Might do a revision from VSG- DS or RNY

Hello,

I am 1.5 years out from VSG. The surgery was fairly successful but it did not really achieve the amount if weight loss that I had hoped. Im down about 72 pounds. I lost 34 of that before the surgery. So. , I visited my PCP today and depending on my A1C number, I think I might work to get approval on either the DS or the RNY. I think this will help me get the rest of the weight off. WHich should be another 50-70 pounds. Has anyone had a similar situation and went through the revision with good/desired results?

The RNY revision doesn't seem to be worthwhile from what I have seen over the years on these forums - twenty pounds, give or take, about what one would expect from going through all of the intense dieting during the pre- and post- op periods. Occasionally we see someone do really well, but they seem to be outliers who took the opportunity to really get serious about their diet and habits (if I'm going to go through all that again, I'm not letting that happen to me again...) Fundamentally, the VSG and RNY are too similar metabolically to really expect a great difference between them, and indeed, overall that is what we see with virgin procedures - very similar results.

I have seen several people come through our support group who have gone to the DS and overall did well with it, as one would expect as it is a metabolically stronger procedure than either the VSG or RNY. If your sleeve is basically behaving itself - not giving any significant side effects like intransigent GERD, then the most straightforward approach is to go with the DS, as you are already half way there with your VSG. Also, if your A1c is being stubborn about normalizing, then the DS would also be preferred, as it is stronger against diabetes than either the VSG or RNY.

You are going about this at the right time; when I talked to my surgeon about this, the prospect of a DS completion/revision if the VSG alone wasn't enough, he told me that this works best if you catch it before any substantial regain occurs. So, by his estimation, you are hitting it at the sweet spot. The down side of this timing is that insurance may not cover it if your weight has gone below the normal qualifying levels of 35/40 BMI with/without qualifying comorbidities and there are no complications that are being addressed (and it doesn't sound like there are.)