Has anyone had their Duodenal Switch revised because they weren't losing enough?

Hi all!

I had my duodenal switch done around 5 years ago. I was very strict the first year out and lost about 135lbs but never got down to goal. I went from 320 down to 185 and Im 5"3 and I found that I did not lose as quickly as some others. There were 3 tragic deaths in my family the first year of my surgery so I'm sure that stress didnt help the situation and I also developed hypophosphatemia after getting an iron infusion and was exhausted all the time. Roll forward to 2018 and I have gained 40lbs back and I am now 225lbs and 5"3. It's rather depressing. Some fo the weight gain came after I began taking phophorous because it tanked after my infusion and more weight was packed on because I felt defeated and began eating more carbs. I also developed hyperthyroid which caused weight gain-never realized that was a thing but I noticed the weight coming on quicker once my PTH rose. Needless to say I am going to try to get my food in order and see if this surgery works for me but I was wondering if anyone else has gained weight with the DS and if they were able to get it off and how OR if they have had revision surgery. My surgeon does a one size fits all DS and I remember reading somewhere that this can sometimes backfire for folks that are shorter and that the HESS method is the more appropriate method to go with for DS. My doc did a 5 oz sleeve and 100cm common channel on all patients and did not use the HEss method. Some of his patients do better and others are like me so I think there is definitely something to getting a DS that is not one size fits all. Trying to figure out if I should have another surgeon take a look at things and see if they can help me.

Cut out all carbs (especially crappy carbs like bread and crackers) and see if that helps you.

Did you post this on the DS forum? They may be able to offer you suggestions there.

You have had the most powerful surgery out there. Please do everything you can to work your tool before considering another surgery. More weight loss surgery could put your life in danger.

If you do want to seek a revision, I would contact Dr Keshishian. He is one of the best.

Good luck.

Hi Laura,

Thank you for your suggestions. Yes, I posted this on the DS forum as well. Going to do my best to help the surgery work for me and see what happens before going the surgery route. Just trying to see if anyone else had a similar situation and how they overcame it.

I know of one person here on OH that revised from a DS to an RnY and has great success losing weight and keeping it off since her second surgery.

Let me see if I can round her up. She'll probably have some good input for you.

In the meantime you probably want to work really, really hard with what you have. With the goal of avoiding any other surgeries ever. It's serious business to get through a revision from a DS to anything else and the only surgeon I'd trust for that is the one Laura mentioned.

Hi there! Yes, I am going to try to work my tool first and see what I can do before I try other options. It's been challenging to reign in the carbs but I'm doing so gradually.

Hi Sunshine! Like Amy said, I am a revision from a DS to a sort of hybrid surgery. My sleeve was revised to a RNY pouch and my common channel was lengthened from 100cc to 200cc.

I had regained 100lbs in the 8 years after my DS. Because I ate crap day in and day out. The main thing to remember is that no surgery can help you if you eat simple carbs. Even with the DS simple carbs are absorbed 100%.

The first thing you need to do is see you doctor to determine if you surgery is intact. If everything is how it is supposed to be than your best course is to use it to the best of your ability.

I was told that after my revision I would probably not lose any weight. The reason for my revision had nothing to do with weight gain. I was so sick I couldn't function. I had chronic intestinal bacterial overgrowth (CIBO) due to the fact that I had a blind limb. All the bacteria was trapped and released toxins to my body. That isn't a common situation but it happens. I needed a revision to get rid of the blind limb.

By the time I had my revision I honestly did not care if I lost weight or not. There are worse things in the world than being overweight and I was living it. I had no quality of life. I had constant diarrhea and very odorous gas. Flagyl helped but my doctor didn't want to prescribe it any more for fear of developing a resistance to antibiotics. I used probiotics but it didn't help.

Even though my doctor told me not to expect weight loss after the surgery, probably because I had failed so miserably to comply with a healthy eating plan, I decided that if I was going to go to all that trouble to have a revision I might as well make the best of it.

