What happens if your stomach pouch expands post op??

Hi, I am studying the various WLS options trying to define which one is right for me (I'm new at this). 

I read that one of the problems with the Sleeve is that after a while, the stomach pouch expands, and you can again eat "normally" thus gain back the weight... 

Has this happened to anyone?

If this were the case, can you get a "reoperation"? to again reduce the size of the stomach? 

Can the sleeve been transformed into some other form of surgery, if needed?

Just trying to assess all scenarios, even the worst case ones.

 

Thank you

you really have to eat really bad to stretch your sleeve out

 my surgeon said it starts out around 4 oz and after around 1 year stretches to about 8 oz

before surgery it is normal to be 32 oz or more

 also the hunger hormone is much reduced , and most  people feel little or no hunger

 if you do stretch you sleeve most of the time it can be fixed , with surgery  or revised to a ds 

 the sleeve has the least side effects of all the surgery and about the same weight loss as the rny, a little less than the ds

 and much more the the lap band , read the revision forum if you are thinking about a band it is full of horror stories

 the poach in the rny is more likely to stretch  than the sleeve in the vsg or ds and the malabsorption of cal in the ds and rny stop working in about 1- 11/2 years but you still keep the malabsorption  of nutrients      

the surgery for the sleeve is also much safer and is my surgeons preferred surgery for heavy weights

Hi - with the sleeve we don't have a pouch - we have a long thin sleeve.  It is really tight right after surgery from swelling - after several months with healing the swelling does go down - so the person who has a sleeve goes from being able to eat a couple of tablespoons at a time to maybe 3/4 of cup (depends on the person really though).  

The regain issue with the sleeve is less about stretching it out (it is the least stretchy part of the stomach) and more about food choices and grazing.    If you eat high calorie foods, or graze all day long, you will regain...

Hope that helps.

If you have a sleeve and are not happy it can be converted to a RnY. However a RnY can not be converted once that is done its done.

Thank you all for your very helpful responses. I now wonder why my surgeon suggested the gastric bypass rather than the sleeve, given that I have about 77 pounds to lose (but would be happy if I lost just 60 or so!!), so I fall into the "obese" category but not the "very obese". At first I was OK with his suggestion, but the more I read about the various surgeries, and the complications with the R&Y/gastric bypass, the more I am worried about the malabsorption issues. I am already tendentially anemic, such an operation would make it much worse... 

I will talk to a couple more surgeons and see what they say about the sleeve. Oddly I associated this operation with the old time "stomach stapling" on which I have heard horror stories, but if I understand it correctly the sleeve is a more modernized, improved and safer version of that original operation?

Thank you again

Your surgeon may have suggested the RNY because he's more familiar with it.  The VSG hasn't been performed for as long, so not as many doctors do them, and there aren't as many long term studies.  Based on five year data, it has the lowest complication rate of any of the surgeries and patients maintain an average excess weight loss of 60%.  With your history of anemia, the RNY doesn't sound like the best option.  Definitely check with other surgeons and see what they say. 

I'm inclined to agree with you, both about the experience of the surgeon (RNY over sleeve) and the anemia... will keep exploring. Thank you :)

Nina, the surgeon you talked to suggested the RnY because he/she is probably much more familiar with it and has done it routinely. The sleeve as a stand alone for weight loss has probably been around for about 10-15 years. Before that, the partial gastrectomy was commonly performed for ulcer treatment as well as some forms of stomach cancer. There are options in Europe for excellent sleeve surgeons in Germany, Belgium and Spain. I don't know about Italy. If you are willing to travel and can do that insurance wise that opens a whole lot of possibilities. Also my surgeon does travel and performs the sleeve in Europe. I almost had it done here but at the last minute prefered to go to him in Montreal instead. 

With regard to stretching out the sleeve it really depends on the skill and technique of the surgeon in terms of how much of the fundus is removed. If all of the fundus is removed the rest of what is left of the stomach tissue is less stretchy and does settle to about double the initial capacity. I am at one year out now and my capacity is about 6 ounces of which maximum 3 - 4 is protein and then a little bit of vegetables. A far cry from the pre op volume!

Honestly with under 100 lbs to lose, I would not hesitate and go with the sleeve, but you have to research, discuss and decide. 

The sleeve can be converted to the DS if you want the malabsorption. I wrote to you about that in your post on the main forum. The DS is by far the most superior of all weight loss surgeries in terms of amount of loss and speed of loss and maintenance but does come with a very strong malabsorptive component for life and requires the patient to be highly commited to a vitamin regimen and be very vigilant with labs. 

Best of luck with your research. I would be more than happy to speak to you more about it if you like - we are almost neighbours!

 

Hi Julie, thank you so much for both your emails :) I actually had in mind to write to you privately as you so kindly offered to discuss further, I just haven't gotten around to it. I will contact you though - I love that we are almost neighbours, I've really appreciated the support and help I have gotten since I signed up, but somehow the practical vicinity makes me feel even less isolated in this process. I had originally and automatically pushed aside the sleeve option, but the more I read about it, the more I am inclined to agree with all those who suggested it ; I'm very wary of the malabsorption issues, and if at first I wanted a first and final surgery, maybe being less drastic and taking this "progressively" is a better, more reasonable option. I don't think I truly qualify/justify for DS (for sure) nor even necessarily Y&R ; i was "propelled" into thinking it was a solution because of the surgeons's suggestion and driven, in part, by the fear that "nothing else" will work well. I am not concerned about losing all my weight in 10 seconds, but more about having a valid tool that will help me lose the weight and KEEP IT OFF, alongside the necessary emotional/psychological work.

I will contact  you privately and we can discuss further. 

Thank you again