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Hey all! It’s been a while since I have been on here, but I am having my revision done on Thursday May 30, 2019 after finding out that I have a hiatal hernia and large fistula opening to my stomach. I’m nervous about this and wondering if anyone has had this done? What is the recoup time? What am I to expect after? Thanks all!   

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Hi there!  I haven’t posted for a while either but have been ‘crazily’ scouring the internet for people in similar situations to me (and lurking here obviously!),  you’re as close as I’ve come so far!  I can’t offer much insight for you I’m afraid as I’m only 6 days out from my RNY revision surgery but would love to compare notes moving forward!

My surgery was meant to be a RNY Gastric Bypass revision (original surgery was May 2015, from gastric band to bypass) for a range of reasons, as well as the Hiatus Hernia repair but ended up being much bigger and more complex (5 hours with the first 3 of that ‘just’ being division of adhesions to get to my stomach). It was at that point the surgeon discovered the range of anatomical issues necessitating the surgery (including the Gastogastric Fistula).  I’d known instinctively for a long time that things just weren’t right despite fairly limited symptoms, pre-surgery testing did not show the extent of my issues, so I felt very validated when I saw my surgeon after the surgery and he filled me in.

i am recovering really well, I stayed in hospital for 4 nights  (the first night in ICU due to concerns about potential pain issues due to the complexity of the surgery - I was fine) but that was mainly because I travelled to another state for my surgeon of choice so he wanted me to stay until I was up to flying home.  I’ve got 2 weeks off work but could probably go back now at a pinch (I drove to the supermarket yesterday!).  I’m off all pain relief medication now as well.  To be honest, the biggest part of my recovery so far has been the mental processing of it - it still feels quite surreal!

I am so thankful that despite the complexity of the surgery it was completed laparoscopically (I’m so glad I did my research and chose my amazing surgeon, I’ve never spent better money) as it makes recovery so much easier.  I was warned by the surgeon going in that a) revision surgery is much riskier than ‘virgin’ surgery (and this is my second revision), b) that the only guarantee was that he would repair the HH,  nothing else was a given, c) it might end up being open surgery rather than laparoscopic like my first revision so I was fully prepared for that and d) not to expect the results that are likely with a first time surgery (I’m not too worried about that as the biggest determinants of WLS success are the lifestyle changes one makes post-surgery so the ball is firmly in my court, and besides that I lost 165 pounds after my first revision).

i think the most helpful thing for me going into this surgery was accepting that whatever would be would be and whatever happened I have the mental strength to work through it step-by-step.  Also, that the pain, discomfort, loss of independence etc. would all just be temporary and would ultimately help me achieve something more permanent.  I expected the worst but ended up being very pleasantly surprised.

i wish you all the best with your surgery and look forward to reading your updates sometime soon!

 

 

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26 minutes ago, the_gilded_lily said:

as warned by the surgeon going in that a) revision surgery is much riskier than ‘virgin’ surgery (and this is my second revision), b) that the only guarantee was that he would repair the HH,  nothing else was a given, c) it might end up being open surgery rather than laparoscopic like my first revision so I was fully prepared for that and d) not to expect the results that are likely with a first time surgery (I’m not too worried about that as the biggest determinants of WLS success are the lifestyle changes one makes post-surgery so the ball is firmly in my court, and besides that I lost 165 pounds after my first revision).

i think the most helpful thing for me going into this surgery was accepting that whatever would be would be and whatever happened I have the mental strength to work through it step-by-step.  Also, that the pain, discomfort, loss of independence etc. would all just be temporary and would ultimately help me achieve something more permanent.  I expected the worst but ended up being very pleasantly surprised.

 

 

Hello to a fellow South Australian. I also had a revision from an earlier WLS although mine was much earlier than your first (1986). I did have my revision in SA...at the QEH. Just love my surgeon and still have regular check ups with him. I went into my revision with exactly the same lack of expectations. I was told that while they'd try laprascopically, it would most likely be open incision. There was no guarantee they'd even be able to complete it, and that it was a far riskier surgery than a "virgin" WLS) but in my case much less riskier than my original surgery was. Surgeon told me the risk of death on my original surgery was 10%. My surgery was completed laprascopically,  by two surgeons, over 4+ hours. The bulk of the work being to break up scarring, separate adhered tissue, and repairing the damage from that. The funny thing was that this damage wasn't caused by my 30+ year old bariatric surgery, rather it was from a two year old open hysterectomy. 

