WEIGHT LOSS SURGERY REVISIONS | Reoperation after Bariatric Surgery

Dr. Blaney is talking about re-operation after weight loss surgery. This is occasionally required when patients experience unsatisfactory weight loss or weight regain. However there can be complications or side effects that might necessitate converting or revising a previously preformed bariatric procedure.

[TinaRN]

Had a RNY in 2002, Lost 120 pounds, but it was hard work. Regained 60. He told me he’d bypassed 75cm. I’ve also been sick for nearly the entire time!
I had a conversation to a duodenal switch, two weeks ago. He discovered I’d had a 50cm bypass! No wonder I regained! He also made me a new pouch from my stomach that was hanging in limbo.

[tawnjoans]

How much weight do you loose after a revision?

[Aileenlight]

I have gastroslevee around 5 ayears ago and before i was almost 400 the first year i get in 134 my goal weight but i have a baby 2 years after so about a year i star having bad reflux bleeding vomiting at the point i cant eat anything nothing i cant go out do nothing because i fall for dizziness i vomiting more then 11 times at day and now every 2 or 3 months i have to do a biopsy with endoscopy to the doctor monitoring the beret sindrome i have so see so many doctor and finally my doctor tell me if i reverse my gastro sleeve i can feel better i just pray is true becsuse so many times i just thinking give up i feel so miserable vomiting day and night and bleeding like crazy

[amandaathanas]

PART I OF II:

He looks half dead.

At 3:18, he goes against his own initial definition in the beginning of the video by talking about changing a Gastric Bypass to a Duodenal Switch as a “revision” rather than a “conversion.”

Why on earth would anyone go from a Balloon to a Gastric Band (as he mentions), when everyone knows Gastric Bands are an utter failure, both in terms of weight loss and complications caused by the band? Also, he already stated in the video that the most-oft performed conversion by far is from Gastric Band to other weight loss surgeries, due to the fact that the Gastric Band usually fails to achieve the promised weight loss. In fact, almost no bariatric surgeons worth their salt will even perform Gastric Bands anymore, unless they see it as a way to make extra money by performing the Gastric Band first (knowing it will fail) and then being able to make extra money off of the patient down the road when they predictably come back with poor weight loss and/or slippage or complications related to the band, at which time they can talk them into the Gastric Sleeve or the Gastric Bypass...

As far as reflux after the Gastric Sleeve, it can be resolved by the patient themselves naturally by taking Betaine (“made from beets”) Hydrochloric acid (“HCL”), which is available wherever supplements are sold, including Amazon. There are several brands available. I do not sell anything. I am not associated with Amazon. I do not recommend any particular brand.

It is usually under $20 or $30. Most people would not even go through 1/4 of a bottle before they resolved their reflux. But I would hold onto the bottle anyway, because after you are several years out from Gastric Sleeve, you will able to eat more quantity of food (which requires more stomach acid to deal with), and if you have a particularly large meal or are under a large amount of stress, you might have a kind of “reflux-y day” and then you could take 1/5 of a OTC HCL pill and be on your way. So don’t throw the bottle away just because you don’t need it anymore.

The only time HCL would NOT be recommended is if the patient has a current Hiatal Hernia that has not been repaired surgically yet. These are usually repaired down the throat endoscopically. You do not need laparoscopic or open surgery to repair a hiatal hernia. But if they get the Hiatal Hernia repaired, THEN they can use HCl after about a month of healing time. However, they probably wouldn’t even NEED HCL after they had the Hiatal Hernia repaired, because the Hiatal Hernia itself causes reflux in most cases, and that may be the only reason why they ever had reflux.

