DS or SIPS? The new question of the day...

Stefanie S.

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Dec 24, 2016
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Location
Raleigh, NC
I started out my morning trying to decide between RNY and SIPS. I thought I had ruled out DS, but now it seems like that is the way to go. Would love any feedback... pros... cons... your experience? I am supposed to provide my answer by Tuesday and I feel so overwhelmed. Thank you!
 
Ok, I am a virgin DS. Back 6 years ago, the SIPS didn't exist. Hell, MY options were lap band(oh hell no), RNY (I'd rather stay fat) and the DS. I am also a lightweight so I had to fight surgeons who insisted that the DS was too extreme for anyone under a 50 BMI. I succeeded. My surgeon did make my common channel longer (175).

Now, if SIPS has been an insurance covered option, I probably would seriously consider it but my hang up with it is lack of long term data. The first DS was done in 1988. SIPS is not anywhere near that in data. We have 2-3 solid years, some in Turkey are over 5 years. But no one, not a single person is 10 plus years out, not a one.

The data may prove it out but who knows.
 
Ok, I am a virgin DS. Back 6 years ago, the SIPS didn't exist. Hell, MY options were lap band(oh hell no), RNY (I'd rather stay fat) and the DS. I am also a lightweight so I had to fight surgeons who insisted that the DS was too extreme for anyone under a 50 BMI. I succeeded. My surgeon did make my common channel longer (175).

Now, if SIPS has been an insurance covered option, I probably would seriously consider it but my hang up with it is lack of long term data. The first DS was done in 1988. SIPS is not anywhere near that in data. We have 2-3 solid years, some in Turkey are over 5 years. But no one, not a single person is 10 plus years out, not a one.

The data may prove it out but who knows.
And it looks like you have done extremely well with your DS! Did they do the slightly longer channel because you started at a fairly low weight?
 
I will be brutally honest. A proper DS is the only WLS surgery that we know with certainty works. The SIPS is experimental and if you are having a surgery why do something that is not proven? The RnY GBP, well it doesn't work and their are numerous RnY to DS revisions on this board.

Please investigate the Hess Method DS. Common channel and Alimentary limb lenghts are equally important but people have been conditioned to believe the CC is all that matters. Anyway the channel lengths are primarily a function of total small bowel length and NOT WEIGHT. Patient history (including weight, any disease or medical condition etc, weight is just not the overriding determinant) is also taken in to account when determining the proper limb lengths.

Best wishes. DS is the way to go, IMO and it is equally important to find a great DS surgeon.
 
Hi and welcome @Stefanie S. I think the SIPS is interesting and might be appropriate for those who want to be part of the pioneer population undergoing an experimental procedure, but who need a good kick-start for weight loss and are good at dieting, since a lifelong low fat, low carb diet is probably going to be needed for maintenance. I recommend DS in the first instance to friends and family because of the proven long term results and because revision to DS down the road isn't in the cards for most people due to lack of insurance coverage and risks of re-operation. Grateful to those who get SIPS, though, as it is wonderful to have additional subjects to contribute to study results.
 
Hi and welcome @Stefanie S. I think the SIPS is interesting and might be appropriate for those who want to be part of the pioneer population undergoing an experimental procedure, but who need a good kick-start for weight loss and are good at dieting, since a lifelong low fat, low carb diet is probably going to be needed for maintenance. I recommend DS in the first instance to friends and family because of the proven long term results and because revision to DS down the road isn't in the cards for most people due to lack of insurance coverage and risks of re-operation. Grateful to those who get SIPS, though, as it is wonderful to have additional subjects to contribute to study results.

Well said.
 
My insurance has the SIPS listed as investigational/not medically necessary. Make sure you check your policy before getting your heart set on the SIPS procedure.

Some Doctors are putting SIPS through under the code for the DS, this could leave you on the hook for the full cost of the surgery if insurance catches on.

That being said only you can decide what's best for you. I am in the preapproval stages for the DS because my metabolism is shot (I gain weight at 1000kcal/day.) and I take ibuprofen every day. There is no highly effective surgery for me except the DS.

Wishing you luck with your decision.
 
Sorry for the long post, but you have a momentous decision to make. There is no ideal bariatric surgery for every patient. Some people should not have the DS, such as if they are unwilling to follow a rigorous daily supplement program, go to annual follow ups with extensive testing regardless of their insurance, and eat what they should, before they eat what the want. Other people have different goals, such as they would be fine with a 50 pound weight loss out of 100 pounds overweight or okay with some better loss early on, with a higher chance for regain in the future.

I cannot recommend the RNY, with the risks of regain, reflux, vomiting, and dumping, as well as the lifetime limits on food. Micronutrient deficits and bowel symptoms also occur with the RNY for some people, so thats not a good argument for it. Revisions are much more common with RNY than with DS. Wasn't willing to live like that. A lot of other people are. Since RNY and lap band were the only choices when I was looking, and I knew people who had failed with both, I would not have had surgery without the DS. My reasons for DS were long-term success, lack of hunger controlling my life, diabetes and high cholesterol reversal, and the ability to eat normally, just less quantity and more protein. It's worked out well.

