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There are times when a patient needs to change from one bariatric procedure to another for various reasons--complications with the original procedure or the volume of anticipated weight loss was not achieved. In this case, a more complex, but highly successful procedure called a duodenal switch (DS) procedure may be the solution to achieve the desired goal weight.
It is a more advanced procedure, but also offers the patient the greatest volume of potential weight loss, in many cases.


Duodenal switch surgery is a combination of a gastric sleeve and gastric bypass surgery, in simple terms. It decreases both the quantity of food that can be accommodated by the stomach and the number of calories that can be absorbed and used by the body.
It is considered one of the more specialized weight loss surgery procedures and is only performed by bariatric surgeons who have successfully undergone procedure-specific training to perform it.
WHO IS APPROPRIATE FOR DUODENAL SWITCH SURGERY?
Duodenal switch revisional bariatric surgery is sometimes performed as a secondary procedure after a gastric band or sleeve gastrectomy surgery did not achieve the desired overall weight loss the patient hoped to achieve.
This lesser know procedure actually offers the patient the highest opportunity to lose the highest volume of weight loss.
DUODENAL SWITCH KEY FACTS:
*It may reduce hunger significantly.
*You may have nutritional deficiencies and must take multi-vitamins daily
*You will not experience dumping syndrome if you consume sugar.
*You will carefully monitor your diet to ensure you are consuming enough healthy foods.
Duodenal Switches involve stapling about 70 percent of the stomach off and leaving the rest of the stomach connected to the first part of the intestine (the duodenum) which is then re-attached at a lower area of the intestine.
This procedure prevents bile and digestive juices from processing food further down the intestine which results in less caloric absorption. Because of this longer period between eating and digestion of food, the food passes to the colon faster, and the patient doesn't process the full amount of calories he or she normally would have.
The positives and negatives of DS Surgery
Duodenal switch surgery has excellent results, with the average patient losing 70 to 80 percent of excess weight in the two years that follow the procedure. However, patients who choose this type of surgery are at higher risk for nutritional deficiencies than with other types of weight loss surgery. Nutritional supplements, including Vitamins and minerals, will be necessary for the lifetime of the patient.
If you are still considering your bariatric options, talk with your surgeon about the viability of this weight loss surgical option for you.

thanks for @@Debbie3sons to let me know i have a fellow patient who has my doctor also..i went in to have WLS and he wanted me to have the bypass due to my size..i was as wide as i am tall...and i was scared to get it and wanted the lap band...he looked at me with a yeah right, you will not lose look and that just made me more strong...and also upset me..he then told me about the plication (i band and also now called gastric band and imbrication and etc)...he told he it was a new helper to the band and that he thought it could help me but def let me know that i had to help myself first..i like knowing the results i have (are) maybe making the plication and lap band more successful..truth be told any WLS can help and any WLS cannot help..i feel it is a lot patient doing in regards to the success..and to me losing 50 pounds is a success...losing ANY is a success...people seem to forget it it about better health, a better life or for me, it was to merely walk again and be able to wipe my ass again...that is why i had WLS
i am somewhat familiar with the (SIPS) but not enough to comment on it..
i say go for it
make yourself well
dr enochs is a superb doctor as is his staff
yeah the office is kinda slow but when i go monthly
now, i schedule the appt around 1 or 2 and then take the rest
of the afternoon off
and as i always say for its true to anyone reading my words:
for best results, with any WLS, it is wise to follow the doctors advice
sometimes things (complications) happen and sometimes they don't..
its major surgery not a manicure...just do the best we can with what
we have...and where you are now...if you don't do good one day, do better
the next...its a lifestyle change..not a diet...it wont happen overnight but if
you keep going...eating, moving, believing it will happen..

First of all I have complete confidence in my surgeon. My wife and I own a medical practice and his reputation and surgical skills are impeccable. Secondly whilst the version of this surgery is fairly new the surgery itself is not new. It has less connections than the duo switch with better results with fewer complications.
I'm happy for the sucess you have had but statistically I think this surgery is right for me. Additionally I expect this surgery will become a surgical cure for type 2 diabetes in the near future for the non obese population. A much need cure for a terrible progressive disease with current treatment costing way more than the cost of this surgery. Truly a jump in treatment Of type 2 diabetes!