On the other hand, people that have Gastric Sleeve often do develop reflux because of the loss of stomach acid, due to the loss of 85% of their stomach wall tissue. The stomach wall tissue contained their proton pump cells which produced their stomach acid. By removing 85% of their stomach, they lost 85% of their stomach’s acid-producing cells, so they ended up with low stomach acid which is the TRUE cause of reflux (except in the case of Hiatal Hernia). Of course, a Gastric Sleeve patient with a Hiatal Hernia can have two (2) reasons for THEIR reflux. The first thing they need to do is get their Hiatal Hernia repaired then wait and see if their reflux goes away, and if it doesn’t, use HCL to get rid of the reflux that remained due to the low stomach acid after the Gastric Sleeve. If you were diagnosed with a Hiatal Hernia before having your Gastric Sleeve done then by all means insist that your doctor repair your Hiatal Hernia during your Gastric Sleeve procedure. Then after about a month, if reflux rears its ugly head, you can start on over-the-counter HCL. Do NOT let a bariatric surgeon get away with not fixing your Hiatal Hernia during your Gastric Sleeve if you know before your surgery date that you had a Hiatal Hernia. Many of them are remiss in fixing the Hiatal Hernia during the Gastric Sleeve procedure, and I believe that is because they know that it causes reflux to have a Hiatal Hernia, and they are looking forward to the extra doctor visits, diagnostics, prescriptions and future surgeries that they think they can count on by not repairing your Hiatal Hernia during your Gastric Sleeve surgery.

Some people only developed a Hiatal Hernia after their Gastric Sleeve. That usually comes from eating too much volume at each meal. But in any event, what they should do is immediately get scheduled for endoscopic Hiatal Hernia repair. They could try eating less at each meal and stopping before they get that full feeling for a few weeks or months to see if the Hiatal Hernia self resolves. But if it doesn’t, then they need to get it endoscopically repaired or they will continue to have reflux and continue to damage their esophagus which is a really bad idea because that can lead to something called Barrett’s Esophagus which can then lead to Esophageal Cancer. So don’t play with reflux.

But if there is no Hiatal Hernia involved in the situation, and you simply have reflux after getting a Gastric Sleeve, then in order to fix reflux it is necessary to put BACK the lost stomach acid by taking HCL. However, after having 85% of your stomach removed, the dosage of the HCL that you would need would be about 1/5 that is on the bottle label. Another caveat is that if you have had the Gastric Sleeve and you have reflux and you have allowed your doctor to put you on a PPI (such as Protonix/Pantoprazole or Omeprazole or Dexilant) for any length of time, you will need to WEAN OFF of that prescription for at least 2-4 weeks before starting the HCL. That is because stopping PPIs suddenly will cause a phenomenon called Rebound Reflux. This is probably because the PPIs were telling the proton pump cells in your stomach wall NOT to be active or create stomach acid, and then when the PPIs are stopped suddenly, the cells go into overdrive and start making up for lost time, causing Rebound Reflux. If a person starts HCL after stopping a PPI suddenly, they will experience Rebound Reflux and erroneously blame the HCL.

Note that PPIs don’t actually fix reflux — they only cover up the SYMPTOMS of reflux. They actually do the opposite of what is necessary to fix the root cause of reflux. The root cause of reflux is actually LOW stomach acid, not high stomach acid — as we are constantly LIED TO by all of our doctors, including all bariatric surgeons. That is because this is what they were taught in medical school. The reason they were taught that lie in medical school is because Big Pharma controls medical schools and controls what is taught about reflux in order to sell their PPIs, which are a $10 Billion annual business to Big Pharma.

But after a doctor has been in practice for a year or two, they will have had plenty of time to realize they were bamboozled in medical school and that the opposite is actually the truth, that LOW stomach acid causes reflux, not high stomach acid. However, they must continue to lie to all of their patients in order to keep their jobs and their medical license thanks to The Standard of Care (which forces all doctors to do the same thing and act like robots, even if doing something different would be better for the patient, which explains why no matter what doctor you go to you get the same runaround).

There already WAS a natural solution for reflux for several decades prior to the development of PPIs. But Big Pharma could not make money off of a natural supplement, so they had to create a complete 180° opposite-of-the-truth lying narrative to create a market for their PPIs. The truth is that LOW stomach acid causes reflux, because it does not trigger the Lower Esophageal Sphincter (LES) (which sits between the bottom of the esophagus and the top of the stomach) to close and close tightly. The LES needs to sense ENOUGH stomach acid beneath it in order to be triggered to close and protect the esophagus. It’s all about the LES valve. Stomach acid should be HIGH which is how it was designed to be by God, in order to kill off pathogens, bacteria such as H-pylori (which causes ulcers), and viruses before they pass through the stomach. High stomach acid is healthy. It starts to break down food particles. It is an important early part of the digestive process. Lowering someone’s already low stomach acid by putting them on PPIs is going to worsen their health and lower their immunity which is a really BAD idea during Covid.