Expert: Karla K. - 8/8/2007

Question
Hi,

I has y enroute gastric bypass in 2005.  My starting weight was 331, I got down to 249 pounds and am back up to 285.  I heard about a procedure called Stomaphyx which will strink the stomach again.  The thing is it's not offered in my state.  I'm now considering an altrnative to Stomaphyx and came across the gastrc bypass revision.  Can you explain exactly what takes place during the revision?  I'm looking for something that is as non-invasive as Stomaphyx.

THansk!

Answer
Hi Aneika:

In general, a gastric bypass revision usually means that the surgeon will bypass more of the intestines--and thus, it is considered pretty invasive (even if it is done laparoscopically). This type of revision is sometimes covered by your insurance company... although some will require you to go through a physician supervised diet again.

StomaphyX is a very new procedure--and I'm sure more and more physicians will be trained in it.  Try checking back with the EndoGastric Solutions website's physician locator to see if a physician in your area begins to offer it. http://www.endogastricsolutions.com/ (However, be warned that it probably would not be approved by your insurance company.)  

Another similar option is EROS (Endolumenal Revision of Stoma)...it's another endoscopic procedure which may appeal to you.  It uses sutures placed endoscopically to reduce your pouch size; whereas StomaphyX uses polypropylene fasteners. As it is a new procedure, it faces similar issues to StomaphyX--limited physicians trained in the procedure as well as doubtful insurance coverage.

Many Roux-en-Y patients are also electing to have a Lap-Band placed around their pouch. Although this involves surgery, it may be covered by your insurance company.

You can also look into a duodenal switch as a revision operation. It involves much more vigilance to vitamins and minerals--as well as greater operative risk; however, long-term weight loss is excellent.

Finally, you can look at a few behavior changes (easier and cheaper than any revision).  Try going back to basics with your surgery and see if that speeds up your weight loss.  You're only two years post-op, so it’s unlikely you've had much pouch stretching in that time.  Many people find that by going on an exclusively protein shake diet for one to two weeks, they can shrink their pouch, eliminate cravings, and get back on track. (Anecdotal evidence, no studies to support this.)  Following that, choosing healthful proteins first, fruits and veggies second, and carbs third in all of your meals should lead to continued weight loss. Of course, an exercise program of any type will help as well.  Collagevideo.com has a great selection of DVDs and VHSs by skill level.  Other weight loss surgery patients find success with Weight Watchers and other programs—as their reduced stomach capacities make the plans do-able.

Whatever you choose to do, please seek out a surgeon who has experience doing revisions; rather than just a general bariatric surgery. Revisions carry their own risks/issues and it helps to have somebody familiar with those issues.

Good luck!