SIPS or SADI-Y

Is there a section on SIPS?

Not here, but I believe there's one on Facebook.

SIPs, Sadi and single loop DS are all the same thing, a newer version of the DS that leaves a longer common channel, about 350 to 400 cm, instead of 50 to 150 cm under a standard DS. Many people mistakenly think you don't lose as much weight or get lesser results but I am a big believer in this procedure, and the lower risk during and after surgery.

This DS board has many people who have had the Sadi which is now becoming more common.

Actually it is more like a better version of the RNY...one that keeps the pyloric valve.

There is no separate forum that I am aware of on OH for this operation. It is controversial. There are some people who swear by it and I'm glad they are pleased with their surgeries. However, it is still considered experimental, at least in the USA, and long term results are unknown. There is actually a clinical trial underway on this very subject, though it is not designed in such a way as to measure long term results, only short term.

 There are a few DS surgeons who are now doing SIPS instead. There are also some surgeons who have been doing gastric bypass for years who are now offering SIPS. I do think SIPS is better than gastric bypass and avoids many of the disadvantages of gastric bypass, such as possible dumping, inability to take NSAIDs for the rest of your life, etc. But at this point there is no evidence to show that results of SIPS are equal to those of the DS. The lowering of surgical risk is small, IMHO, because the one anastamosis (bowel to bowel connection) that is avoided is the easiest part of the operation. All the risks of the sleeve gastrectomy and the work on the duodenum are still present. As to whether or not there will be less issues with nutritional deficiencies longterm, this remains to be seen, but the rate of such deficiencies with DS is small to start with when patients are properly educated as to their nutritional needs, and usually due to noncompliance.

I would encourage you and any other pre-op to carefully research all your surgical alternatives. If the surgeon you are seeing does not offer the operation you feel is best for you, go to a different surgeon. Also, check your insurance carefully as well. If you want the DS and it isn't covered, that can often be appealed. But most insurers don't cover experimental procedures. There are apparently some surgeons who are coding SIPS as a DS, when they are NOT the same operation, and whether or not that will come back to bite them in the behind remains to be seen.

I had SIPS on October 26,2014. My surgery was coded as two separate procedures: sleeve gastrectomy and small bowel anastomosis. Apparently it was ok with blue cross. 

As for the malabsorption component, I cannot imagine DS being that much better. I've found that when I focus on protein and really watch the fat and carbs, my weight loss is slower than when I eat more fat and carbs. As a matter of fact, when I hit a stall, a day with heavy carb consumption seems to get the scale moving. Whether that effect lasts long term is still to be seen. What I do know is that I eat significantly more volume than RNY patients that I know and the weight just keeps falling off. 

When I decided on SIPS, I did it because of the lower risks.  If it doesn't work out long term, revision to DS is always an option.

I had SIPS in January 2015, it was revision surgery, I previously had a RNY in 1996. I lost about 45 pounds very quickly and now the weight is coming off slim to none. I don't know what I'm doing wrong. I can eat more now than I could with the RNY and that with the slow weight loss is frustrating me greatly. Dr. Jon Bruce did my surgery. Any tips you can give me are appreciated.

Did Dr Bruce revise your rny pouch to a sleeve?

I am sooooo glad to find someone who has had a revision like the one I am contemplating and bonus from the same surgeon.  I have had sooo many questions and no one to turn to.  I had RNY in 2004, since then i've regained 67 lbs since then still not as heavy as  I was pre - RNY.....of which I am happy about.  But if you don't mind answering the following I would appreciate it.

Insurance company?

Pre-op Tests you had to take?

and any tips you have for me as well.

Well, that was some very creative coding IMHO! Sleeve gastrectomy doesn't involve any anastamosis. It sounds like your surgeon (or his employee) just took two existing codes and cobbled them together.  If I were the insurance company employee reviewing this, I would wonder what the heck the anastamosis was for. But apparently someone ok'ed it without asking any questions.

Larra