Expert: John Pilcher, MD - 3/8/2010

Question
I had to have my 2005 RNY "reversed" after 2008 emergency surgery indicated ischemic and necrotic small bowel in several locations, one being the end by the small pouch. The "old" stomach was viable and surgeon was successful in reattaching everything. I only have 150 cm of viable bowel remaining. However, I've gained  54lbs in 16 months. Is there any type of WLS that might be considered for my circumstances?  General health is good but bmi is creeping up and is now around 35. I try to control eating and exercise daily. Thank you

Answer
Linda,
Goodness, you have had a rough time!

I believe that some version of a sleeve gastrectomy might help you keep eating under control, without creating any additional problems with absorption.  Your surgeon would need to get a good understanding of your current gastric (stomach) anatomy and would need to figure out a stomach reduction procedure like a sleeve that fits with your current body shape.  The concern would be that removal of a large part of your stomach can never be reversed.

Some surgeons might recommend a gastric band, and while I suspect this is possible I am not as confident about long term success.  The plus side of the Band plan is that it could be reversed in case of problems.

You can find experienced and highly competent bariatric surgeons in your area online at:
http://www.surgicalreview.org/locate.aspx

Yours is a challenging situation, but I would not throw in the towel yet!

Best of luck,
Dr JP