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Update: I went back and forth with one of my surgeon’s coordinators today and I had the Single Anastomosis Gastric bypass (aka mini gastric bypass) plus the gastric sleeve which together is the literal definition of the SASI procedure, so it appears that’s the name for it!

I think the most important thing we need to do is dig in deep and see what is the root cause of why we are overweight. Each one of us who is overweight has a different reason or cause. I am a binge eater and I have dealt with yoyo dieting and weight issues my entire life. I am also a breast cancer survivor. Originally I was looking to get a surgery that would be minimally invasive and best for my body and health over all. I did not want to do the bypass because of the malabsorbtive aspect of it, I thought it would not be good for my body being through cancer already. Now, almost 3 years post op, I realise that I should have chosen the bypass. I have had no peace of mind. My starting weight was 235 lbs, surgery weight was 227 lbs, lowest weight was 167 lbs. I am 5'5" tall and I was never able to get to goal weight. Last summer I regained some weight and went back up to 182 lbs, Jan 2022 my Dr. in Los Angeles put me on contrave and topomax, I weigh 174 lbs now. I got weight loss surgery so I dont have to be on medication, I am so sad that I am dependent on medication right now. I am struggling, and constantly worried about climbing back up to 200's. I got the VSG to have peace of mind and be healthy but unfortunately that does not seem to be the case for me. My oncologist told me that obesity increases your risk of breast cancer recurrence and death by 35%-40%. I had to sit there an reevaluate my situation, and decide to to do the bypass so I can have peace of mind about my weight and not worry about getting cancer back and dying. I have heard and seen so many stories of people who are binge eaters do so much better with the bypass as it forces them to eat better and make better choices. So now I realize this was the better option for me and I should have done it from the beginning. So at this point I want to do the bypass so I do damage control, I dont want to get back to 235 lbs or above to make this decision. I hope this helps. I am looking to go back to Tijuana because I can't afford to do this surgery in the USA. I would go back to OCC as my Dr. there, Dr. Ariel Ortiz and his center OCC were fantastic but they are on the high end when it comes to price and I can't afford to go back there. Sent from my SM-G991U1 using BariatricPal mobile app

Hi. I see you got the sleeve just a few years ago. Why are you getting a revision?

Anyone get the gastric bypass surgery or vsg to gastric bypass revision surgery in Tijuana Mexico. Can you share you good and bad experiences with me. I am looking for a great Dr. to do my surgery, any recommendations would be appreciated. Sent from my SM-G991U1 using BariatricPal mobile app

I am about 8.5 months out past bypass surgery. At the beginning, you really can barely eat without feeling full. Five saltines would fill me up. I remember that once of my first trips out to eat after I was cleared to eat solid foods was to Cracker Barrel for breakfast with my wife. I ordered a small bowl of grits and two scrambled eggs and did not finish either one. As you heal, you begin to be able to handle more food. Right now, if I go out to eat, I'll find grilled chicken or fish on the menu and order it with veggie sides. I can usually finish the chicken/fish, unless the entree is huge. But I don't finish the sides. The restriction hasn't gone away by any means, but I could never eat the same amount of food in one sitting that I did pre-surgery. For the first six months after surgery, I don't think I felt hunger, which was a nice change of pace. At this point, I occasionally feel hunger, but it doesn't feel nearly as strong as it did pre-surgery. To give an example... I drink protein shakes as my lunch/snack at work (drink one on the way to work, one for lunch, one on my way home from work). One day about a month ago, I forgot my shakes at home and had only water/tea to drink at work all day. Pre-surgery, I would have either ordered a massive lunch off DoorDash or hit a drive-thru hard on the way home. I probably would have had a massive headache too. On that day, I drank my water/tea, felt fine all day, drove home and had some tuna fish and saltines when I got home. It really is life-changing.

We're surgery buddies! I'm due for gastric bypass and hiatal hernia repair on May 16th. As far as I've read oh what people do free up with their diet everyone's doctor has said something different but the bottom line is to not work the liver too hard thus shrinking in size if rested and no fats to work on. I will be starting my diet tomorrow with two shakes and 2 cups of low starch low carb vegetables. Hope all goes well for you! Please let us know how you go post-op, would love to hear from you. Wishing you all the best. 🙏🙏🙏

I had a revision at 8 months after sleeve for a hiatal hernia of almost my entire gastric sleeve causing gerd which was so bad I had hiccups from the time I woke up until I went to bed. Life is so much better after revision. I rarely get reflux now and no more hiccups.

