RNY Gastric Bypass After Lap Band Surgery

Question Below Submitted By:  

Linda (a patient from Natick, MA)

I was banded March 2011. I have to admit I am disappointed in my choice. It is uncomfortable all over – I have problems swallowing and never am full. I wish I had RNY – what was I thinking!

I don’t want something reversible – this is a rest-of-my-life decision. I would like to revise my bariatric surgery, remove the band and have RNY now I feel this could save the risk of waiting longer which could mean tissue scarring etc. Feedback please!

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01.

Expert Responses to the Question Above

Response: RNY Gastric Bypass after Lap band Surgery

by: Alberto Aceves

Hello Linda,

My recommendation is to do an honest analysis to see if you are really using the tool you have properly. You know the rules to make the lap band work.

Are you following them?

You have invested in this tool so using it properly before considering a revision is the first and obvious choice.

That being said, the lap band is not the best solution for everyone.

If there were a perfect surgery or one that works for everyone then we would only need one type of procedure. Reality is that there are a few others because the band is not the best choice for everybody.

The gastric sleeve and the gastric bypass have better weight loss results long term. The weight loss is greater and the % of people keeping it off is also higher.

Some people need more than just a restrictive procedure and the bypass or DS are good options to consider.

Before you consider a revision of any type be sure you are ready to follow the rules and guidelines for the new surgery.

Rules are very similar for all surgeries: you need to choose nutritious food over junk food, you need to eat slowly, chew very well, exercise, etc.

But tools do work differently so a revision may be an option in case you find that the band is really not helping you lose weight after giving it an honest try.

Dr. Alberto Aceves

(click here for Dr. Aceves' full bio & contact info)

Dr. Alberto Aceves

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Lap Band Problems & Lap Band Complications
- Lap Band Surgery Failure - 2 Types & How to Avoid Them

02.

Patient Responses to the Question Above

Weight loss

by: Beth

Next week (next Monday, actually, the 21st) will be 3 years since my banding. I've lost 80 pounds so far, but I did hit some self-inflicted snags.You certainly can cheat on the band, and when I was finishing my undergrad schooling, I was cheating plenty and regained about 35 of those 80 pounds. I'm back to losing again and have lost those 35. I have about another 50 I need to lose to get in the neighborhood of a decent weight.

Thanks Beth

by: Linda

I really appreciate what you've shared with me, especially that reminder about breakfast. I work out at 5am daily then rush to get family in order then rush to work, so yep, breakfast is missed. I will snap back into shape with that 1st meal of the day. How much weight have you lost so far and how many months post surgery are you? Linda

All good questions, Linda

by: Beth

Your sweet spot is that spot you hit with your band where it's working, you're losing, yet you can eat -- not too much, not too little. It's that spot where everything comes together and works wonderfully. In reading your earlier post, you're not there yet. And it usually takes a while to get there, so your eight months is still a bit early.For me, my meals consist of about 2 to 2.5 ounces of protein (lunch and dinner) and a couple small sides of veggies (probably 1/2 cup or less worth), and sometimes a small salad as well. For breakfast, I eat either a package of oatmeal or grits OR an egg or two OR a small cottage cheese AND a small serving of some fruit. I'm never hungry for breakfast, but I have to eat something to get my metabolism going.I think I may need a teeny fill right now because I get just a slight bit hungry, but for ME, I found that my stomach was rather numbed. In other words, I never felt hunger, so I just ate when I knew I should. The downside to that is that I never felt full, either, until the food was in my throat. That's why I measure.I know some docs use some really odd combinations of stuff, but what I outlined above seems to work for me.But the one rule I follow is the one about liquids. Not only should you make sure to wait a good hour after eating before you drink anything, you should ALSO wait about a half hour BEFORE a meal before you drink as well. I dry pouch helps the food stay there longer, giving you more a sense of fullness.I ALSO exercise 4 to 6 times a week as well.I saw you were asked about fills -- I don't know how many you've had or how full you are, but if you haven't had too many, it sounds as if you might need to continue with that until you get to your "sweet spot."I hope this answered some of your questions. I would just hate to see you give up on the band if it's just a matter of it hasn't gotten to the point where it's really helped you yet.Related Pages:- Bariatric Diet (What you eat)- Bariatric Eating (How you eat)- Exercise for Bariatric Surgery Patients

