Guest guest Posted October 20, 2001 Report Share Posted October 20, 2001 This is from the OSSG Hungry group.....for those who are knowledgable any comments? Judie > Judie, > Yes, some of that is true, but one of the selling features of > the RNY is that it can be reversed. Realistically, it is a difficult > surgery and it will never be the same as it was before we started > tampering with the GI tract, but the fact is, it can be reversed. > The pyloris does continue to function as long as the remnant > stomach is in there. It has to open and close to release the gastric > acids and gastric juices that are continuously being produced inside the > remnant stomach. Yes, if it has been a real long time the pyloris may be > slow to function, but there are drugs that help that and if you are > having problems as a result of having had the RNY and you need to have > it reversed, you are more than willing to deal with the reversal > problems. > In our practice, we have had 2 reversals out of 850 patients. > One was a woman who was unable to adjust to the dramatic eating changes > and chose to have it reversed. She has since gained all her weight back > and more. The other, had ulcerative colitis and could not stop losing > weight. When she got down to dangerous lows, she and the doctor opted to > reverse her. She has done fine and has gained very little weight back. > Very few surgeons, if any, routinely remove the remnant stomach > during an RNY. It is necessary in the BPD due to the removal of any > drainage point from the remnant stomach. It would be a blob of stomach > sitting in there with no way to release all of the acids and gastric > juices it is constantly producing. This fact makes the BPD irreversable. > > I was told by a DC area surgeon, at the ASBS convention, that it > is possible to revise an RNY to a BPD/DS. I didn't ask him the details > of the " how " and wish now that I had. I was just amazed that, he assured > me, it could be done. > Michele > > Not sure what you mean here.....if in the RNY your stomach is just > transected then they can put that back together? Its my understanding > its > not very easy to do that but its possible however once the pyloric valve > has > not been functioning for a long time its " iffy' if it would ever work > again. > Some people have their entire stomach removed in the RNY so there is > nothing > there to revise it to if that's been done. > I dont have a pouch, I have my own stomach with 80% removed but the > pyloric > valve is intact and functioning as normal.... > BPD's as in the Scopanrio method? > > Judie > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2001 Report Share Posted October 20, 2001 Judie, It is possible to reverse the RNY, but it is a difficult procedure. To revise the RNY to a BPD/DS is even more difficult, but it has been done succesfully. Dr. Anthone refuses to do it any more because he feels that it is just too risky. It is true that the gastrectomy for the DS is not reversable. However, the gastrectomy is much less restrictive in nature than the RNY. The intestinal part of the BPD/DS IS reversable. Those that have required intestinal reversels have done very well living with only moderate restriction and no malabsorption. Generally the reversals are needed on people who loose too fast, though occasionaly the side effects of the malabsorption are not tolerable. For those that loose to fast, they end up very close to ideal weight after the reversal. For those that are reversed due to side effects, they end up still moderately obese after the reversal. This is why doing the gastrectomy alone can be but is generally not effective. Only those that lost too much weight with the malabsorption do really well without it. Unfortunately, it is difficult to predict ahead of time who will loose to much weight. There are some correlations. Generally the ones that loose to much weight are female with a starting BMI under 45. Women have been shown to require reversals at a dramatically hire rate than men. Smokers have also require a high rate of reversal. Some patients become anneorexic and require reversal for that reason. In very rare circumstances, kidney or liver problems requires reversal. Hull > > > This is from the OSSG Hungry group.....for those who are knowledgable any > comments? > > Judie > > > Judie, > > Yes, some of that is true, but one of the selling features of > > the RNY is that it can be reversed. Realistically, it is a difficult > > surgery and it will never be the same as it was before we started > > tampering with the GI tract, but the fact is, it can be reversed. > > The pyloris does continue to function as long as the remnant > > stomach is in there. It has to open and close to release the gastric > > acids and gastric juices that are continuously being produced inside the > > remnant stomach. Yes, if it has been a real long time the pyloris may be > > slow to function, but there are drugs that help that and if you are > > having problems as a result of having had the RNY and you need to have > > it reversed, you are more than willing to deal with the reversal > > problems. > > In our practice, we have had 2 reversals out of 850 patients. > > One was a woman who was unable to adjust to the dramatic eating changes > > and chose to have it reversed. She has since gained all her weight back > > and more. The other, had ulcerative colitis and could not stop losing > > weight. When she got down to dangerous lows, she and the doctor opted to > > reverse her. She has done fine and has gained very little weight back. > > Very few surgeons, if any, routinely remove the remnant stomach > > during an RNY. It is necessary in the BPD due to the removal of any > > drainage point from the remnant stomach. It would be a blob of stomach > > sitting in there with no way to release all of the acids and gastric > > juices it is constantly producing. This fact makes the BPD irreversable. > > > > I was told by a DC area surgeon, at the ASBS convention, that it > > is possible to revise an RNY to a BPD/DS. I didn't ask him the details > > of the " how " and wish now that I had. I was just amazed that, he assured > > me, it could be done. > > Michele > > > > Not sure what you mean here.....if in the RNY your stomach is just > > transected then they can put that back together? Its my understanding > > its > > not very easy to do that but its possible however once the pyloric valve > > has > > not been functioning for a long time its " iffy' if it would ever work > > again. > > Some people have their entire stomach removed in the RNY so there is > > nothing > > there to revise it to if that's been done. > > I dont have a pouch, I have my own stomach with 80% removed but the > > pyloric > > valve is intact and functioning as normal.... > > BPD's as in the Scopanrio method? > > > > Judie > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2001 Report Share Posted October 20, 2001 At 11:13 AM -0700 10/20/01, Judie Hensel wrote: >This is from the OSSG Hungry group.....for those who are knowledgable any >comments? > >Judie > > > Judie, > >... > > >> I was told by a DC area surgeon, at the ASBS convention, that it >> is possible to revise an RNY to a BPD/DS. I didn't ask him the details >> of the " how " and wish now that I had. I was just amazed that, he assured >> me, it could be done. > > Michele Dr. Elariny in Virginia has revised two RnY's to BPD/DS, that I know of. Both patients have been doing fine. --Steve -- Steve Goldstein, age 61 Lap BPD/DS on May 2, 2001 Dr. Elariny, INOVA Fairfax Hospital, Virginia Starting (05/02/01) BMI = 51 BMI on 10/18 = 40 (-73 lb.) Losing more slowly than most, but enjoying renewed health and life in general. Quote Link to comment Share on other sites More sharing options...
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