Sleeve revision to DS

on 2/25/20 11:04 am
VSG on 06/27/16

Hi! I had a sleeve done June 2016. It went fantastic and I lost 130lbs. I then got pregnant and had a baby boy and since then I have noticed I'm able to eat a lot more. I saw my surgeon who then said because I have gained 70lbs back I should get either the bypass or DS. I chose the DS but am now second guessing myself because of the fact that the doctor said he wouldn't be touching my stomach because I've already had the sleeve. He would just be doing the switch part "bypassing intestines". So now I am worried that it won't be as effective if my stomach has stretched.
Does anyone know anymore about this? is it just as effective without doing a re sleeve on the stomach as well?
help I'm so confused!!

White Dove
on 2/27/20 4:17 am

A virgin D'S is more effective than the two part procedure. But that train has passed. The D'S will give permanent absorption of fat. Carbs will still be absorbed.

You need to do a lot of resear*****luding talking to people who have done this. Learn what your life will be like after the surgery. This is not the sleeve.

Research here and ask your surgeon to get you in touch with other sleeve to switch revisions. Ask about how they handle eating, bathroom changes, gas, and weight loss. Know what you are getting into and decide if it is what you really want.

Real life begins where your comfort zone ends

on 2/27/20 8:13 am
VSG on 06/27/16

Thank you so much! I will definitely do some research. I would love hearing from people who have had it for sure. I have not been able to find many people.

on 2/27/20 8:16 am
VSG on 06/27/16

Also I have not found much information on a DS without the sleeve.

White Dove
on 2/27/20 4:35 pm

Some surgeons were doing that in Europe about 15 years ago to try to stop diabetes in people who were normal weight. I don't think it was ever done in the USA.

Real life begins where your comfort zone ends

Janet P.
on 2/28/20 10:36 am

I know of one person years ago who's husband had it done to stop diabetes. He was normal weight and only had the switch done. Don't know any more details.

Janet in Leesburg
DS 2/25/03
Hazem Elariny

on 3/1/20 8:37 am
DS on 12/17/18

I think you mean the DS will give permanent MALabsorpion of fat. Carbs will still be absorbed.

OP, do your research and maybe get a second opinion from another bariatric surgeon.

White Dove
on 3/1/20 9:06 am

You are right, I did type that wrong and meant malabsorption of fat.

Real life begins where your comfort zone ends

on 3/1/20 6:09 pm - CA

When I had my VSG, I talked to Dr. Rabkin on this subject - the prospect of revising to a DS later as a "plan B" for regain, and he noted that their experience on the matter is that it works best if you catch it early, before substantial regain occurs. A parallel note is that in the support group meeting descriptions, they presented a semi-rule of thumb that with the DS, it is the sleeve that gets the weight off, while the switch keeps it off. That may not be 100% correct, but call it an 80/20 proposition. So, look at the switch part as more of a maintenance tool than a weight loss tool.

As to whether your sleeve should be revised along with a switch revision, IIRC Keshishian noted in some of our group meetings that when he does the revision, a resleeve is a sometimes proposition, depending upon the condition of the sleeve. Given that there were quite a few wonky sleeves done in the early part of this last decade when it was new to most bariatric surgeons ("twenty years of doing bypasses and they think they know how to do a sleeve...") then there were quite a few that had to be resleeved. As others have said, I would be inclined to get a second opinion and maybe get an upper GI done to get a look at what shape your sleeve is in.

Historical note - as the story goes, the DS had its origins with procedures developed in Europe to treat diabetes, to which the VSG was added to make it a weight loss oriented procedure. These days there are several implantable devices in development that seek to emulate the what the DS does for diabetes by blocking absorption in the upper intestine (things like endoscopically implanted sleeves) so the idea is still active, but being explored in a different form.

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


on 3/2/20 7:17 am
VSG on 06/27/16

Thank you so very much for all of this information! I will talk to the surgeon again! My fear is regaining weight again. With the gastric bypass, it is very possible but with the DS it's less possible. That is why I want the DS but I also want the resleeve so I'm nervous.
thanks again! Wish me luck!!!

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