Sleeve to SIPS how much weight should I expect to lose??

I HAD THE SLEEVE DONE OVER 3 years ago. Have gained back 60 of the 110 that I lost. Looking intorevision to SIPS. HOW MUCH WEIGHT SHOULD I EXPECT TO LOSE. ALSO DO THE MAKE THE STOMACH POUCH SMALLER IF YOU ALREADY HAVE THE SLEEVE OR IS IT JUST REROUTING??

Do you know why you've regained the weight that you originally lost? Is it because of mechanical issues with your VSG, or because of your eating habits?

It's generally a good idea to consider your behavior before going into a revision.

Your surgical team would be the people to ask those questions.

A smaller sleeve increases your risk of GERD, so that will probably not be done. You will have malabsorption with SIPS so should experience weight loss.

In the end, maintaining weight loss is a function of eating less than you burn, so the overall success is based on that.

I lost 12 pounds. In spite of being 100% on plan, eating 100 gas of protein a day and less than 20 carbs a day, sometimes less than 10 carbs a day. I was totally focused and on it.

Why are you getting a revision? Is there something wrong with your sleeve?

How did you come up with that estimate?

SIPS/SADI/LoopDS (basically different names for the same thing) is a new procedure. It is showing great promise for initial loss, however, long-term results remain unknown because the procedure is not yet standardized and less than 10 years old. I think the longest post-op I've seen is around 5 years.

It is often billed to insurance as a DS (duodenal switch) because it's "kind of" similar...but it's not.
There have been patients who were denied payment because the OP report shows that it's not a DS, and because they signed a paper promising to pay in the event that insurance won't (common practice), the surgeon and hospital went after them for it. Billing for DS and doing SIPS is fraud, and while many pass it through without paying attention to the number of anamastoses and length of common channel, know that you could also be at risk for this, so ask your insurance specifically if they cover SIPS procedure.

You may find some SIPS/SADI/LoopDS patients out on the Duodenal Switch forum, and I know that they have created some groups on Facebook to learn more first-hand experiences. With the revision to this or an actual DS, the surgeon will inspect the stomach for abnormalities and reshape only if necessary. Most of the time it's not necessary.

This new procedure, once standardized, may be a wonderful solution for many, but I fear with the labeling of DS, that the data may wind up completely skewed, especially with three names and some just calling it DS and not really understanding what they really have. For now they are marketing it as DS Light, or the safer DS, but they just don't know for sure. Theoretically, you should require less vitamins than the DS does, but then again we look at the needs of RNY with a much longer digestive system and they're on the bandwagon for many pills, too. Just know going into it that not a whole lot is known for the long-run.

It's actually just 10 years old; the first procedures were designed and done in 2007. It's still in press, however I just reviewed an article doing a meta analysis of the data. There are sparse studies, but even after this one study eliminated several, there were over a thousand patients who had it despite there only being maybe 9 studies or so. So we do have not insignificant data. There is far more DS data, but there's also very good clinical data for the SADI/SIPS, and I'd argue that there is enough to make an informed decision from it at this point. The long term outcomes aren't so far apart, and there are definite benefits to both procedures, as well as definite disadvantages.

I think a lot of support staff are leery of the DS more so than surgeons are, and have reservations which is why the traditional DS isn't as common. Also, with the DS repetition and practice are key. For isntance, here in the Chicago area there are only maybe 3-4 surgeons I'd ever see who would be willing to do it. Prachand is probably just as (if not more experienced) than Dr. K, for instance, just from sheer surgical volume, however this is a tangent.

Val is absolutely right and makes a good point - we do not yet have a diagnostic code for the surgery, which means they either bill under multiple procedures, or bill incorrectly. This is a big issues because it is technically insurance fraud, and so if you have issues down the road and insurance decides to be *****ly, you can run into many coverage issues. And, you know....fraud is illegal, if not unethical. Experimental procedures are almost never covered by insurance, though I've seen people appeal to get SADI/SIPS covered despite it. Also, several of the places currently that do perform it do so in conjunction with studies, which is how they often get around insurance issues.

And, many surgeons explain this poorly and/or are not quite forthright with the procedures they perform, which is horrible.

They do not make the stomach smaller for the SIPS/SADI. A lot depends on the surgeon. In my case if I was getting the DS (or SADI), the surgeon would not touch the sleeve. My sleeve is already slightly larger than average anyway at 40F, though.

As for weight regain, you can still regain the same with a SIPS/SADI, and you can too with a DS. Those surgeries off-set regain quite a bit, but the consequences are higher for not eating properly in general, as when we regain we are typically not eating protein but eating crap.

So, to a large degree, it depends why there is regain. If it is a behavioral issue all the surgery in the world won't fix it.

You must check your insurance for the revision policy, as well. Some insurance will not cover it at all, and others only will if a mechanical defect is present.