assistance, please do not hestitate to ask.

Best wishes,

Mini

[genepha 47]

Hi Clive,

I'm also banded and am considering either the sleeve or gastric plication revision.

I am not a bypass candidate because I have severe anemia so the malabsorption would

be a huge issue for me. Plication is very new and mostly performed in Mexico so I'm

not quite sure yet if I'm 100% comfortable. My dr. here in California likes the plication

but won't perform it until more clinical trials are completed (about 2013). Anyway-

I hope you find out some good information here. Please keep us updated so we can

learn about your decisions.

Thanks,

genepha

[brittu 42]

Let's see... here are some things to consider. Here's my story. I had a band for 3 years. I was successful until my band slipped and I had serious enough complications that my quality of life wasn't too good and I started regaining weight. Once that I happened I also had to admit to myself that the band was farily unpleasant even when I was losing weight. I hated the feeling of food sitting at the top of my stomach and I had frequent sliming and stuck food issues. But I had just kind of been in denial about all my issues because my weight loss was good.

I fought for insurance coverage for revision for over a year so I had lots of time to do research. My insurance would cover a new band but not a revision to anything else. It was a long, soul-destroying process - no point in detailing here . For a revision, I was willing to go anywhere in the country or Mexico and I spent a lot of time reading boards and researching stats. I also found out about the sleeve and spent lots of time researching it and bypass. I also went to an OH conference, met with several surgeons, did phone consults, you name it. I even watched video of all of the surgeons I was considering doing the procedure. I admit it, I'm a compulsive researcher.

Surgeons - in Washington I felt the best choice was Dr. Billing at Puget Sound Surgical. He's done more sleeves than other surgeons in the area. He's pioneered a technique he refers to as a "lap-sleeve". He's always interested in learning and sharpening his skills - I found him to be both confident and caring without the arrogance that afflicts so many surgeons.

Dr. Billing removed my lap band in October of 2009. Because of the insurance issues we didn't convert at the same time. He would have but his preference was to wait because he was concerned about damage to my stomach and giving it time to flatten back out and heal before doing the sleeve.

The only two other surgeons I was willing to go to were Dr. Cirangle in SF and Dr. Aceves in Mexico.

In June I did end up going to Dr. Aceves. I had a scheduling issue and had to have my surgery during a specific week. I also lost my legal case and had to self-pay. Dr. Aceves and his staff were fantastic and I appreciated have 3 full days of care in the hospital.

Late this summer I developed a serious hernia. My abdominal wall was separated from my sternum to below my belly button. My primary care doc actually sent me to Dr. Billing who did the repair surgery three weeks ago. Other surgeons could have been kinda pissy in this situation - after I, he didn't do my sleeve. But he understood why I had to go to Dr. Aceves and was more than happy to help me. Once again, he was great, I trusted the surgical decisions he made, and I'm doing well. (He also told me my sleeve looked great and took a picture of it for me while he was in there - nice since he wasn't the surgeon who did it).

Bypass or sleeve for revision:

I did a huge compilation of research on revisions as part of my legal case. You can read my summary. The bottom line is that a sleeve is an appopriate revision for a failed lap band patient. Dr. Billing believes that sleeve will overtake bypass and may completely replace lap band surgery in the next 5-10 years just because the outcomes are so good. He said something really interesting to me a week ago when I had a follow-up. He told me that his sleeve patients, even his revisions, are far and away his happiest patients. They feel great, they have little to no complications and they seem to have little or no difficultiy maintaining their weight loss.

http://vsgappeal.blogspot.com/2010/07/summary-appeal-letter-studies-and.html

In my case I had regained my lap band weight loss and was back at 236 when I had my surgery in June. I'm already down to 174. I really didn't expect to lose that quickly.

