Aussie H

Reversal is now off the table.

11 posts in this topic

For those who've followed my story so far I've been deliberately quiet while waiting for answers regarding future surgery rather than allowing myself to become self-absorbed in what might, or might not be. Seems it may have been a good move.

Today I had yet another appointment with my bariatric surgeon, appointment number 6!!! This was a followup after my second endoscopy and the appointment where I was expecting the decision would finally be made between a reversal or Revision of my original Gastroplasty surgery to gastric bypass. I've had the impression from earlier appointments that the surgeon wanted to perform what he believed would be the much more straightforward reversal surgery, although I had already decided that I wanted the bypass given I already know any surgery will be open as opposed to lap. I had decided that if I was to endure the longer more painful recovery from open surgery then I wanted the whole nine yards surgically. Today he told me that a reversal is no longer possible. In the 12 months between the two endoscopies the opening between my pouch and remaining stomach has completely scarred over making a gastrogastrostomy impossible.

I have to admit that I've always had complete confidence in my surgeon but today he showed a lack of confidence that quite frankly left me very confused and pretty miserable. During the endoscopy the surgeon found that the completely impenetrable stoma is just 1 inch below the oesophageal sphincter, which means that an attempt at gastric bypass may also be ruled out as the end pouch size will be so small that there could virtually be no stomach to speak of. He then told me that there is no way of knowing before going in whether expected adhesions and other scar tissue will leave a long enough piece of intestine to join to the pouch.

So I'm back playing the waiting game again. Next week the surgeon will take the endoscopy results, barium swallow films and CT scans to a team meeting to determine what options others can come up with and for them to examine the risk vs reward equation regarding revision to RNY. He has told me to expect a call to go to the city for oesophageal manometry to determine whether the oesophagus has sufficient strength to function properly before they risk an almost total bypass of the stomach. I have a feeling he may also schedule a laproscopic exploratory to check for intestinal adhesions just because he has now mentioned this a couple of times.

All this just  highlights that once you have WLS you are never really safe from potential complications. My original surgery was in February 1986!!!

Sleevalicious and tmcgee like this

Share this post


Link to post
Share on other sites

Aussie H

I'm so sorry for all the bad news. I can't even begin to imagine how frustrating all this must be. And the waiting game is always difficult to handle.

It's also frightening because as you said there are no guarantees and we are never really safe from potential complications.

I hope your medical team are able to find an acceptable solution for your problem.

Best of luck on the bumpy road ahead. I'll be praying for you. Please keep us informed of the developments..I can only offer my support and encouragement.

Aussie H likes this

Share this post


Link to post
Share on other sites

I'm so sorry you're going through this! I'm sorry I am not familiar with your situation but I assume you have been having complications that require revision? It sounds like a really difficult situation.  I can only offer support by saying I'm sorry and please keep us posted. Hopefully your team will come up with a viable solution soon!  Hugs to you!!

Aussie H likes this

Share this post


Link to post
Share on other sites
7 hours ago, Raeme said:

I'm so sorry you're going through this! I'm sorry I am not familiar with your situation but I assume you have been having complications that require revision? It sounds like a really difficult situation.  I can only offer support by saying I'm sorry and please keep us posted. Hopefully your team will come up with a viable solution soon!  Hugs to you!!

The easiest way to describe what has happened in my situation is that over the decades my internal scar tissue has continued to grow to the point that original passage through my stomach (the stoma) closed off gradually. Before that happened completely the pressure in my stomach caused a less scarred section of the staple line to burst (known as staple line dehiscence). While food can still passage through the stomach eventually, for now it appears to follow gravity to the lowest point where the now non-existant stoma is and then have to bounce around the stomach (a bit like a pinball machine) until it eventually finds the new opening. This causes continual regurgitation of food, and the gas that builds up while food is being broken down but can't move through to the intestines gets very painful until I can release it, usually back up through the oesophagus.