I went into my surgery believing that the decision to have surgery was actually made 30+ years earlier. This one was just to fix a complication that had developed (in my case it was stapleline dehiscence),  so the reality was there was no decision to be made. I was very much fast tracked through the public hospital system with only a five month wait, and not even having to go through the outpatients clinic, no hoops to jump through etc. In my headspace that all meant the surgery wasn't a choice, so I never really questioned anything when it came to the should I -shouldn't I. I just headed forward into it totally accepting it needed to be done and "whatever will be will be." As it turned out the bypass went ahead and to plan, the rest of my excess weight just fell off, and life goes on better than before.

Best wishes for a successful surgery and a complication-free recovery @saglass75

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45 minutes ago, Aussie Bear said:

Hello to a fellow South Australian. I also had a revision from an earlier WLS although mine was much earlier than your first (1986). I did have my revision in SA...at the QEH. Just love my surgeon and still have regular check ups with him. I went into my revision with exactly the same lack of expectations. I was told that while they'd try laprascopically, it would most likely be open incision. There was no guarantee they'd even be able to complete it, and that it was a far riskier surgery than a "virgin" WLS) but in my case much less riskier than my original surgery was. Surgeon told me the risk of death on my original surgery was 10%. My surgery was completed laprascopically,  by two surgeons, over 4+ hours. The bulk of the work being to break up scarring, separate adhered tissue, and repairing the damage from that. The funny thing was that this damage wasn't caused by my 30+ year old bariatric surgery, rather it was from a two year old open hysterectomy. 

I went into my surgery believing that the decision to have surgery was actually made 30+ years earlier. This one was just to fix a complication that had developed (in my case it was stapleline dehiscence),  so the reality was there was no decision to be made. I was very much fast tracked through the public hospital system with only a five month wait, and not even having to go through the outpatients clinic, no hoops to jump through etc. In my headspace that all meant the surgery wasn't a choice, so I never really questioned anything when it came to the should I -shouldn't I. I just headed forward into it totally accepting it needed to be done and "whatever will be will be." As it turned out the bypass went ahead and to plan, the rest of my excess weight just fell off, and life goes on better than before.

Best wishes for a successful surgery and a complication-free recovery @saglass75

Hi there @Aussie Bear, it’s nice to be formally acquainted with you as I must confess I’ve read many of your posts when on the hunt for information about revision surgery!  It’s also really encouraging to see your success post-revision, you must be thrilled!  It sounds like you had a very skilled surgeon, I put some of my issues down to my original surgeon, I didn’t realise what a bad job he’d done until after this latest surgery (though I suspected)  but even so I really did my research this time as I wasn’t taking any chances.

The similarities in relation to the adhesion issues with both our surgeries is interesting, who knows what mine are related to, could be the two previous WLS, could be the Appendicectomy (open) or Caesarian or all of the above.  The lap band left me with a dilated Oesophagus if nothing else.  I’m just so thankful that I had a professional, patient surgeon this time who worked through the issues to compete the surgery laparoscopically.  I was blown away when he told me he’d taken 3 hours just to get to my stomach! 

Glad to hear life goes on better than before, I’m certainly hoping this is the end of the road surgery wise for me now (at least in regard to WLS), hopefully I’ll be as successful as you in the long term!  I want to lose 20kg to get to  healthy BMI and then I’ll reassess my goals.

 

Edited by the_gilded_lily

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Thank you all, for responding! My Doctor advises me he would try laparoscopically but may have to do it open. My first one was open so, not too worried about that. He did tell me it will be a 4+ hour surgery. I to was fast tracked I believe this whole time from start to today has been about little less than 3 months! Tomorrow’s the day!! 

