DS vs VSG

This is the first I have posted on a forum. I have been working through the 6 months of required nutrition visits, psych eval and lab work. All along I have been considering the gastric sleeve, due to being a less invasive procedure. When I met with the surgeon, he presented the option of a duodenal switch- I had not really been considering that. His points are 1) more weight loss, less risk for regain 2) my insurance will not cover any further weight loss surgery and if the sleeve fails or I am not successful- i've used my chance 3) DS provides reminders when you have eaten something that is not appropriate.

He encouraged me to talk with those that have recently had the procedure, and also those that have a few years under their belt. I look forward to any and all comments. What do you all think?

Well... The sleeve is just another diet with a smaller stomach. How have diets worked for you in the past? Success with the sleeve is still just a diet. I have been around WLS world for almost 20 years now. I had my DS in 2003. I can tell you for sure the DS is the only surgery that works long term for just about everyone. Someday there will be something better but not today.

Can you take supplements a couple times a day and can you afford them? If you can there is no better option than the DS.

And BTW, the WORST part of the DS is the gastric sleeve. Forget the less invasive argument. If you get the DS make sure you get the real thing, a 2 anastomosis surgery. No SADI/LOOP. No way would I trade my DS for a sleeve or anything else out there. My biggest regret is not having the surgery when I was about 10!

Those seem like solid reasons to me. Although I think the third one can be over emphasized.

The idea of more weight loss and less chance of regain is what really sold me on the procedure. When my surgeon explained the possibilities to me this seemed like the best choice for me. I was at 464 at surgery and over 500 before then so I had a lot to lose. If I was going under the knife I wanted the best post-op chances on my side.

I don't know about the insurance issue but that sounds right from what I have heard from others. Nothing was covered for me so I self payed. I think the DS is a better answer.

As for the reminders. Some things are always an issue (very high fats, extreme sugar content) but for me most of that is gone after 4 years. I can eat just about anything as long as the serving size is reasonable.

You do have to pay more attention to vitamins, protein intake, and hydration with the DS than you do with the VSG but it is just one of the tings you roll into your daily habits. Harder at first but easier as time goes on.

I've never regretted my DS even early on when you can't quite figure out why something you ate gave you a problem. I'm just happy to be at a more normal weight and more active than I eer thought I would be again.

I hope that helps. Read through the archives I had more questions after reading them because it gave me ideas of other things to ask about.

Pete

You can read through this forum...I'm a big fan of the DS.

I had the surgery 11 years ago...and have maintained a 300 lb weight loss. Several people in my family have had the RNY- at least 2 of them are really struggling. One never lost more than a few lbs and the other is is regaining

Thanks for your feedback. I particularly like the "think twice, cut once" philosophy :) I didn't mention I am an RN that specializes in healthcare quality and safety. It is important to me to hear experiences and real life stories! Thank you!

As Larra said, we do have to take supplements on a regular basis, but that is easier than trying to diet for the rest of my life (at least for me). I can pop a few vitamins and get regular bloodwork...but I cannot eat 1000 calories a day for the rest of my life. Sorry...been there...tried that....dieted for 30 years and failed.

Like Scottie, I'm about 11 years post-op with absolutely no regrets and a very normal life. There are a lot of vitamins you need to take, and this is a lifetime commitment, but as important as it is, that doesn't mean that it's difficult. It becomes a part of your daily routine, like brushing your teeth, and you adjust your vitamins occasionally based on your labs.

We are seeing more and more people wanting/needing to revise from sleeve (and other operations) to the DS all the time. It's becomming increasingly clear that for many people, sleeve only helps temporarily, and after that, it's just a low fat, low carb, low calorie diet with a smaller stomach. The DS gives you not only malabsorption but also metabolic benefits that you won't get with a sleeve. Of course you must make your own decision, but I wouldn't have settled for anything less.

Larra

I, too, am an old-timer, had my DS in 2005 and still love it.

I lost 147 lbs initially, and regained 14% of that back, which is still under the average expectation of bounceback (15-20%). Aside from being mindful of carbs, I can eat plenty of protein without supplements, and that's all I really count. I try to go to full natural fats, and avoid anything that has been made artificially fat free (i.e. chemical ****storm).

The biggest challenge is keeping nutritional levels up. We take vitamins and watch our labs, which with you being a nurse, should be a cakewalk. We do have to argue with docs about our needs (why yes, taking 100,000 iu of D3 daily will not get toxic with me), for they are often clueless....sadly even nutritionists. We share alot out here for that reason.

Had my DS 14 years ago and wouldn't change anything. Some things to consider:

• Are you willing to commit to a lifetime of vitamins, maintaining labs, eating the right amounts of protein?
• Not every surgeon has the experience and expertise to perform it. If you are truly considering the DS, make sure your surgeon has that experience and expertise. I wouldn't let just anybody perform the DS.
• Like every other WLS, the DS is a tool. You have to learn to work the tool.