dodging pre-op curveballs in nyc



I wanted to introduce myself. My name is Cher and I'm pre-op at Cornell Hospital with Dr. Dakin. I jumped through all the hoops for the sleeve, and then was told that my endoscopy results (large hiatal hernia, acid and bile reflux) disqualify me for VSG due to the risk of Barrett's esophagus. I was recommended for RNYGB, and have been mulling over this.

Then, I stumbled upon this website, and the prospect of DS has me intrigued. I wish I saw this before meeting with Dr. Dakin, as it wasn't mentioned in our discussion. Does anyone know if the DS increases the risk for acid reflux à la the sleeve, or does it redirect acid away from the esophagus like RNY does? (I'm sorry if I didn't get the pathophysiology correct, I know I have a lot to learn.)

A little about me.. 30s, female, BMI of 45, overall healthy relative to MO.

Thanks so much in advance. I appreciate all of your contributions.


Staff member
Welcome Cher

I know of one person with Barrett’s that got the DS. No, I don’t know much about his journey other than he seems to be doing well. My thoughts are to try and get the DS if you can. My husband had Pomp for his surgeon. We never had a chance to meet Dakin.


Thank you for your feedback. Fortunately, I do not have Barrett's. But my surgeon was concerned that I was a risk due my endoscopy and pathology indicating active esophagitis consistent with gastroesophageal reflux injury. I am looking into DS thanks to the encouragement and wealth of info here. Thanks again -Cher


Well-Known Member
What DianaCox said - with a sleeve as a stand alone, many surgeons make a more narrow sleeve because if they don't, when the sleeve stretches (and it does) a couple years out, regain becomes a major problem. And that's assuming initial weight loss was adequate, which it often isn't. A sleeve by itself is a diet with a smaller stomach, which does make it easier, but not forever, and which doesn't address any metabolic issues you may have.
With the DS, you have a sleeve, but your surgeon can make a more generous sleeve, which lowers the risk of severe reflux problems, and with any bariatric surgery the hiatal hernia can be corrected at the same time. So risk of reflux problems is less, AND you get the metabolic benefits of the DS and the malabsorption that helps so to sustain our weight loss in the years to come.
I think it's a shame the DS wasn't even discussed, and also a failure to provide informed consent, as this is a standard of care bariatric surgery, not something experimental. The DS has the best statistics of any bariatric surgery not just for percentage excess weight loss, but also for maintaining that weight loss, which is so important, and for resolution of almost all comorbidities. The one exception is reflux, where gastric bypass does do the best - BUT many people who are MO have reflux, and unless yours is severe, there is no reason, IMHO, that you can't consider the DS. Losing a lot of weight should improve your reflux, along with the HH repair.
I would recommend at least getting a second opinion with a bariatric surgeon who does the DS on a regular basis. You can go over your specific issues with reflux and make an informed decision as to which option is best for you.