Expert: John Pilcher, MD - 9/6/2008

Question
I had open roun-y done in Sept. 2000, and lost 175 lbs.  I have gradually gone back up (was 376 lb) mostly in the last 2 yrs. and now weigh about 270.  I can't take putting on any more weight, I already am bombarded with health problems---asthmatic, fibromyalgia, oesteoarthritis,  bursitus, rheumoatoid arthritis, a crippled ankle and the list goes on.  I am currently on disability and cannot do much exercise at all.  Have been to PT and tried everything my Drs. have said.  One Dr. recommends trying a lap band procedure--and want to know if it is feasible and what the risks are following the roun-y.  I am 2 hr. from Columbus Ohio and dont know how to find a Dr. there, but have been told that they do them.  What are my other options?  Any info will help me.
Thank you.
Karen

Answer
Karen,
There is no single right answer for what to do when you have weight regain after bariatric surgery.  I'll give you a few thoughts, but the key thing will be for you to meet with a Center of Excellence surgeon close to you.  You can find a listing on our national organization website at:
http://www.asbs.org/html/about/membersearch2.html

I am familiar with the idea of putting a Band on a gastric bypass.  My personal opinion is that if the gastric pouch is large enough to accept a Band, then revision (surgical shrinking) of the pouch should be considered instead.

The surgical team will also have to consider whether your pouch is enlarged at all, and you need to know that sometimes gastric bypass patients gain weight even if the surgical anatomy is perfect.  That is a hard situation where lifestyle change is the only way for further weight loss.

In closing, I strongly recommend you focus your energy on finding an experienced surgeon in your area.

Best of luck!
Dr JP