SIPS Surgery - Anyone?

Hi!  Had my final surgeon appointment today and I thought we were all on board for RNY, but instead she really tried to convince me that SIPS would be more appropriate.   I will be a revision from the sleeve.   Does anyone have advice or info?   I had turned down the DS option because I didn't want to worry about malnutrition or frequent BM bathroom trips!  Do I need to take more vitamins with the SIPS than I would with RNY?   Those are my main questions right now, but I would love to hear anything about this.   Thank you!

Sips is more like DS - try to ask the question on DS forum or the main forum. 

Unless you have GERD - SIPS may be better surgery than RNY.   I had RNY, but knowing what I know now - I would pick SIPS over RNY. 

Good Morning!  Can you elaborate on "knowing what I know now"?   Did you have problems with RNY?   Thank you for replying, btw :)

https://nwhsurgicalweightloss.org/learn-about-your-condition -and-treatment/pyloric-preservation

Do we fail the surgery or is the surgery failing us?

Aug 30, 2011

Gastric bypass surgery has long been considered the gold standard for weight loss. However, recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital's Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial - a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.

The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis - there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar - followed by a swift exaggerated plunge - was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine. The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.

Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve - sleeve gastrectomy and duodenal switch - would lead to better glucose regulation, thus suppressing weight regain. The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure. The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.

"Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss," said Dr. Roslin.

Thank you for sharing that!  We are all just an experiment, aren't we? ;)  This makes so much sense and I'm grateful that you shared this!

A few issues. Major issues. 

Food allergies, leaky gut, problem digesting foods like raw veggies. 

RNY- can cause dumping. This is good or bad. The bad part - RH - severe Reactive hypoglycemia. Insulinoma My body makes too much insulin when I eat carbs. Any carbs - fruits. Dairy.etc. 

Too much insulin - very easy to gain  weight. Too much insulin causes insulin resistance. 

To maintain weight loss and good blood sugar I have to be very careful what, how much and how often I eat. 

I need to limit carbs. 

I am fortunate that my doc made my pouch and stoma just right. 

Maintenance is more difficult than it was losing weight. 

Thank you for sharing.  You made me realize... I am so focused on losing the weight, when I should be well aware of and just as concerned about how hard it is to maintain...

Very interested in this surgery.....are you self pay or insurance?  What doctor?  I had a sleeve in 2010 and have gained all weight back except 15lbs.  Just trying to figure out something.

I am having a vsg revision to a ds next month. I would head over to the ds board and ask questions about the sips surgery. The majority of sips patients that I've encountered have a slower weight loss and mega regain issues. The also have to follow the ds vitamin regimen. If you are going to have to take in all those vitamins, why not have the real ds with better weight loss, massive decrease in comorbidities and less weight regain of all wls? I would strongly encourage you to look more into pros and cons of this surgery (like you are doing) before you have your revision. Take care and good luck!

I had the SIPS procedure on 12/24/14 as a revision from the lap band. A little bit about my stats. When I got the lap band in 2009 I was 398 and lost 120 pounds which my final weight was 278. I stayed at this weight for 5 years and could not lose a pound. In the meantime I had a lot of vomiting and could hardly eat anything that was good for me. I started not being able to drink and had my band loosened in early October 2014. Within 30 days I had gained over 30 pounds bringing my final weight back up to 335. The Dr. decided that I could revise from the Lap Band to the SIPS as long as my insurance would approve it. Mind you I had changed insurance from the company who originally covered my Lap Band. After the liquid diet right before my SIPS surgery I had gotten down to 306. I will be 3 years out in December and the last time I weighed was February 2017 I was 180. Revising from the band was the best decision I made and so far the SIPS procedure has worked for me. The only down side is bad gas and bowel movements. My surgeon is located in Durham, NC.