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I am really new to this posting thing, thank you so much @the _gilded_lily For your comments. I am hoping that my “insides” aren’t too torn up,  for this procedure. 

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I’m crossing everything for you @saglass75 surgical techniques are advancing all the time so I’m sure all will go well whatever happens.

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how long before you were able to eat soft food? It’s been so long that, I believe it was 6 weeks of clear liquids before I could it my last surgery... 

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Oh wow, that sounds long on clear fluids! I was on full liquids and purées from the third day in hospital, which I’ll be on for at least 4 weeks until transitioning to soft foods, my surgeon wants me to be super cautious due to the risk of complications. I’m finding some purées a bit stiff at this stage though, a soupy texture seems to work the best.  I’d pretty much forgotten what it was like last time, it really is like being a newbie again! 

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5 hours ago, saglass75 said:

how long before you were able to eat soft food? It’s been so long that, I believe it was 6 weeks of clear liquids before I could it my last surgery... 

I was put straight onto soft foods in the hospital the day after surgery, cleared to eat anything I could tolerate at two weeks. My surgeon is into quick transitions. From what he's said to me at various times he believes the earlier people introduce a range of foods the more likely they are to eat more diverse foods after rather than develop physiological interances. From previous members here it seems very similar to their experiences in Europe. My surgeon did extensive testing before surgery, and also did an intra-operative leak test so knew leaks weren't an issue before he even let me leave the OR.

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6 hours ago, the_gilded_lily said:

Hi there @Aussie Bear,

Glad to hear life goes on better than before, I’m certainly hoping this is the end of the road surgery wise for me now (at least in regard to WLS), hopefully I’ll be as successful as you in the long term!  I want to lose 20kg to get to  healthy BMI and then I’ll reassess my goals.

 

Thanks. While I always read revisions aren't as successful from a weightloss point of view, my surgeon did say beforehand that he expected I'd be into the 60s (kg) and in fact was more concerned I'd go into the 50s than he was that I might not lose all my excess weight. I don't know why he thought that....maybe my original surgery being so long ago meant I had regained my "virgin" status (LOL). Maintaining the loss is the hardest part for me. My only surgical related issue has been being diagnosed with reactive hypoglycemia.... That sucks big time, and I have little to no control over it unfortunately even with acarbose and diet changes. The one stage where I managed (to quote my GP and SA pathology report) "excellent glycemic control" I started to have issues with fasting hypoglycemia as well. Unfortunately it is one of those situations where the treatment is also the cause, making it a horrible cycle once it starts. Regardless I'm happier at the weight I am now than I ever was before. I'm one of those folk that believe we are the masters of our own destiny as far as results go. It sounds like you've got your head in the right spot to master your goals as well.

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16 hours ago, Aussie Bear said:

I was put straight onto soft foods in the hospital the day after surgery, cleared to eat anything I could tolerate at two weeks. My surgeon is into quick transitions. From what he's said to me at various times he believes the earlier people introduce a range of foods the more likely they are to eat more diverse foods after rather than develop physiological interances. From previous members here it seems very similar to their experiences in Europe. My surgeon did extensive testing before surgery, and also did an intra-operative leak test so knew leaks weren't an issue before he even let me leave the OR.

I find all the different approaches interesting, both in regard to pre-op and post-op diets, I’d love to know the evidence base behind each one (assuming there always is!). I’m sure your doctor’s approach is in part in relation to his faith in your ability to use common sense, you wouldn’t be one of those people who have pizza on the way home from hospital after surgery causing serious damage and necessitating a 6 week hospital stay (true story!)!

