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Bariatric / Weight Loss Surgery Community
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Avatar universal

Extremely Confused

I have been approved for the roux en y gastric bypass operation but I am not sure that I can go through with it.  I am not sure that this operation is right for me, and I'm really scared too.  I went to a general/bariatric surgeon looking to repair a large sliding hiatal hernia with half of my stomach moving in and out of it, and to get anti reflux surgery.  

I have long segment Barrett's esophagus for 2/3 of my esophagus, but no dysplasia, moderate peristaltic dysfunction with frequent failed peristalsis, severe GERD, and two doctors have said they that they think I have a really slow digestive tract.  I also have celiac disease, and have already had major malabsorption issues.  I am morbidly obese, but my BMI is either 36 or 37.

I saw a regular general surgeon, before this new bariatric one, who wanted me to lose a lot of weight so that he could do a hernia repair and a partial fundoplication because of the swallowing problem.  It is extremely hard for me to lose weight and keep it off so this surgery hasn't worked out yet.  I have also heard that regaining weight can make a hiatal hernia repair much more likely to fail, and frankly I really see myself regaining weight after losing it for this surgery, but I am willing to try losing weight again, and maintaining the weight loss, if surgery is necessary.

My question is since I already know how to deal with what I've got, and there have been no changes to the Barrett's, should I just do nothing, or do I really NEED to fix my problems?  Does this new surgeon's plan sound reasonable and like my best option, or does the first surgeon's much less drastic plan sound better?The new surgeon says that the roux en y would protect the esophagus from further damage; he doesn't want to do even a partial fundoplication because of my swallowing issues.  He says that the roux en y would help protect the hernia repair because I would be losing weight and taking pressure off of the repair.  He says that if not fixed the hernia could keep getting bigger; I am not sure that this is even a likely scenario.  He calls the roux en y a win-win surgery for me, meaning I lose weight and get my gastro problems fixed too.

I really want to just leave everything alone, keep treating my symptoms with Dexilant, diet, elevated bed, and the occasional round of inhalers, steroids, and antibiotics when I aspirate.  I am not sure which surgeon to believe about my swallowing and the partial fundoplication.  I have also read about high hiatal hernia repair failure rates, even without an obvious reason.  Even though I have symptoms, why should I even fix the hernia?  Suggestions?
1 Responses
Avatar universal
I'd get second and third opinions from another bariatric surgeon as well as a GI surgeon. I'd probably skip over the general surgeon because you have complex medical issues. You probably have to decide if you want to minimize the chance of further health detestation as you age against the status quo. (Ie, keep doing what you're doing now.)

After life long failed attempts to achieve and maintain weight loss, at age 44, I had a roux-en-y in 2006 during which my hiatal hernia was also repaired. I've maintained my 100 pound weight loss and was able to discontinued my high blood pressure meds. . Because of concerns with malabsorption,I get regularly blood tests and am really focused on nutrition.  

Hope you're able to find choices that you feel good about!

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