My surgery is Tuesday the 3rd, and I was scrolling through the forum and saw a few posts from some women who felt like they lost their restriction from sleeve surgery after 6-8 months. I had no idea this was a thing!!! Is this a thing??? I'm excited to learn how to have healthy, balanced meals and watch my portions, but I'm not gonna lie, I'm looking forward to the restriction, too. Does it really go away? Can you get it back? Or is a revision needed once it goes away?

Well that's always a possibility, that's what I did. I had the sleeve in Dec 2016 and lost a lot of weight quickly, then I screwed up and slowly gained almost all of it back. In Nov. 2021 I had the revision to bypass and have been losing it all again, and now I know what to do and not to do in order to maintain. That said, if you never lost significant weight in the first place, that might point to other potential issues. Maybe get a second opinion from another doctor.

The surgeon only suggest to transform the sleeve into bypass

I know the OP profile has Sleeve but this being the Gastric Bypass forum I believe some things need to be said. The OP is describing a time released medication. For Gastric Bypass, time released medications can be problematic. Some seem to have no issues while others seem to fail completely, and of course many fall in between these extremes. I had pain medications that failed completely, while my Iron seems to work adequately. My heart Doc didn't even want to risk time released not working. There are meds I take where I handle spreading the immediate release meds through the day. Further adding to the mix, my experience and the experience of many others is that some non-time release medications for which you can feel an effect don't last as long as they did pre-op, so it requires a bit of manipulation/planning to deal with the changes. Talk to the surgeon because if they actually talk to their patients they should have a decent idea of which time released meds can be problematic. I've noticed also that some Sleeve people dump (which would indicate the pyloric valve isn't working as a gate keeper as well as pre-op, so for some Sleeve folks all these time released issues may possibly likewise be an issue, perhaps to a lesser extent, so pay attention early on. Good luck, Tek

Hi everyone, I'm Kirsten from Vancouver, Canada. I am getting RNY bypass in a few weeks and I am super excited for how this is going to change my life.

I am also getting surgery with Dr. Gagner in Montreal! I'm getting rny bypass on May 18. Good luck with your surgery tomorrow.

I am May 18th too for bypass! Are you getting excited yet?

Hi, I’m new here but have been reading the forums for a while. My surgery is in Montreal with Dr Gagner on May 2nd. I’m a VSG revision to a SADI.

You'll be fine. After my sleeve surgery they had me eating scrambled eggs, egg salad, tuna salad, and chicken salad the day after I got home. Same after my revision to bypass surgery. Some doctors are more conservative than others I suppose, but our anatomy is the same, so if I was OK you'll be OK too.

Nexium is omeprazole. Just a different brand name. Don’t know what it’s like in the states but in Australia you can only buy 10mg Nexium over the counter. 10mg is fine for basic heartburn but reflux & gerd really needs a stronger dose. Here 20mg is by script & 40mg requires the doctor to fill out additional paperwork because of the strength & effects of long term usage of PPIs so they are reluctant to prescribe the 40mg. As to your surgeon. Did he describe what he would do in your surgery before your surgery? If so did he say he would do the sleeve gastrectomy as well as the bypass? As the form said he would do additional procedures if necessary, what was his justification for doing the gastrectomy? His saying it’s what we do here is not good enough because he told you you’d have bypass surgery & you did not have a gastric bypass alone. If it’s what they do there the gastrectomy aspect should have been identified on the consent form. At the very least you were provided with inaccurate & incomplete information about what your surgery was & involved. Generally, your lower BMI would indicate a sleeve would be most appropriate for you, however, your existing GERD would support the decision to have bypass. Doing both seems excessive. Just my opinion.

I was self pay. Qualifications are bmi of 30+ at most places for self pay. I was at 31 when signed up but lost a few lbs from stress. Bypass was recommended to me bc it’s supposed to cure my long-standing GERD.

