Is it possible to revise Roux en Y

[2014malves 2]

I'm 10 years out Roux en Y with major issues suddenly from malabsorption causing malnutrition experiencing pancreas problem, poor declining general health, trouble healing from even minor scratches, hair falling out, teeth decaying, general feeling of being unhealthy and unexplained weight loss with trouble even maintaining current below normal healthy weight with numerous Vitamin and mineral deficiencies not helped by supplements.

I'm wondering if a revision surgery, if it's even possible to do, from current status of Roux en Y to the Gastric Sleeve would improve my health overall. All the required plumbing is there it really seems like just a matter of creating a new pouch and changing the location of where my stomach pouch connects. Rearranging the current way my pouch connect to the gastric sleeve way of connection on my small intestine. I know I'm making this sound so simple when in fact it's probably extremely dangerous and very complicated if it even is at all possible. I just think in theory it should be possible and can happen. Wanted to ask if anyone has had it done and what your experience has been like prior to having a possible pointless discussion with my Bariatric surgeon about it. My current overall decline in health has me reaching for any possible way to help stop what feels like my slide to eventual premature death from the gastric bypass caused health problems. Any thoughts/suggestions?

[Michelle920 66]

Are you getting in all your Protein, Water and Vitamins? I would imagine it's easy to let those things slide after ten years. Also, do you need to lose a great deal of weight? I know you can have RNY reversed but I don't know if you can then get sleeved. I've just never heard anyone talk about that. I've heard of sleeve to RNY. If your weight is stable and you've made all the necessary lifestyle changes, why don't you just have the RNY reversed? But definitely talk to your surgeon.

[Airstream88 361]

You say you are taking your supplements but are you taking good quality Bariatric Vitamins and supplements each and every day? Vitamin deficiency takes a long time to show up according to my Nutritionist. Vitamins and Calcium found in grocery, pharmacy and big box stores are not well-absorbed by RNY patients - according to my NUT, only 25% is absorbed so you would have to take 4x the regular dose. You might try Nutrametrix Isotonic vitamins and calcium. They are powder you mix with Water and are 95% absorbed within 15 minutes.

I've heard that RNY can be reversed but can't imagine you can be converted to a sleeve after 10 years.

[RickM 1,753]

There are several ways to approach a problem like this, and generally surgery should be a last resort - the more you cut the more you get backed into a corner and remove future options - but such revisions are possible.

Have you consulted with your surgeon, or another bariatric surgeon? The RNY has been around for a long time (the basic procedure has been around for some 130 years!) and is the most widely performed weight loss procedure, so there is considerable experience in the field with the various complications that can arise, so your problems are not going to be unique.

An RD (registered dietician) would also be appropriate to consult. Many on these forums poo-poo nutritionists/dieticians because they usually aren't falling all over themselves to recommend the latest fad diet someone saw on YouTube, but problems like these are right up their alley. A bariatric or hospital RD can be a good choice - many are bored stiff dispensing post-op diet plans to discharging patients who really don't care and want to get out of there, but they really thrive on someone bringing a real problem to them. They are worth a try.

On the surgical revision front, since most revisions are done because of poor weight loss performance or regain, and the sleeve and RNY have similar performance, there usually isn't much to gain by revising an RNY to a sleeve from that perspective, and most surgeons aren't going to have a lot of experience in doing so. There is a small group of surgeons around the country who do perform RNY to DS revisions which does involve revising the RNY pouch to a sleeved stomach in addition to all of the fiddly work in altering the intestinal configuration (which you don't particularly need.) Two docs that I can think of in your region that do such revisions and would be worth consulting if you get that far are David Greenbaum in north Jersey and Mitchell Roslin in NYC. Both should also be well up on the nutritional problems that people can have with these different procedures as they tend to work with the more difficult case.

Good luck in getting this worked out, whichever way you go.