why revisions?

[liveaboard15 1,293]

Hi

So i am planning on getting the sleeve. But i keep hearing about people needing revisions to bypass. Those that got the revision. Why? This worries me because i am paying cash for my sleeve which is roughly $20K and i dont have the money for a revision if that will be needed. Makes me not want to get the surgery at all.

[Hop_Scotch 1,630]

A lot of people revision to a bypass from a sleeve due to suffering ongoing GERD with medication doesn't help. Others due to weight gain.

If you already suffer a lot with acid reflux you may want to chat with your surgeon.

I suffered with acid reflux but mine was definitely related to the type of foods I was eating and the amount of food I was eating. If my food intake and portions were healthy I was fine. I discussed with my surgeon and I went with a sleeve. So far so good.

[Guest]

1 hour ago, seadoo2021 said:

Hi

So i am planning on getting the sleeve. But i keep hearing about people needing revisions to bypass. Those that got the revision. Why? This worries me because i am paying cash for my sleeve which is roughly $20K and i dont have the money for a revision if that will be needed. Makes me not want to get the surgery at all.

I'm self-pay, too, and this is why I chose not to get a sleeve. And since you're paying yourself, you have options! Also beyond sleeve or RNY.

I absolutely love my mini gastric bypass, which isn't 'mini' anything. Consider it, maybe? (Other names: one anastomosis gastric bypass (OAGB), Omega loop gastric bypass, single-anastomosis gastric bypass).

More room for food, better weight loss than both sleeve and RNY, long-term maintenance statistics look great, easy to revise or reverse if you need it, and better resolution of co-morbidities. Downsides are you need to take your Vitamins (like, you must) and the potential for bile reflux. However, the anti-reflux stitch they do now helps with that (thanks to Dr. Carbajo in Spain for inventing it).

It's been done since 1997 and is a popular surgery in Europe, Australia, and Asia. I have no idea why American insurance companies aren't getting on the train, but that's not of concern to you as a self-pay.

Anyway, I know Dr. Illan is close with Dr. Rutledge who literally invented the MGB and he does MGB in Mexico. There's tons of MGB surgeons in America, too. Feel free to reach out for more questions. I posted a long thread about my first year experience with it in the Mini Gastric Bypass Forum.

https://www.bariatric-surgery-source.com/mini-gastric-bypass-surgery.html

Edited December 28, 2021 by Guest

[Arabesque 7,185]

I saw a study that said about 10% of gastric sleeve patients seek a revision, 5% of bypass patients have a revision & 26% of lap band. In 2019 around 256 000 people had bariatric surgery: 18% had bypass. 59% had sleeve & 1% had a lap band. (Included lap band just out of interest.)

Some people develop GERD after sleeve surgery (I read it was about 10% so that seems to match the above revision stats) & consequently require a revision if medication or other management options don’t work. If you already have GERD sleeve is not for you. I had reflux before my sleeve which, like @Hop_Scotch, I mostly managed with dietary choices. Still have reflux but it manifests itself differently now.

Some surgeons recommend bypass to patients who have more weight to lose or who they think need extra help to loose their weight as bypass is considered the ‘stronger’ surgery. Sleeve is a less invasive surgery (fewer changes to your digestive system). Generally though the average stats on how much weight is lost with either surgery is about the same at the 5 yr mark (about 65% of the weight to be lost).

Malabsorption issues & dumping are a consideration with bypass. You’ll need to continue to take Vitamins & may have to adjust medications you take. Malabsorption is rarely an issue with sleeve & dumping is not common. Sleevers often do not need to continue taking vitamins (individual health issues may mean they have to). Personally I haven’t taken vitamins since goal as I absorb all I need from what I eat.

Some choose to have a revision because they have had regain or want to lose more weight. Regain can occur because of complacency, bounce back weight, medication, changes to your lifestyle, job, health, etc. or sometimes just life in general which can just throw crap at you.

Have a long conversation with your surgeon as to which is the best surgical option for you from a medical perspective & which can best help you achieve your goals (health, weight, lifestyle). Then you know yourself best as to which surgery best suits how you want to live your life after surgery & whether you will need the stronger surgery to get you where you want to be in the long term.

All the best.

[raelyce 0]

I am also getting a revision surgery too. I have complications with GERD after getting the sleeve done. Honestly the best option, knowing what I know now is that the duodenal surgery would be the best option for you since you’re doing it out of pocket. It will eliminate the issue of development of the reflux

[catwoman7 11,209]

7 hours ago, raelyce said:

I am also getting a revision surgery too. I have complications with GERD after getting the sleeve done. Honestly the best option, knowing what I know now is that the duodenal surgery would be the best option for you since you’re doing it out of pocket. It will eliminate the issue of development of the reflux

I'm not sure about that - they do a sleeved stomach when they do duodenal switches (in fact, sleeve used to be phase 1 of the DS back when they usually did the DS in two stages. They usually do it in one stage now). A lot of people lost enough weight after phase 1 that they didn't really need to do phase 2 - so at some point the sleeved stomach (VSG) started to be offered as a standalone surgery. So I would think reflux would be a potential issue with either VSG or DS. Unless there's something about the intestinal part of the DS that helps with reflux? I don't know. Any DS'ers out there know?

P.S. I just googled it and found an article by the NIH - yes - looks like the intestinal part of the DS redirects the bile or whatever that can cause reflux with the sleeve - so you are correct!

Edited December 29, 2021 by catwoman7

[Lisa LoVuolo 63]

I had the RNY bariatric surgery

Sent from my octopus using BariatricPal mobile app

[Queen ApisM 427]

My practice required an endoscopy before doing a sleeve to ensure that there wasn't undiagnosed GERD (you can have it and not know it) to start with - if there had been, they wouldn't have done a sleeve since there is an excellent chance it would worsen with a sleeve and necessitate a revision later. Obviously, I could develop it in the future but we'll cross that bridge if we get to it.

I'd definitely broach the subject with your doctor before making a final decision, since you will have to weigh all the pros and cons.

[liveaboard15 1,293]

18 minutes ago, Queen ApisM said:

My practice required an endoscopy before doing a sleeve to ensure that there wasn't undiagnosed GERD (you can have it and not know it) to start with - if there had been, they wouldn't have done a sleeve since there is an excellent chance it would worsen with a sleeve and necessitate a revision later. Obviously, I could develop it in the future but we'll cross that bridge if we get to it.

I'd definitely broach the subject with your doctor before making a final decision, since you will have to weigh all the pros and cons.

Interesting. I had a colonoscopy and Endoscopy earlier this year due to me having diverticulosis. No issues they mentioned. Just spasms in my large colon.

[ShoppGirl 4,728]

20 hours ago, seadoo2021 said:

Makes me not want to get the surgery at all.

I think you really do want to just get that new sea doo. 🤣

Edited December 29, 2021 by ShoppGirl

[ShoppGirl 4,728]

2 hours ago, seadoo2021 said:

Interesting. I had a colonoscopy and Endoscopy earlier this year due to me having diverticulosis. No issues they mentioned. Just spasms in my large colon.

You could ask your surgeon if it would be helpful to get his office those reports but it seems like they would’ve said something.

[liveaboard15 1,293]

4 minutes ago, ShoppGirl said:

You could ask your surgeon if it would be helpful to get his office those reports but it seems like they would’ve said something.

I provided the report on initial consultation.

[liveaboard15 1,293]

7 minutes ago, ShoppGirl said:

I think you really do want to just get that new sea doo. 🤣

I already have 1. I want a new one lol. Which i do plan on getting soon but with surgery i would rather wait and recover and then buy one lol.