What really amazes me about my old band vs. the sleeve is that it's not just about limiting my volume. I don't know whether it's the grehlin being gone or just how quickly the satiety switch gets set off in a smaller stomach but I just don't really crave food or want to eat to fullness. When I first started eating solids I ate too much a few times and it was really uncomfortable. I backed off a bit so I wouldn't get to that point but it's really more than that. I just feel find and completely uninterested in food after a few bites so it's very easy to stop before my little sleeve is packed full. Somehow the sleeve changed how I feel about food - what I want to eat and when I feel like pushing the plate away. I haven't heard anyone I know say that about their gastric bypass.

I also was uncomfortable with the other health issues of bypass like dumping and malnutrition.

Another suggestion about surgeons:

I've met most of the surgeons in the Seattle area who do weight loss surgeries. I think most are good doctors and are well intentioned. But every surgeon's opinion is colored by their own experience. They have what they do well, they have their comfort zones, and some are more willing than others to push beyond them. Sleeve is new and some surgeons are just now starting to look it it. Others, like Cirangle and Billing, have been doing them awhile and feel confident in the technique and in the successes their seeing with their patients. Dr. Lauter has done some sleeves but not a huge amount. He seemed like a great guy to me but it's worth considering that if he's most comfortable with bypass then that's what he's most likely to suggest to his patients. And it stands to reason that he would.

All in all I'd say my research shows the sleeve to be as good and in some ways a better revision option than bypass. I prefer Dr. Billing to other local surgeons and would suggest meeting with him if you have the time to come up north. Even if you don't go with him it's good to have another medical opinion.

Take care. I'm sure whatever you decide will be right for you. Happy to answer any questions you might have. At just about 6 months in to my revision I'm no expert but I can certainly share my own experiences so far.

[Nina in Seattle 0]

Lots of great info Brittu! Thank you. I just sent you a PM with some details about me I'm not brave enough to share yet on the list, so I hope I hear from you. Nina

[Margaret 4]

My weight loss group in TN has GREAT success stories with band to sleeve revisions. The people in my support group are in awe of how easy and successful it's been. They are positively giddy over it all!

He said in revisions from band to sleeve are not as successful in keeping the weight off. He said that the few statistics that are out there show that people that have bypass have greater success and keep it off longer. The complications with the a sleeve revision are really high. He said that if I was going to do the revision and risk the complications I would have greater success with bypass. I have to be honest, bypass scares me! Actually any revision is making me nervous at this point, but just wanted to know if others had thought about bypass before they got the sleeve. I just don't want to make another mistake.

[rsr53 1]

I have a RNY that is 10 yrs old. It has now stretched about 80% and I have regained 2/3 of the initial 85 pound weightloss with my bypass. My surgeon is trying to get my Medicaid carrier to OK the sleeve gastrectomy revision so that I can lose about 70-90 pounds and maintain it. I have high blood pressure but cannot take meds for it due to severe allergies to those drugs. With the RNY, there is chance of severe recon issues concerning the pouch and stoma opening. The opening is dime sized, with the pouch about the size of a walnut. Over time, there is some stretching, but mine got to the point where my GERD probs have reoccurred. I try to keep a weightloss program going, but now with no real satiety the intake probs are guesswork at best. I don't lose any weight, and the gaining is consistent, which is damaging my efforts overall. I was recommended the sleeve for my revision because of the stretching around my opening. I honestly think you might find the sleeve a better longterm choice because structurally in anatomically there are not quite as many limitations in nutrition and followups as with the bypass. It might not hurt to get a 2nd opinion before choosing RNY over the sleeve. Of course, since you have the band now, you will have to check for such things as foreign body infections, and any other issues that would need addressed before getting the revision surgery. My sis has the band about 5 yrs now. She has some issues with it, but I think she is looking very good. Not sure exactly how much weight lost, but the whole matter is constant work! Each day is a new day with it--don't beat yourself up emotionally! Good luck! Ronda

PS: Look closely at your lifestyle and habits with food to see which procedure RNY or Sleeve best suits your needs. If you do that, and study up on the surgeries in their treatment plans, etc, I think you will make the best choice. Take care! Ronda

I had a consultation today and the surgeon recommended revision to gastic bypass over the sleeve. Did anyone else that has had a revsion get this same response? I'm more confused now than ever!