Expert: John Pilcher, MD - 7/11/2008

Question
Twenty-six years ago, I had a gastroplasty surgery. After losing 110 lbs., I had a complete obstruction (stomach pouched tipped over when solid food entered) even though I was following all the rules, & the gastroplasty was reversed.  I'm now back to a BMI of 42, & I've been told recently that I am not a candidate for laprascopic surgery and would need to have a revision. What risks would I be facing, & would I even be considered as a revision candidate?  If so, who is the best "revisionist" in my region (I live in Ashland, KY)?  THANKS!

Answer
Linda,
My opinion is that revision surgery would be fairly risky because of the old scar and the disruption of your gastric anatomy, BUT that it may well be worthwhile from a health standpoint because of your increasing weight.  There are some surgeons who would aim to do a revision like this using laparoscopic techniques, but many other excellent surgeons who would only attempt this using an open approach.

I don't really have a handle on who is the best "revisionist" in KY but to be honest I would be cautious about promoting a certain surgeon in any case.  I think you can't easily go wrong if you go to a surgeon & program who have been designated as a Center of Excellence.  You can find such surgeons in your area using our national organization website at:  www.asmbs.org

Given the complexity of your case, you may need to visit with more than one surgeon or program.

Best of luck to you!

Dr JP