DS for lower BMI revision in Duodenal Switch Surgery Forum Posted December 12, 2019 My BMI is 36.2, I had a Sleeve Nov 2013 and significant regain since. I am scheduled for a revision to DS in January. Like you, I also want this to be my last surgery. The way I see it was is I don't have reflux so all options are open. The bypass is the most restrictive surgery, the DS has the most malabsorption and an increased metabolic effect. I don't think adding more restriction will help me long term personally, I think increased malabsorption and metabolic surgery will be best for my lifestyle and eating habits so that is why I chose the DS. Either surgery a lifetime of supplements is required, there is no one way to go about this so just look into it for yourself. Here's a link to something I think summarised my thinking re revision. https://www.tugruldemirel.com/en/content.asp?d=sleeve-gastrectomy-revisions&id=6134 All the best.