DS or Gastric Sleeve?

Sorry, I might have questions all over this post, hopefully it makes sense.

I was initially looking at the gastric sleeve but I am concerned about either insufficient weight loss or else weight re-gain. And because my BMI is so high, 55, I may have to have the additional surgery in the end basically make it a DS in the end anyway for long term effectiveness. So anyway, I am more in the deciding what surgery I want and I would like to hear your opinions on both. I would want it laprascopically as open would terrify me, am I being silly, are they able to do it laprascopically? I am also concerned about the risks associated with this surgery, they are much higher than for just the sleeve are they not?

Also, what doctors would you suggest? I am from Canada and would have to do a self pay, I imagine go to mexico, I know Dr. Ungson is the only doctor in Mexico that does the DS, any other options for this out there? Also, what is the cost like with this one?

Any information or advice you could give me would be great!

 I went for the D.S. for a few reasons. My insurance would only pay for one WLS in a lifetime. I wanted to have the most weight loss with less chance of regain. The most normal foods, with no throwing up when out to dinner with friends was high on my must have list. A 2 part D.S. is possible but not advised because you wont get the most weight loss that way. A virgin D.S. produces the most weight loss because your body makes adjustments to drastic weight loss in a few months, making losses slow down. The trick is to lose as much as you can right after surgery. My D.S. was laproscopic, with about 6 tiny cuts which are disapearing, lightening up. this method is less recovery, and less pain from the get go. Only 1-2 cuts hurt right out from surgery. I had no pain if I held still resting right from surgery on, even after I was home needed only Tylenol the first week. Everyone has  different pain med needs. They send you home with enough to be comfortable. I didnt need all the pain pills they gave me. 

I found a great D.S. vetted nationally renoun surgeon in Grand Rapids, Mi, Dr Kemmeter. Attending his poening information lecture gave me a chance to get to know him, and see his style, what he thought was important to tell prospective surgical candidates. I went to a few surgeons lectures before I decided on the D.S. Surgeons who dont perform the D.S. tend to exagerate the negatives of the D.S. to stear you to choosing them for other surgeries they do perform. Its all about business.  I traveled 2 hrs out of town to Grand Health Partners to be able to have him do my D.S. I have never regretted it for a moment, and would do it again in a heart beat, with Dr K. at St Mary's Hospital. It all was such a positive experience for havinh a major surgery.

From the first meeting with Dr. Kemmeter, he expects you to have done your homework about the D.S. if you will be accepted as a surgical candidate of his. Can you tell him why its the best of all the WLS for you? Convince him. Seriously, this surgery takes analytical planning to organize your protein, fluid. carb, vitamin and supplement levels.

Reading food labels, limiting carbs does not end when you reach your goal weight. the D.S. and all the other WLS are tools to help you change your lifestyle, eating choices, and exercise for life. "Lifestyle" changes must be made or regain can happen to anyone with any of these surgeries.

Express your motivation to Dr Kemmeter, this will go a long way to convince him you are ready for surgery. Do lots of research on line, make a print out notebook of D.S. facts- find info on www. DSFACTS.com and google search for additional info. Learn the anatomy, be able to identify the anatomy of the surgery. Watch youtube of several D.S. surgeries to see what will be hapening to your insides. If you have any questions, just ask me. I am 6 months out from surgery, lost 105 lbs, so happy I did it, only wish I had it sooner in my life.  ;-)

 If you are in canada, Michigan is close for you. For self pay prices contact www.Grandhealthpartners.com

I would travel for the D.S., but not to Mexico. Keep it closer to home, in US hospitals, with vetted surgeons, from the approved list on this site. Do lots of research before chosing any surgeon.

Ditto what Sandra said!

I was a cash pay with Dr Lutzrykowski in Pontiac (near Detroit). He only does the DS open. The all in cost was $7000 for the surgeon and $11,800 for the hospital. 

Open surgery is not as bad as it seems. There was a post on this site sometime within the last three months and I was surprised that the majority had the surgery open.   You may have to prioritize the cost element and the lap vs open.   If you cant find a good price with the lap, dont be afraid to go open. 

There is a surgeon that people have had good luck with in Mexico, but I dont know his name. You can find out more about surgeons by looking at past threads on this forum or go over to the proboards site. 

With your BMI, I wouldn't settle for anything less than the DS. 

Good luck!

The DS done in two parts isn't really a DS at all.  There is a synergism when you get the sleeve at the same time as the switch which allows for the weight loss that us one shot DSers get that you may not see if you get two surgeries.

With your BMI you should ONLY consider the DS.  Ungson is a great surgeon and you can't go wrong with him.  Cost out all the surgeons you are interested in from www.DSFacts.com.  I've heard that Stewart has good self-pay rates also.

~Becky

I think the most important issue is whether or not you can expect longterm success with your choice of surgery. With the DS, there are longterm studies with large groups of patients that document the excellent success experienced, not just with losing weight, but with maintaining that weight loss and also for maintaining good nutritional health.
     Longterm results for the sleeve are not known - but we are seeing patients at about 4-5 years out looking into revisions due to inadequate weight loss or significant weight regain. And even many of the surgeons who support the sleeve do not recommend it for people with higher bmi's such as yourself (though of course, with money in hand, you can find someone who will gladly do it for you).
     This is far more important than whether or not the surgery is open or lap - but the DS can be done lap, it just depends on the surgeon.
     Dr. Ungson in Mexico has an excellent reputation. I have no idea what his current price is, but I'm sure his office staff could tell you. You are also being pointed to some potential self-pay options in the USA, though they may cost more.
    I'll send you a pm with a little more information.

Larra

 I was selfpay and am from canada. I had my ds by Dr gagner 1 year ago in montreal.  He did it laparoroscopically. He is a great surgeon and you would be in canada and any complications would be covered by your provincial health card.
He charges about 20000 i believe and he can be reached by email.

Just wanted to drop in with my 2 cents.  I was sleeved almost 5 years ago.  From my experience, the sleeve is perfect for those who have less than 150 pounds to lose.  When I was sleeved, I had 300 pounds to lose.   I lost 189 pounds and then quickly began to regain.  At first it was about 30 or so and I stayed there for a while, but then each month the scale kept creeping up higher and higher.  I tried to make adjustments in my diet but this was very short lived.  I have dieted and dieted and I kept gaining...  Now I have gained back 100 pounds. 

I started out at 425 with a BMI of 70+.  I am now 340 and looking into a DS revision.  If you have more than 150 pounds to lose, then you might want to seriously consider the DS.   I should have...

Good luck with your research!!!

I had my DS open, and about 18 months later I had a lap hernia repair. Frankly, the lap hernia repair was just as painful as the open DS.

I would NEVER knowingly have a "lesser" surgery thinking "Well, if this doesn't do the trick, I can go back and add X." Twice the surgical risk, twice the expense---andthe DS just doesn't work as well when the two parts are seperated in time by more than a few months.

Get the DS---you'll be glad you did.

 Something to consider with open vs. lap - is that you're under anesthesia longer with a lap procedure, so it's an extended risk there.  My DS was open, and considering what all they were doing inside of me, I was comforted having their eyes and hands in there doing it instead of a camera and machine.  There was no torturous liver shrinking diet to make it easier for machines to work around.  They just moved it aside with their hands.  My incision was glued all the way down, so no stitches to worry about either and my incision was healed in 2 weeks.   Don't let the idea of open surgery scare you.  It's not too terrible.