So I double posted this topic. See the other topic for their response for info request. I now understand the difference and feel good about my decision.

My husband will not have the surgery. It's not for everybody and I understand that and respect his decision so he should also respect mine. I think that he does it just scares him that I am losing so quickly and changing fast. I think that he is afraid it will change who I am and in a way it will and already has, I just hope he will see that it is a good change in the long run.
We had a conversation about our little argument the other night and he apologized and admitted that he is a little jealous of my accomplishment. He said it's frustrating that he is still overweight and it won't come off as quickly for him. I told him there is no hurry as long as he is getting healthier. He agreed to counseling as well which I think will do both of us good.
I decided to keep my accomplishments to myself amongst my friends and family unless they ask. The last thing I want is for them to look at me as though I am bragging (although I do have bragging rights). I am trying to have a better understanding of their feelings.
So things are looking up for the moment.
One last thing. I went to the local department store today to pick up a dress I had ordered. As I was walking through the store I saw this lady walking towards me. She kept coming directly at me and I even wondered, is she going to walk right into me. I looked down and continued walking and glanced up again. I realized the lady was ME! I was looking at my own reflection in a mirror in the distance. I didn't recognize my own reflection! It made me laugh. I really have changed.
Thanks again for all the support and advice!

There is nothing "easy" about wls. They will realize that when they have wls and will have to "eat their words" on the days they cannot tolerate food.

My husband is the only one who knows about my surgery. I had dinner with some of my friends last night. They were discussing how they need to lose weight (I was unusually quiet). My one friend said well I am just going to have gastric surgery and take the easy way out and the other said yes!
And that is why only my husband knows.

It just makes me so unbelievably angry and sad..years and years we all sit around with our friends & families, and talk about how fat & unhealthy we are, how we all need to lose weight, how we need to get to the gym or just start exercising...and when ONE of us seriously decides to do something about it..and ARE doing something about IT..the "Seven Deadly Sins" take over our friends & families? , and the "Ten commandments" go straight out the window..Funny, we humans, quite contradictory we are, and much hypocritical . I just want to cry for you, I really do!

This is a joke right? Not happy with 6 lbs a week?

Lexie, All good points. And I'm not talking about shouting it off the rooftops or posting it on social network venues. It's more about the excuses and fibs told when directly asked about our obvious weight loss. I proudly stand up for my decision, but a lot of people don't and I believe there is an element of embarrassment and shame that people aren't admitting to and that isn't being talked about on these forums.

So this is going to piss off a lot of people. But I call BS on everyone that says they are a "private person" or "its nobody else's business" when trying to justify why they don't admit to having WLS. Saying you had your gall bladder removed or a hernia repaired or any other number of fake surgeries instead of WLS is "sharing" a personal health issue, just not the one you actually had. If you needed a knee or hip replacement, would you fib and say you sprained something to explain your brace and/or crutches? Do you hide your need for insulin if you have diabetes? Do you all wear contacts instead of glasses so people don't know you have bad vision? How about if you needed your appendix removed? A kidney transplant? Can you seriously say you would come up with a "story" to cover up the fact you needed these surgeries?
What are you all afraid of? Why are you ashamed? This was a huge commitment for all of us. Why aren't you willing to stand up and defend your convictions by being honest about your decision to have surgery? Some people claim they don't want to hear negative feedback. Well how is the social stigma of obesity and WLS ever going to be overcome unless those negative people hear and see all of our success stories for themselves. Every time I am asked about my weight loss I see it as an opportunity to educate. Maybe next time the subject is brought up, that person can say "I know someone that had VSG and she looks and feels great! Why don't you give her a call".
I don't mean to offend, I just don't think "privacy" is the whole reason why WLS isn't admitted to and talked about openly.