I followed the post op diet to a T. I avoided all sugar and gluten. One thing that did help was finally having good restriction. My sleeve was made very large. They didn't use bougies at that time, at least my surgeon didn't, and when I asked about it's size I would told he removed about half of my stomach. I honestly didn't feel like I had any restriction at all. I was able to eat pretty much the same amount as before surgery and I was hungry all the time.

After my revision I did have good restriction and that helped a great deal in sticking with a healthy eating plan. In spite of my doctor's prediction that I wouldn't lose weight I lost even more weight then I did the first time. I reached a normal BMI in about 6 months and continued to lose weight. In fact my weight became too low. At one point I was under 100 lbs. Then I had the tricky part of learning how to gain weight without overeating or eating junk.

I followed the post op plan for about 5 years before I allowed myself to experiment with my eating. I was careful about what I ate and the amounts I ate it.

My weight has stayed very stable for many years. I weigh myself daily, which I think is one of the reasons I have managed to keep the weight off. I haven't had any big gains but if I see things trending upwards for more than a few days I cut bac****il I am back to my normal weight.

I stay right around 110 lbs on my home scale. I have never gone over 115 except one brief period when I was eating popcorn every day and I was getting up to about 120 lbs so I cut out the popcorn and went back to my normal weight.

I am glad I had the revision, not only because it took care of the CIBO but because I finally had a tool I could work with. I take advantage of the restriction by always eating protein first. By the time I have a few ounces of meat I am satisfied and able to eat less of the carbs like fruits and vegetables. I completely avoid sugar, which I also credit with helping me. I was a big time sugar addict and since my revision I found I dump and dump badly when I eat sugar so that is enough for me to strictly stay away from it.

I am also lucky in that I haven't really had issues with low blood sugar. I had a period with I did have some episodes but learned how to best eat to avoid them.

I would do anything to avoid a revision if I were you. It was a very hard surgery on my. My surgery was open and I was cut from the bottom of my breasts to the bottom of my pelvic bones. It was a tough surgery to recover from. You also would probably have a hard time finding a surgeon to operate on you if you don't have any complications just to lose more weight. Really the only things that you could have done would be to have your sleeve made smaller or your common channel made shorter, but like I said if you don't avoid the simple carbs than that won't help you much in losing more weight.

You do already have the most powerful surgery available so that is an advantage. Maybe you can find a nutritionist who can work with your eating, or a counselor or both. I worked with a nutritionist for the first year because I needed help in learning the best way to eat. As far as counseling goes that has helped a great deal, too.

Good luck to you. Another big help for me is finding support from other WLS patients. That is something I did not do the first time around. It really does help to have accountability and guidance. I have learned that I don't have to be perfect. I just do the best I can do everyday and learn from my mistakes.

In the past if I ate something I shouldn't that would be an excuse to go on and eat more and more. Now I just look at how I am eating and see if there is a way to make better choices. If I find myself having a problem with a certain food I can recognize it early on and change before the habit becomes too ingrained to change.

Hang in there. You can do it. If I can turn around a failed WLS and figure out a way to make it work than anyone can. Stick around and see what you can do to make things better.

Hi, I had gastric bypass surgery in 2006. I lost close to 100 lbs. Within the last 2 years i have regained 50 lbs. My Dr said my connection from my pouch to my intestine has stretched. I have a revision scheduled for July 31 but I am a little nervous. I had complications with the first surgery. I also had a perforated ulcer repair 2 years ago. Any suggestions. I am very unhappy with my current weight of 242

I'm in the same boat! I had gastric bypass in ((SW 249#)2003 and lost 99#. In the past few years I've gained about 73# back and now weigh 223#. I also had an ulcer 2 years ago but it healed with medication. I now have a hiatal hernia, stretched ouch and stoma is too large. I'm having the hernia fixed and a revision on 5-31-18. Good luck! I hope all goes well for you!

I'm sorry about your regain and hernia. It seems that quite a few folks regain their weight post weight loss surgery, but most folks dont regain much back with the Duodenal switch from what I understand so I am one of the rare ones. I wish you the best and hope that you are able to heal from your hernia.

BBSams: Good luck with your revisional surgery & hernia repair today (5/31)!