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16 hours ago, Aussie Bear said:

Thanks. While I always read revisions aren't as successful from a weightloss point of view, my surgeon did say beforehand that he expected I'd be into the 60s (kg) and in fact was more concerned I'd go into the 50s than he was that I might not lose all my excess weight. I don't know why he thought that....maybe my original surgery being so long ago meant I had regained my "virgin" status (LOL). Maintaining the loss is the hardest part for me. My only surgical related issue has been being diagnosed with reactive hypoglycemia.... That sucks big time, and I have little to no control over it unfortunately even with acarbose and diet changes. The one stage where I managed (to quote my GP and SA pathology report) "excellent glycemic control" I started to have issues with fasting hypoglycemia as well. Unfortunately it is one of those situations where the treatment is also the cause, making it a horrible cycle once it starts. Regardless I'm happier at the weight I am now than I ever was before. I'm one of those folk that believe we are the masters of our own destiny as far as results go. It sounds like you've got your head in the right spot to master your goals as well.

Ha, love the regaining of your ‘virgin’ status! 

Yes, maintenance, an interesting concept as I’ve not been a weight I wanted to maintain in my entire adult life - it’ll be a novel experience and a whole different challenge!

I’m sorry about the Reactive Hypoglycemia, but it sound like overall the benefits of your surgery far outweigh the disadvantages.  And yes, agreed, the ball is in my court now and I am the master of my destiny for the most part! 

 

 

 

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Hello all, 

3 weeks post surgery.... I would advise anyone doing this surgery to reconsider doing it or carefully weight your options... after my surgery, I was so swollen that my eyes were swollen shut. What was supposed to be a 5/7 hour surgery needed up being an 8 hour surgery. The day after the surgery, I was able to be on a liquid diet, I drank water, lemonade, and little unsweetened tea. I immediately had to go back into surgery because I had a microscopic leak. Had to be intubated for over 12 hours (which was HORRIBLE), and put in ICU for 2 days. So for a surgery that I was supposed to only be in the hospital 1 day ended up being 7 days, and still recouping at home. My Doctor told me that this surgery wouldn’t be easy and he didn’t know what to expect ( because he isn’t the DR that performed my original surgery), but I didn’t expect this at all!! If I had to do it all over again I wouldn’t have done it and lived with the constant heartburn and reflux. While I was in the hospital, after ICU, I couldn’t eat or drink anything for 3 days, after my 3rd day I was put on liquid diet for the rest of my stay and sent home for 7 days on clear liquids. 7th day had my drains and staples taken out and was clear to progress from soft foods to normal foods, but to take it slow and easy. I’m completely off of pain medications. Before I was released my potassium levels were low and they couldn’t keep them up, so I’m doing everything I can to get them up. I believe in a couple of weeks I will go to my primary care physician and have them draw blood and see if I have any low levels. To all that are considering this revision, really research it before doing it. 

Edited by saglass75

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I’m so sorry to hear about your challenging experience, it sounds like it was very difficult for you.  Revision surgery is known to be more risky than first time surgery, I’m so sorry that you were one of the percentage of people who had complications as a result. I definitely feared similar complications, particularly a leak. I’m assuming your surgeon did a leak test as part of the procedure? I known mine did one during the surgery.

In terms of whether or not you would do it over again, it doesn’t really sound like you had an option, particularly in relation to the Gastrogastric Fistula, the potential longer-term complications of leaving it to go unmanaged are just as scary in my mind. The reflux etc. is one issue but the GGF is another matter altogether.

i wish you a speedy recovery, hopefully you’re on the up and up now, perhaps you’ll feel differently when the benefits of the revision are more apparent. I had an awful time with my previous two surgeries, my bypass ended up being open, I spent time in ICU, I too was intubated then was going to potentially be tube fed for 6 weeks (it wasn’t needed thankfully) and had a long recovery but ultimately lost 160 pounds as a result, my only regret despite it all is that I didn’t choose a better surgeon.

Thinking of you and I hope you feel much better soon! 

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So sorry you are having a rough time @saglass75@Kim M had a revision not too long ago form sleeve to RNY because of gerd.  Hope I never need to have one and hope my meds keep doing their job.

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Thank you so much, I know after the surgery I did a barium swallow and was cleared for liquids. So I would have to assume that they didn’t see any leaks? I was so out of it the whole time in the hospital, I have no clue what was going on to tell you the truth! I’m glad it’s over and am slowly getting my strength back day by day. 

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Great to hear and I hope you continue to improve day-by-day.

 

 

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