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No RNY for BMI over 50?



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Has anyone been told they cannot have a Roux-enY (RNY) if your BMI is over 50 even though your weight is less than 350 pounds? And the Duodenal Switch (DS) would be the choice? I hear horror stories about the DS. Any comments would be appreciated.

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I was adamant that I'd have the RNY Bypass.

My surgeon, though, was not sold on the idea.

His reasons were: 6'4" with a BMI over 50 and an umbilical hernia that he had to repair at the same time.

He said the repiping would be taunt, at best. If it became involved in a failed hernia repair then bad things could happen.

He suggest the sleeve very, very firmly. It is what I went with and so far have zero regrets.

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I went into the intial consulation wanting the sleeve, but since my BMI is 57 my surgeon will only consider RNY. I'm still not sold on the whole re-routing part of it, but RNY does have a higher weight loss % in 5year+ studies. Good luck and let us know what your doc says.

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Educate yourself on the surgeon and go with the best. I went in for the sleeve and was told it would only make my reflux worse and that it had to be the RNY. I totally trust my surgeon so I went with it. So far I have had no problems.

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@@MiteyMom,

If you have selected a reputable surgeon and surgical center....trust in them. TALK to them and convey your concerns. Remember, you need to be your own advocate. That includes your opinions and having a say in what happens to your body. However, let your surgeon explain why he thinks the specific surgery is right for you.

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When I first joined the bariatric program at my hospital, my BMI was 66.9. When I met with the surgeon and she asked which surgery I was leaning towards, I said the bypass, and she said "no problem." I think most likely your surgeon doesn't feel comfortable doing an RNY after a certain weight, which is why they have that rule. Personally, this would sort of ruin my trust in that surgeon's capabilities. But I'm also pretty discerning when it comes to things like this. I have trust issues as it is, and I REALLY needed to trust my surgeon, as my life was and is in her hands.

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my BMI was over 50 and I had the RNY

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I had RNY at 429lbs. My surgeon won't do DS because of the risks. He says the 5yr mortality rate from complications is unacceptable. He told me that RnY would be his first choice, but if I wanted the sleeve, he would do it because I have to live with my decision either way. I went with the RNY and do not regret that decision one bit. If your surgeon won't do rny and you are under 350, I'd question whether this is the right surgeon to go with. The right surgeon means the world when it comes to getting through surgery and life beyond.

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DS is not done by many surgeons. ... it is a specialty kind of thing, although maybe with the newer SIPS procedure that is changing.

My BMI was 52, and I was sleeved so I guess it seems strange that you are told you "can't " have a specific procedure.

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Please ask you Doctor more questions.What procedure do you want?Its your body and you have to live with him.Find out more.I know very little about DS but you need feel comfortable.Take control.

Please ask you Doctor more questions.What procedure do you want?Its your body and you have to live with it.Find out more.I know very little about DS but you need feel comfortable.Take control.

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Sounds like it would be a good idea to get a second opinion. Schedule a first visit and think of it as if you are interviewing the doctor. You are the customer about to purchase a service (surgery) that will change your life forever. It would be ideal to get matched with a doctor who puts you at ease and who makes sure you understand the surgery and that you are comfortable with the choice. I wish you well.

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well i am 24 and my bmi started at 52 when i started this process and i only weigh 281 right now thankfully but if you watch my 600 pound life that doctor performs bypass on patients that are over 500 pounds so i dont know why itd be an issue for your doc i would deffinatly get a second opinion

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Don't be afraid to get a second opinion or change surgeons.

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some of the other posters may be right - that particular surgeon just may not be comfortable doing RNY with patients with higher BMI's. I *have* heard of surgeons who won't do them on people with a BMI over 60 (I'm guessing they might refer those patients to surgeons who specialize in higher risk surgeries), but I haven't heard yet of a surgeon who won't do one on people with BMI's over 50. Lots of people on these boards have had an RNY with a BMI over 50. Just talk another surgeon if possible - there are evidently a lot of surgeons out there who will do it with your BMI.

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@@MiteyMom

I was told exactly opposite of you. I was told flat out at my very first exam-interview that my surgeon only did gastric bypass on pts with a BMI 59 and above. The head Nurse Practioner and the surgery staff spent a lot of time explaining why and providing documented evidence about each surgery and the long term stats.

I trust my surgeon, I love my support staff, and I'm at peace that the Dr has the skills and is doing the best surgery for me! ????

Others have urged you to get a second opinion, do more investigation, advocate for yourself. I TOTALLY AND WHOLE HEARTEDLY AGREE!!!! This is your life here! You need to be positive and at peace with the surgery! You do what YOU need to do to feel that peace! I'm putting on my prayer list ????, and sending encouragement to you!!!

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