I think the lack of data with SIPS is a matter of concern, and you are young to have a procedure with unknown 20-year outcomes. The chance for micronutrient deficits would seem to be lower with SIPS over DS but that is still theoretical. The chance for long term weight gain would seem to be higher with SIPS, but that is also theoretical. The chance for less diarrhea or flatulence would seem to be better, but many people with DS don't have these problems and it is unknown how many SIPS patients will have or not have these problems. If you have obesity-related diseases, I would want to be assured there was a good chance they would be resolved with SIPS.

I would certainly get a second opinion about this, because you may get different asessments of risks and benefits. Congratulations for rejecting sleeve gastrectomy and the horrible lap band. I think only you can decide what's right for you, given your goals, your age, and your tolerance for risk. I'm glad you are investigating. Think twice, cut once!
 
My insurance has the SIPS listed as investigational/not medically necessary. Make sure you check your policy before getting your heart set on the SIPS procedure.

Some Doctors are putting SIPS through under the code for the DS, this could leave you on the hook for the full cost of the surgery if insurance catches on.

That being said only you can decide what's best for you. I am in the preapproval stages for the DS because my metabolism is shot (I gain weight at 1000kcal/day.) and I take ibuprofen every day. There is no highly effective surgery for me except the DS.

Wishing you luck with your decision.
I just got words today too that SIPS isn't approved...
 
Sorry for the long post, but you have a momentous decision to make. There is no ideal bariatric surgery for every patient. Some people should not have the DS, such as if they are unwilling to follow a rigorous daily supplement program, go to annual follow ups with extensive testing regardless of their insurance, and eat what they should, before they eat what the want. Other people have different goals, such as they would be fine with a 50 pound weight loss out of 100 pounds overweight or okay with some better loss early on, with a higher chance for regain in the future.

I cannot recommend the RNY, with the risks of regain, reflux, vomiting, and dumping, as well as the lifetime limits on food. Micronutrient deficits and bowel symptoms also occur with the RNY for some people, so thats not a good argument for it. Revisions are much more common with RNY than with DS. Wasn't willing to live like that. A lot of other people are. Since RNY and lap band were the only choices when I was looking, and I knew people who had failed with both, I would not have had surgery without the DS. My reasons for DS were long-term success, lack of hunger controlling my life, diabetes and high cholesterol reversal, and the ability to eat normally, just less quantity and more protein. It's worked out well.

I think the lack of data with SIPS is a matter of concern, and you are young to have a procedure with unknown 20-year outcomes. The chance for micronutrient deficits would seem to be lower with SIPS over DS but that is still theoretical. The chance for long term weight gain would seem to be higher with SIPS, but that is also theoretical. The chance for less diarrhea or flatulence would seem to be better, but many people with DS don't have these problems and it is unknown how many SIPS patients will have or not have these problems. If you have obesity-related diseases, I would want to be assured there was a good chance they would be resolved with SIPS.

I would certainly get a second opinion about this, because you may get different asessments of risks and benefits. Congratulations for rejecting sleeve gastrectomy and the horrible lap band. I think only you can decide what's right for you, given your goals, your age, and your tolerance for risk. I'm glad you are investigating. Think twice, cut once!
First, thank you for saying I'm young! All of these doctor appointments lately... they like to say, "Well, as you're getting older..." Uggh! Second... my choice just got determined for me. My insurance won't cover SIPS. But I was really, really considering DS anyway. Now, my next thing is to fully understand exactly what I'm getting. I've seen people talk about a 300 cm common channel, even with DS. Things like that. Is that a good idea? What else is to be considered or questioned?
 
"I've seen people talk about a 300 cm common channel, even with DS."

That's not a DS - it's just NOT. I wouldn't accept anything over 150 cm common channel. I have 100 cm and didn't lose all the weight (until recently - I've recently lost some more weight, and I'm at 167, but have at least 10 lbs of skin that could be removed if I was willing to do that).
 
"I've seen people talk about a 300 cm common channel, even with DS."

That's not a DS - it's just NOT. I wouldn't accept anything over 150 cm common channel. I have 100 cm and didn't lose all the weight (until recently - I've recently lost some more weight, and I'm at 167, but have at least 10 lbs of skin that could be removed if I was willing to do that).
Yesterday there was a lady in Dr K's FB closed group who said that Kronk (Anthone's partner) gave her the following lengths:
15731873_10155676820334972_7865516902539148870_o.jpg

That is just freaking insane. She basically has a reverse HESS with a 62% absorbing path and 38% non absorbing. The poor lady thinks Kronk is grea and loves him because she won't be at risk of malnutrition. Guess what lady, you are at a very high probability of having a 35 BMI at best with that tine bit of malabsorption. She obviously doesn't understand why the DS works and that sure she will lose weight because of the sleeve, but if she ever gets near goal weight it will be for a cup of coffee and then back up because she has so little malabsorption.

The sad part is that Kronk was a Hess DS guy.
 
Hi! So part of my plan today was to figure out what I felt like these lengths should be. May I start with you? I see the numbers that you posted that shouldn't be... what are your suggestions for what should? Thank you so much!
 

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