Failed VSG need to do revision TO DS or RNY-want the DS but issues abound

So I had my VSG in 2009 my doctor then tried to sway me towards RNY I did not care for it at the time, but because I have diabetes and PCOS I have learned that I probably need the malabsorption component.  Problem is that my sleeve is bigger than it should be and I can hold alot of volume-found this out on my upper GI at surgeons office-ugh I only acheived max 45 lbs with VSG (never even went below 200 -started at 260).  Now I have gained 20 back over 2.5 years and my diabetes, co morbids are cropping up again.

If I go with DS how is that going to make a difference if my sleeve isnt revised as well? or is the malabsorption make up for that? or do I simply go for RNY to get the smaller pouch and the malab?? I am not sold on pyloric or not I just want to get some more weight off and control or eliminate my co-morbs.  Also surgeon I am seeing is just training in the DS he has been in bariatrics a long time and realizes the benefit-(he is at Barix) so do I want to be one of his first-feeling nervous about that as well

Any thoughts, concerns would be so appreciated

I think the DS would be your best bet. It has the best track record at resolving comorbidities. You could have your sleeve tightened at the time of the "switch" part of the surgery, or just let the malabsorption do it all. From what I understand, the sleeve made in DS patients is generally a little bit bigger than a sleeve patient anyway. You are already halfway to the DS, so the RNY would not even be an option for me. You should post on the DS board as well, since it gets a lot more traffic than this one and talk to some of the vets there. I am only 6 1/2 weeks out from the DS, so I am in no way an expert, but this is just what I've learned in my time researching.

The DS is your best bet.  IMO, a revision from VSG to RNY is not smart.  Your pyloric valve regulates the movement of food from your stomach to your intestines.  This prevents dumping syndrome, which is huge in RNYers.  DSers can still 'dump', but not at any greater rate than a normal person who had not had any type of surgery.  The CURE rate for Diabetes LONG TERM is much higher in DS than RNY.  Many RNYers see a return of diabetes after 5 years.  Wouldn't you rather have it gone permanently?  Having your sleeve revised as well would be ideal.  Especially if it is too large and you have very little restriction.  Unfortuately, you will need an expert revision surgeon.  Not just any DS surgeon should be trusted.  Be very careful. 

Your surgeon is not an expert revision surgeon.  I would highly suggest you look into one of these drs.  

Dr. Keshishian, located in California

Dr. Rabkin, located in California

Dr. Simper, located in Utah

Dr. Elariny, located in Virginia

Dr. Roslin, located in New York

Dr. Buchwald, located in Minnesota

She isn't going to get the RNY to DS.  Just VSG to DS or RNY.  There are many others than on this list that do the DS.  (she just needs second half.

I think you'd be happier with the DS. As for whether your Sleeve actually needs to be tightened---I know a lady who, due to some medical reason, has DS intestines with a NORMAL, full-sized  stomach. She's done very well.

My sister has the DS and yes, they usually make the sleeve slightly larger than many sleeves.  But some surgeons make the sleeve only as large as the average DS sleeve.  There is a lot of people in Canada that have it and do great with the larger sleeve alone.  I would defiantly do the DS over the RNY.

Hi there. I had the VSG surgery in June of 2009 as well. I lost 60lbs total but after pregnancy and a divorce I managed to gain 40lbs back and my old eating habits. I revised to the RNY after doing my research and found that it would be a better fit for me than the DS. Day of the revision I weighed in at 263 and today I weighed in at 205. I've dropped from a 24 to a 14 in pants size and 3X to an XL and some L in shirts. EVERYONE on here told me that I was making the wrong choice with the RNY but I'm more than happy with my decision. They said that the DS will give me more weight loss results but I'm only 35lbs from my goal weight and less than 5 months out from revision. I think it's the other changes that I made as well as committing myself to working out and sticking with what is approved for me to eat instead of testing my limits!

In the end it's what is best for you and your body... read all the negatives and positives in having both surgeries. That's what swayed me one way or the other! Good luck!!!

Hi, just curious as to why you chose RNY over DS. I was contemplating ad vertical sleeve but I have heard about foks struggling with maintenance so I moved on to RNY or DS. Can't figure out which one to do. Curious to hear your perspective on RNY over DS.

Mainly the side affects. The main one was how 90 percent of the people I talked to that had it have bowel issues. They all said they have very very loose stools to almos****er like with everything they eat. One is struggling to keep weight on and HAS to take many many pills and vitamins. She lost almost all her hair. Lots of issues and talking with several doctors the RNY was just best for me since I already have trouble remembering to take my meds.