How do sleevers get RNY?

[mousecat88 2,280]

Can someone explain how someone who has the sleeve can get revised to RNY? Don't they completely remove the part of the stomach RNYers still have? Do they make your stomach even TINIER somehow and connect your bile ducts to the new stomach? How big is the new RNY pouch after you've already had a sleeve? Yes I googled for images of this and couldn't find anything. Just curious!

[Ed_NW 684]

It's not much of a revision. The sleeve was first done as a pre surgery for the super obese to loose enough weight to get the RNY safely. Just picture the anatomy of an RNY with part of the stomach already removed.

[mousecat88 2,280]

12 minutes ago, Ed_NW said:

It's not much of a revision. The sleeve was first done as a pre surgery for the super obese to loose enough weight to get the RNY safely. Just picture the anatomy of an RNY with part of the stomach already removed.

Yeah but RNY still has the second part of the stomach in there and that's where the bile ducts are attached. So do they have to reconnect the bile ducts elsewhere? I guess it seems like the new stomach would be REALLY tiny. Like much tinier than RNY somehow.

Edited December 21, 2018 by mousecat88

[Ed_NW 684]

2 hours ago, mousecat88 said:

So do they have to reconnect the bile ducts elsewhere?

The duodenum is the section of intestine connected to the bottom of the stomach that mixes the digestive juices from the pancreas (insulin) and the gallbladder (bile) and it along with the remaining part of the stomach is reconnected further down stream.

[elcee 3,341]

I would love to know the answer as well because I always thought that after a sleeve the next step is duodenal switch not RNY

[mousecat88 2,280]

Just now, elcee said:

I would love to know the answer as well because I always thought that after a sleeve the next step is duodenal switch not RNY

I'm just having a hard time picturing the logistics due to the size of the stomach that is left, I guess. I need a graphic representation of this procedure specifically. lol.

[Starry*Night 148]

On 12/21/2018 at 3:01 PM, elcee said:

I would love to know the answer as well because I always thought that after a sleeve the next step is duodenal switch not RNY

I originally thought the same thing. I mentioned it at my pre-op class, and they said most doctors won't convert it to DS anymore and will convert it to gastric bypass. I was also surprised when I heard this - I don't know the details of how it's done, the DS seems more logical to me since the sleeve was a precursor to DS

[Frustr8 7,886]

But the DS brings about more metabolism/malnourisment issues than the RnY does. One doctor I mentioned it to, no not my Dr Needleman, said unless you can afford over $150 a month in Vitamins and minerals to keep yourself alive, forget it! Pretty radical a weight loss surgery, often a last resort and few surgeons choose to do it.

[New&Improved 1,780]

Yeah I found one surgeon who does the DS or the revised BPD DS and that was 500 miles away.

He said that is reserved for the Super morbidly OBESE or people who failed with previous surgerys.

So yeah not very common anymore very severe malabsorption issues

Edited February 21, 2019 by Mikeyy