Revising from VSG to DS, opinions on the switch portion only

Gmat

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Oct 24, 2015
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Hello Everyone,

I was looking at the revision from VSG to DS. I had VSG done in 2012 and lost almost 90 lbs. Have regained about 45lbs. Was wondering if just getting the switch portion will help or should I try to get the resleeve as well. I am definitely on the light weight side, about 5ft 10 in..and currently at 195lbs, but putting the weight back on around 1-2lbs a week it looks like. I really don't feel any restriction at all anymore.

Also, any differences in recovery between the 2 procedures.

Thanks
Gmat!
 
Hello I have no answer for you but just wanted say welcome . According to the Bmi calculator you should weigh 151-186 for normal bmi. Are you cash pay. I find it hard to believe insurance would pay for a switch because you are 9 pounds over weight. Your bmi is only 27. Idk @Larra and @DianaCox would know best.
 
You don't qualify for surgery at your weight. You could probably get down to a normal BMI in a month of eating low carb. Do you have any metabolic diseases? Because there is no way in HELL you should have bariatric surgery in this circumstance if it's only that your weight is going back up, in particular a dangerous procedure like resleeving.
 
As to whether or not a resleeve would make a difference for you, that depends on the condition of the sleeve you already have. If it was not constructed correctly to start with, or if it has stretched out a lot over time, a resleeve would be needed. This determination could only be made by your surgeon, after checking out whatever testing has been done/will be done to look at your sleeve.
As to the risks, it is much more risky to do a resleeve than a virgin sleeve because the surgeon must make certain that the entire old staple line is removed. Otherwise, he/she will be stapling over staples and that creates an area that is at higher risk for a leak, which is a very serious complication. Also, there will be scar tissure around the sleeve to deal with, and that can also create problems, but the staple line issue is the bigger issue.

According to my calculations - well actually the bmi calculator at the NIH website - your bmi now is about 28 and your original bmi when you were 45 lbs heavier was 34.4. My guess, which I freely admit could be wrong, is that you self-paid for your original sleeve, and are self-paying now if you have further bariatric surgery. There are plenty of docs who will gladly accept your money, cash up front, for surgery. That doesn't mean the surgery is in your best interests. I don't know anything about your overall health, and can only hope that you are putting your health as your number 1 concern and stuff like appearance, clothing size, etc a very distant second. That's why I always refer to bariatric surgery and not "weight loss surgery". This is about your health, not the scale or your appearance.
 
Question:
Is it safe for him to want to get down to the low end of his normal weight which is 151lbs resulting in 44lbs to loose, not 9lbs.? And while 44lbs seems like peanuts to some, it's a lot for others. And he probably just wants some restriction too because he still battles with eating disorder and continues to gain and just needs a tool to help like all of us. The main question is what are his consequences health and risk wise compared to anyone else? I know someone who had VS to DS revision surgery with only 60lbs to loose and is doing very well. She could have only lost 34lbs to get to normal bmi but she lost a total of 55lbs which got her down to the low end of her bmi. Smaller than I liked to see her but she eventually gained a few and looks beautiful and healthy for a 54 year old person.
 
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It is my opinion that the DS surgery should be reserved for those who are morbidly obese-period. As mentioned, you will always be able to find a surgeon if you self pay, but that doesn't mean it's the correct thing to do. Like all important decisions in life a risk/reward ratio must be considered. You must weigh the value of losing those 9-25 lbs against life long malabsorption requiring huge numbers of vitamins daily, an inability to use slow release medications of almost any form, stinkier bowel habits and gassiness, and the risks associated with the surgery itself. Some here, myself included, have actually lost too much weight and struggle to keep weight up. A few have had to either revise their switch or undo it entirely. This is not a procedure to consider frivolously, and I think you should absolutely not entertain the thought of taking such a radical step. We who were morbidly obese or in my case super morbidly obese had no option....you do. I would instead recommend you explore why your procedure is failing you, and look for a solution to address that problem directly. There are no magic wands out there, and the dream of eating whatever you might want without any consequences has NEVER existed for any of us. Don't make the mistake of looking only at the positive aspects of the DS, but look also at it's many draw backs. Best of luck to you.
 
It is my opinion that the DS surgery should be reserved for those who are morbidly obese-period.

I disagree and I'm sure others do. Our own @southernlady was a light weight. I believe that anyone who has life threatening diseases should be able to have the surgery. I would have tried if I was a lightweight. l was a brittle diabetic at 1 point. I took 8 shots a day. I had my endocrinologist's Cell number. If my sugars were high I had to call him directly to get how many extra units to take. My mom had 11 siblings all except 2 had kidney failure due to diabetes. So with that being said what road Do you believe this chick was headed. I already had 2 incidents of my kidneys shutting down. Having to loose 25 Pounds can be just as hard as loosing 125 Pounds for some. That's just my opinion.