Wondering if they started with the sleeve since it's the most common WLS these days, realized their mistake and went bypass. Having said that, I had the VSG to bypass revision recently and asked a surgeon at the hospital how would it be different than the straight bypass and he said basically the same thing as your surgeon did. He said that with the sleeve, I already have far less ghrelin production than a normal stomach, so after the revision it'll be even more so. I couldn't find any studies online though.

Hi Chiru, I also had a combination of the sleeve and bypass on April 26th as well! I’m not exactly sure the name for it other than it’s a form of gastric bypass. I had mine done in Mexico so these kinds of procedures are apparently more common abroad then in the U.S

This is what I found about the SADI: SADI-S stands for Single anastomosis duodeno-ileal bypass with sleeve gastrectomy. It is a new surgical treatment option for morbid obesity that is basically a variant of duodenal switch surgery, in which a single intestinal bypass is made as opposed to two. Patients spend less time in surgery and are exposed to a reduced risk of complications. DFW Bariatrics and General Surgery has got you covered if you are considering undergoing the SADI Procedure in Dallas and surrounding areas. How Does SADI Work? There are two steps involved in the SADI-S Procedure: Firstly, the surgeon performs a sleeve gastrectomy to remove approximately 80 percent of the stomach. Secondly, they detach the intestine just below the stomach after which they reattach it to an intestine loop roughly 2 meters down. The effect of the SADI-S Procedure is to bypass food from the part of the intestine that is metabolically active. This results in the lessening of the length of the intestinal loop in which nutrients are absorbed. Patients experience a smaller appetite, consume less meal portions, and have hormonal changes that positively affect their metabolism. Benefits of the SADI-S Procedure Reduces the risk of diarrhea and nutritional deficiencies often associated with the duodenal switch Gives patients greater weight loss when compared with standard gastric bypass or gastric sleeve, which is great for those with a BMI above 50. The SADI-S Procedure can be performed on patients who have undergone sleeve gastrectomy but experienced insufficient weight loss or a relapse. Reduces the long-term risk of intestinal obstruction when compared with duodenal switch and gastric bypass. It is great for people with poorly controlled Type-2 Diabetes as it offers a more powerful metabolic effect when compared with a standard gastric bypass or sleeve gastrectomy. Unlike gastric bypass surgery, patients experience a reduced likelihood of issues such as unstable blood sugar fluctuations, dumping syndrome, marginal ulcers, food restrictions and intolerance. Potential Disadvantages of SADI-S Procedure Potential risks associated with the SADI-S Procedure are similar to those of any other bariatric procedure. These include: Anastomotic leaks Infection Bile reflux Intestinal perforation Venous thrombosis and pulmonary embolism Bowel obstruction in the long-term Abscess

I looked up my informed consent paperwork and it said there are several variations of the gastric bypass and it’s the surgeon’s discretion to choose which one based on multiple factors. 🤔

Gastric bypass should eliminate your reflux so hopefully you will be good with that.

This is what I found that sounds like what you had done: A biliopancreatic diversion with duodenal switch (BPD/DS) is a less-common weight-loss procedure that entails two major steps. The first step is sleeve gastrectomy in which about 80 percent of the stomach is removed, leaving a smaller tube-shaped stomach, similar to a banana. However, the valve that releases food to the small intestine (the pyloric valve) remains, along with a limited portion of the small intestine that normally connects to the stomach (duodenum). The second step bypasses the majority of the intestine by connecting the end portion of the intestine to the duodenum near the stomach. A BPD/DS both limits how much you can eat and reduces the absorption of nutrients, including proteins and fats. While a BPD/DS is very effective, it has more risks, including malnutrition and vitamin deficiencies. This procedure is generally recommended for people with a body mass index (BMI) greater than 50. https://www.mayoclinic.org/tests-procedures/biliopancreatic-diversion-with-duodenal-switch/about/pac-20385180

It sounds like he's made changes with in the basic surgery, removing the blind stomach means changing the part of the stomach the pouch is created from so the bile ducts that used to dump into the blind stomach now dumps into the pouch. Less importantly (I suppose) the bypassed intestines would also be removed since there is no longer a blind stomach to attach them to. I would be upset that he didn't actually perform the promised surgery, as this is no longer an Roux En Y Gastric Bypass. I would be considering legal action if this happened to me. Good luck, Tek