In response

by: Linda

Thanks to you all for your honest and heartfelt comments. It was good to hear.I will be seeing my doctor in December- unfortunately the most recent appointment I had was rescheduled due to our freakish weather here.I would love to pick your brains. What does "sweet spot" mean? I haven't heard this phrase before.Also, I would be really grateful if you all could show me your daily meal examples. This is something I have requested in the past with my WLS team but instead I had the daily guideline of protein-veg-etc...A sample from any of you who are experienced and obviously successful bandsters would be so greatly appreciated.Another question - how do you know if your band slipped? Does the surgeon ever have x-rays as part of the f/u visits?Thanks again

give your tool some time

by: Julie

Hi, I have to agree with what the other ladies said. Just wondering, have you talked to your surgeon about this? Have you been getting regular fills? I was banded, and am now awaiting a bypass (should be in the next month or two). I am in a different situation than you, though. I did well with my band (113 pounds in 2 1/2 years). There were times that I regretted (slightly) not going for a bypass because I thought I wasn't losing fast enough. But, in the long run, I did lose, and was probably all the healthier for it. The only reason I am having a bypass is because I lost my band due to lap band erosion (caused by a bad surgeon). Otherwise I would still have my band. It is a wonderful TOOL, but as the others said, with any tool, you need to use it properly.Please don't think that anyone is saying your feelings are wrong. I just feel that you haven't given your band enough time. In the end it is all up to you. I guess one question to ask yourself is why you chose the band over anything else in the first place?Best of luck in whatever you decide. Please let us know your decision.

Lonicera said it all

by: Beth

Lonicera really said it all. You have got to give the band a chance to work, AND you have got to use it properly. I'm not saying you're not, but there aren't enough details there to know what's going on. Trouble swallowing may be pieces that are too big or not chewed properly. Not feeling full may be not eating the right combination of foods, not being at your sweet spot, or drinking too soon after eating.I wrote a piece the other day which talks about realizing that the band is a tool, not a magic bullet. You could have the best Craftsman hammer they make, but if you try to use it to secure a nut and bolt, you're going to be pretty dang disappointed, and some would blame the tool, not the improper use of it.Nobody can tell you what to do, but I can say that eight little months on the band is nothing. If you wanted something more instantaneous, maybe further research before getting the band was in order. If you're following ALL the rules ALL the time, you should have success. Even if you're following MOST of the rules MOST of the time, you will succeed. Only you know if you've been doing things right and given it a decent chance.

Feedback please? Patience please!

by: Lonicera The Bandit

The truth is if you wanted an easy ride you would never have let yourself get obese in the first place.  People who want to lose weight and do it relatively painlessly are those who have little to lose - surely you must have many friends and work colleagues who obsess about being 7 lbs overweight.  People like us who let it get too far are have to be prepared for the long haul if they're to be successful.  But the point is it CAN be done, and IS being done by people all the time - check out the blog of Lap Band Gal, for example.There is no 'comfortable' or quick solution to weight gain so you'll have to resign yourself.  On this Bariatric Surgery Source site try to read previous queries which are virtually identical to yours, and you'll find we all say the same thing:  the band takes time to work, the sweet spot can take 18 months to achieve.  Gastric bypass is a different operation, and people wrongly think it is a final solution.  It isn't, any more than the gastric band is, and again, arguments for and against are in previous correspondence on this site (and click the links for MUCH more information about each procedure).The point is, these surgeries are the best we've got at the moment.  Don't reject the one you chose out of hand, give it a chance to work.  If you want miracles then you'll have to wait for the genie and the lamp.Good luck to you.Lonicera The Bandit.

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