Edited to correct my response being a part of Will's quote
 
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@Will2014, according to the NIH (and Medicare), I was morbidly obese with only 68 lbs to lose. My BMI was 35.2
When I had the DS, the VSG was not a Medicare option. My only three were lap band, RNY, and DS. But even if the sleeve had been one, I would have fought for the DS and I know myself...I would have regained most of my weight back by now and looking to revise.
 
It is my opinion, but the DS is the only Bariatric surgery I ever considered.
 
:thankyou1:
I disagree and I'm sure others do. Our own @southernlady was a light weight. I believe that anyone who has life threatening diseases should be able to have the surgery. I would have tried if I was a lightweight. l was a brittle diabetic at 1 point. I took 8 shots a day. I had my endocrinologist's Cell number. If my sugars were high I had to call him directly to get how many extra units to take. My mom had 11 siblings all except 2 had kidney failure due to diabetes. So with that being said what road Do you believe this chick was headed. I already had 2 incidents of my kidneys shutting down. Having to loose 25 Pounds can be just as hard as loosing 125 Pounds for some. That's just my opinion.

Edited to correct my response being a part of Will's quote

I forgot to mention the presence of any comorbidities which could be treated by the DS, such as the diabetes you mention. As for someone who needs to lose that last 25 lbs, but has no other reasonable rationale for having the procedure done, I stand by my statement that it falls short on the risk/reward ratio scale for me. The negatives far exceed the possible gains IMO (risk of death, major complications alone preclude it for me. Add in all the other negatives and it's just a slam dunk decision in favor of less extreme options.) I have previously posted here some exciting research being done using the DS to cure diabetes in NORMAL WEIGHT folks. This is starting to be done more in Europe and has CURED people suffering with this terrible disease. I'm all for it in those cases, of course! Opining about what decisions others should or shouldn't make is always risky business. Opining about decisions ALREADY MADE is even trickier! But I've never been shy about offering my opinions here or elsewhere, and I think this issue in particular requires a thorough examination of all sides of the argument. Not offering my thoughts would be cowardly and would constitute a disservice to the spirit of this message board.
:exactly:
 
First, I'm going to answer YOUR questions:

YES, getting the DS will help you lose and keep off the additional weight you want to lose. YES, there is a difference in recovery for the two procedures. In my experience, the DS was much more difficult to recover from. You will likely be fatigued for at least a month afterward and you will have lots of crazy lab levels. Neither of those things will likely happen with the VSG.

I had a partial re sleeve where the doctor just removed the excess fundus with two staple fires. He believes that a full resleeve is dangerous. BTW, they don't necessarily need to remove the old staples. If there is enough tissue, they can just put a new staple line INSIDE the old one and remove the excess portion along with the old staple line. That's what was done with me. There are two points, of course, where they will have to overlap the old with new staple lines, but that doesn't seem to be an issue.

Now that I've answered your questions, I'd like to share my experience/opinion. I am also a lightweight -- 100 pounds over (pre-surgery) but I am male and 6'3." Few people would have ever described me as obese, rather I a "big guy." Before I had my current GF I didn't have much trouble getting dates (but, then again, I have lovely blue eyes and am very charming).

If I had been 400 pound plus, the DS would have been a no brainer. But it's all about cost/benefit analyses. Obviously at 400 the risks of staying there are likely greater than the risks of getting the DS. But, at my weight, it was not such an easy calculation. I've read every study I could find and still am not fully convinced that the DS is not going to cause trouble later in life. There are no studies done on people that have had the DS 20+ years. There is one study that took place over 20 years but no studies on groups that have had it for over 20 years. There also may be micro nutrients we don't even know about that we're not absorbing and that may haunt us later in life. Some vitamins were only identified and synthesized last century. When you get the DS you are absolutely playing with nature's evolutionary design in favor of a rarely performed surgery that has some good data, but a lot of unknowns. Most of the data, BTW, is put out by DS doctors. It is not in their interest to put out the scary stuff. Not saying they're lying, but if we're going to question the data of a VSG or RNY doctor, why shouldn't we do the same for DS doctors? You are submitting to being deliberately malnourished and trying to make up the difference through supplements. Aside from surgical complications, if you read this board you'll find many people struggling with anemia, osteoporosis, etc.

But MOST people seem to be doing fairly well, but there is that reality.

I made the decision because I was more interested in the quality of my remaining years (I'm 52). I wasn't 100% comfortable for the reasons I described, but I was comfortable enough. I'm still searching the web trying to put my mind at ease.

But, at your weight, I just can't see how the cost/benefit analyses tilts in your favor. It's too draconian a surgery for such a small benefit with too many unknowns. Frankly, it sounds like some self-acceptance work (easier said that done, I know) might be useful. I don't know you so forgive the presumptuousness, but when you post publicly you get public opinions.

Good luck. You, of course, will eventually do what you have to do, but I would definitely say that some LONG, careful thought is in order.

Best, Mark
 
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As far as ease of surgeries my revision where the stomach wasn't touched was far easier than my original DS. I can't imagine ever being resleeved. The first one sucked and frankly the switch is the more important part to me.
 

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