Another vote here for the DS as the next step for a VSG that isn't providing the expected gain, or if regain is a problem. Averages suggest that a move from the VSG to the RNY is a sideways move, as both are very similar in their weightloss and regain characteristics - the RNY has a token malabsorption component, but it is temprorary at best, though its' mineral malabsorption is permanent. Further, the RNY is something of a dead end, surgically speaking, as if it doesn't work for you, there is little that can be done to change it - there are minor tweaks they can do like tightening the stoma or banding a stretched out pouch, but converting it to something more effective like the DS is very compicated, a procedure for which very few surgeons are qualified (Gagner is one, Rabkin is another, and there are a handful of others - assuming that there is enough to work with after the sleeve has been cut up to make an RNY pouch. The downsides of living with the RNY and DS are similar, though the RNY is more limited in dietary and medical treatment options (no NSAIDs for pain relief, for example); both malabsorb some nutrients, with the RNY more fully malabsorbing minerals while the DS only partially malabsorbs minerals but also malabsorbs the fat soluble vitamins A,E,D & K. The vitamins are more readily supplemented than the minerals often are, with many more RNY patients subject to periodic iron infusions than DS patients. The main long term malabsorption of the DS is fats, along with some carbs and protein; overall, it typically moves ones' metabolism back to a more normal state and allows for more normal eating patterns. It is not a total solution to your eating weakenesses - no WLS is - but it is more tolerant of them than other procedures.
1st support group/seminar - 8/03 (has it been that long?)
Wife's DS - 5/05 w Dr. Robert Rabkin VSG on 5/9/11 by Dr. John Rabkin