Revision to RNY or DS

I had a VSG in 2008 and have regained.  I am looking into a revision and am trying to decide if it would be  better to have a RNY or DS?  I have an addiction to sweets, so I don't know if this takes the DS out of the possibility.  Any info from people would be greatly appreciated.  Also your experience with a DS.  Complications?  Bad side effects?  Etc  Thank you.

Not to sound harsh, but you probably should consider other options before looking into revision. You had a very powerful tool (the vsg) and it sounds like you have learned to work against it by being addicted to sweets. NO SURGERY IN THE WORLD is going to help you lose and maintain a healthy body weight while you continue to remain a sweet addict. Not even a RNY - dumping isn't guaranteed, and even when you have it, I know sweet addicts that consume sugar and just deal with the consequences.  And just so you know where Im coming from - I had VSG in 2011, lost 230 + lbs and regained almost 90 lbs back (in a very short period like 1.5 yrs). I am currently down 60 + lbs of those regain lbs, and I did not have any other surgical intervention. I made the decision to give up sugar, white flour, and follow a set meal plan, and the weight has just come off (over a 7-8 month period) I made the decision to abstain and change my life style after going to and committing myself to overeater's anonymous. It is an excellent program for getting off the sweets and other junk. I highly encourage you to keep an open mind and look into as an alternative to surgery. You only get one stomach, and there are only so many times  you can operate on it.....fix the problem (which is not your stomach!!)

The DS makes much more sense. First, while I don't agree entirely with the person who posted ahead of me (though I wish her well with her approach), she is right that gastric bypass is not any better for dealing with sweets than DS. Dumping is a nasty side effect that some (not all) people with gastric bypass have and has never been shown to be a weight loss tool even for those unfortunate enough to have it. Some people dump on fats and not sweets, others learn exactly how much they can consume at one time and get around it that way, some eat what they want and accept that they will dump, and some really unfortunate people have dumping with healthy foods and really struggle.

    The DS makes more sense surgically was well. You already have the sleeve portion of the DS, you would just need the "switch" portion added without operating on your stomach at all. You would keep the function of your pyloric valve, be able to take NSAIDs safely (they are contraindicated for the rest of your life with gastric bypass), avoid dumping, and get the most effective bariatric surgery available - best statistics for percentage excess weight loss, for maintaining that weight loss, and for resolution of almost all comorbidities. Maintenance is a big problem with the other operations and requires a low calorie, low fat, low carb diet for life. The DS allows for small but otherwise normal meals and has no laundry list of foods you can never eat again. That's one of the reaons it's the most effective operation.

Larra

So you think the poster will be successful with the DS while continuing to be addicted to sweets? Just bc it makes sense bc of the OPs current anatomy doesn't mean it's going to make sense for this specific person. I've been around here long enough to see many people fail with the DS bc of unresolved food issues. 

No one is guaranteed success with any bariatric surgery. However, the DS has well established long term statistics that are the best of any bariatric surgery for percentage excess weight loss, and for maintaining that weight loss. I have been on this forum for over 11 years and on other websites where DS patients post as well, and I have not seen "many people fail" with this very effective operation. To the contrary, I have seen most people experience lasting success thanks to a combination of moderate restriction, significant malabsorption esp of fat, and metabolic changes that the DS creates.

I have also seen many patients fail, after a first few successful years, with sleeve, much as you experienced. I am glad for you that you have found a program that is now working for you. However, what you are doing comes with considerable effort and sacrifice, and you will need to sustain that level of effort and sacrifice for the rest of your life to remain successful. No operation is a free pass, but the effort involved in sustaining success is much less with the DS, and IMHO much more realistic for most people.

The statistics for people who are MO are well known as regards to diet and exercise, that being that long term success is less than 5%. I wish you well and hope you will be one of the small percentage of successful ones. But the OP reached out for help and answers regarding revision surgery, which is now recognized to be necessary for many, many people with failed initial bariatric surgeries. I have provided an answer for her that I hope will be helpful for her. If she thought she could make it to a healthy weight without further surgery she would not have asked.

Larra

Thanks so much for your helpful information!  I can't tell you how much I appreciate it.  I was in a deep depression feeling like there is no hope.  But I feel confident the DS would work for me.  I have a long way t,o go before they will do surgery (6 months), I know I will have a lot of questions along the way, I hope I can hear from you when I do.  You sound like a very informed and caring person. 

Thanks

Linda

The DS is the most powerful surgery there is with the best long term results.  Period.  And you already have half of it so to me it's a no-brainer to just get the rest of the DS.

The VSG is restriction only and restriction only surgeries often fail long term.  Just look at the long term results of the lapband.  Dismal.  For long term success most people seem to need restriction plus malabsorbtion.  The body adapt to whatever you do to it and most of the malabsorbtion with the standard RNY is gone by about the 2 year mark.  Then the regain starts.

Being addicted to sweets means you won't have the best results with any surgery.  Simple carbs are the downfall of all of them.  But you will still do better with the DS than any of the others.

Best of luck!

Thanks for your input.  It all helps me.  I'm anxious to get the surgery and feel like I don't have to hide from people who saw me after I had lost so much weight. 

I am also addicted to sweets and I have a variation of the DS called a SADi DS whi*****ludes a longer common channel than a standard DS. The SADi procedure is really an updated RNY. Since having it done, I've lost more than 100% of my goal, with my issue being too much weight loss over 20 months.

Everyone reacts differently but I would suggest it's a much better option than RNY since there is no dumping syndrome (really impoertant with sugar intake) and there is substantial weight loss.

The prior posts correctly imply you already had a powerful tool added, so you should know the bottom line success for whatever option you choose depends on you, not the tool.

Good luck!

I'd suggest treating your "addiction" with a therapist before revising. Why have another surgery and all the risks just to sabotage yourself? Work on your head for a bit, then fix the rest. Just my .02