My labs showed my Protein levels were horrible and that will cause slow weight loss. I've increased my protein and have lost 8 lbs in a week and a half.

I am 5'5 and 29 years old. I had surgery on November 7, 2013. I am a few weeks away from my 1 year post op date.
I started at 260 pounds. 11 months out I am now 165.
5 pounds away from 100 pound loss. I really wanted to hit that by my one year, but honestly I just don't see it happening. The past few months, I have been stalled at 165-166-167. I just can't get out of those numbers.
I really thought by 1 year I would be a lot smaller than 165........ Just kinda disappointed. I am also disappointed in clothing size. I can wear a 12 at American Eagle. 12 is still BIG. 12 is still at the higher end of the clothing sizes (before you move into plus size)...... I can wear a Large shirt at American Eagle. I know there are lots of people out there who would love to be those sizes, but I just thought going to the extreme of surgery would increase my chances of being smaller and getting into smaller sizes of clothes.
I just still feel big.......still feel the same......still consider myself "bigger" in crowds..... I constantly compare myself to others and think about how I am still larger than they are..... I am just feeling bad lately about myself. I feel like a disapointment and maybe that I didn't do too well during this past year.
My husband of 7 years is 164 pounds.... He wears a Medium/Large Mens shirt and 32 jeans..... neither of these come close to fitting me. I am dreaming of the day I can wear his jacket or that he can give me a piggy back ride in a photo! I just feel like maybe this is the end.... 166 is where I will be.....

Today marks my 8th week post op from plastic surgery! I had a Tummy Tuck, arm lift, breast lift and augmentation. It was hell the first week but now I am really starting to feel more and more like my old self each day! I still have days that I get really tired or sore.. But fore the most part in doing and feeling great! I am loving my new body! Here are some before and after pics !


Same arm before and after


Same arm before and after







Tummy before and after


Where he got rid of the side of boob skin!!



With workout clothes on!

Before Gastric Bypass

After plastic surgery

Thank you everyone for your advice. I'm proud to report we've had the conversation and he's been fantastic about it. In fact he went to the doctor himself today to get a check-up to make sure he's as healthy as he can be. He loves my scars and says they add to the wonderfully sexy person I am. He constantly tells me how tiny I am. Something I never thought I would hear in my lifetime. He's a keeper. All that worrying for nothing. Thanks again!

@Rogofulm Thanks for jumping in with the man's point of view. It is awkward to have some of those pre-intimacy conversations but they are critical and best "before the moment arrives" like the Cialis commercials talk about! lol
I've been having some of those conversations with my new guy and it's funny how some of that goes. Last night I 'revealed' to him I've had WLS not because I felt like it was important to know before being intimate but because the conversation went there -- we were talking about body image and I had told him I had lost a lot of weight this year. He told me he understood and then told me his ex-wife had struggled gaining a lot of weight after their children and that she had WLS. Since the conversation was "there" already, it seemed like the right time to share. Of course, after I told him, he said "I knew already". I asked him how he knew and he said he recognized the diet from the dinners we've had together!
I feel like the closer you get to someone, the better it is to come clean on things as the situation presents itself or before. If I had waited long time to tell him after we had conversations about it, he might wonder why I withheld telling him when there was a prime opportunity to do it.
Besides, he's always asking me why men having been beating down my door because of my "hotness" (his word! ) and it's hard to explain that 4 months ago I was MUCH less "hot!"

I've posted this before, but it applies here as well.
Okay, here's one guy's perspective... I'd prefer to know beforehand. The surprises hidden under our clothes could "spoil the moment" if they are not expected. Besides, if you're anticipating intimacy, perhaps you can work this into "the talk" you probably want to have anyway. STDs and protection are not comfortable subjects to discuss, but we still need to have the conversation, right? So why not roll this into that already not-so-sexy pre-intimacy convo? If he's still on board, great! And if not, then you may have learned something about him while limiting your vulnerability. I wish you the best of luck -- hopefully he's a keeper!