Needless to say it took months and many different surgeons  to discover what was going on. None (until the one I see now) believed the 30+ year old bariatric surgery could be the source of the problem because it was so long ago. Seems the surgeon is stumped now as to how to best resolve the issue. While it is a good thing that he is consulting other surgeons, the wait is becoming very stressful indeed while the escalation of symptoms can't simply be ignored anymore.

Share this post


Link to post
Share on other sites

Praying you eventually find a resolution to your situation.  These surgeons have to find a way to repair or recreate....you cannot continue this path and have good health or be free of pain.

Best wihes!!

Aussie H and Raeme like this

Share this post


Link to post
Share on other sites
2 hours ago, Aussie H said:

The easiest way to describe what has happened in my situation is that over the decades my internal scar tissue has continued to grow to the point that original passage through my stomach (the stoma) closed off gradually. Before that happened completely the pressure in my stomach caused a less scarred section of the staple line to burst (known as staple line dehiscence). While food can still passage through the stomach eventually, for now it appears to follow gravity to the lowest point where the now non-existant stoma is and then have to bounce around the stomach (a bit like a pinball machine) until it eventually finds the new opening. This causes continual regurgitation of food, and the gas that builds up while food is being broken down but can't move through to the intestines gets very painful until I can release it, usually back up through the oesophagus.

Needless to say it took months and many different surgeons  to discover what was going on. None (until the one I see now) believed the 30+ year old bariatric surgery could be the source of the problem because it was so long ago. Seems the surgeon is stumped now as to how to best resolve the issue. While it is a good thing that he is consulting other surgeons, the wait is becoming very stressful indeed while the escalation of symptoms can't simply be ignored anymore.

I'm so sorry you're dealing with all of this! Thank you for sharing.  Hopefully it will be settled for you soon.  Sending more hugs to you!!

Share this post


Link to post
Share on other sites

I'm so sorry to hear this! Was your initial surgery laproscopic?

Share this post


Link to post
Share on other sites
4 hours ago, Kimchan said:

I'm so sorry to hear this! Was your initial surgery laproscopic?

No my original surgery predated laprascopic WLS in Australia anyway. The scarring is from the Staple line though, not the open incision. My surgery didn't involve any cutting of the stomach live today's sleeve surgery or bypass surgeries do. In my case they just opened you up and added a staple line across the stomach leaving a small opening for food passage.  I'm not sure what adhesions the surgeon is concerned about with regard to the intestines. Could be a combination of the open surgical scar as well as hysterectomy scarring. My hysterectomy was also open and that was due to the previous WLS. Laproscopic surgery was deemed not even worth trying at the time due to the lower positioning of the stomach, also presumed to be the result of staple line adhesions.

ShrinkingViolet2 likes this

Share this post


Link to post
Share on other sites

I was on the table for 5 hours, rather than the expected 2 because he couldn't get the intestine long enough, 

i hope you find a solution!

Aussie H likes this

Share this post


Link to post
Share on other sites

Wow. I'm sorry you're going through this. Please keep us posted on your progress.

Share this post


Link to post
Share on other sites

I am determined to share my journey because there is so little information available with regard to both the earlier weightloss surgeries and the very long term complications that can and do arise. Believe me I have searched.

In the last few months since joining this site I have shuddered every time I read comments about how people are choosing certain surgeries because they are "reversible". Since my surgeon first suggested he "reverse" my surgery I've been aware the term reverse is used very loosely in WLS terms. Once put in your stomach the only way a staple can be removed is to be cut away with the flesh the staple is embedded in. It's not like removing a staple used on your skin a few days after originally placed there to close wounds. Reversibility is still probably the major selling point for lap band surgery and I personally know a number of people who chose that surgery for that reason without any understanding that scar tissue is still produced by the body and can bugger things up in a big way. While I can't know what my outcome will eventually be, I want others who might search for similar answers to at least find someone out there has dealt with a similar situation. Their steps to revision may well be different but at least they might not feel quite so unsure of processes available or tests they may need to go through.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now