Having my surgery in a little more than 24 hours, and feeling confused and discouraged by something my surgeon said when I was there last. I am getting revision surgery from the sleeve to the bypass, my BMI is currently 33. Doc says he does the bypass more or less based on BMI, and because I am a "lightweight", he will only bypass a little bit(?) thus not causing much malabsorption. He worries that I will lose too much weight otherwise. I begged him to do it as if I was a 44 (where I started), otherwise, to me, I don't see a point of revising my sleeve into essentially just another sleeve if there is no malabsorption. I didn't think too much of this in the office but as I have had the whole weekend to think, it is really starting to worry and confuse me. Is this the RNY or a different type of bypass? I have never heard of varying degrees of malabsorption. Will I get to speak to my surgeon before the surgery? He seems to think I will lose the weight no problem. I trust him, I just don't trust myself. I love food and I really need this surgery to be powerful and kick my ass into gear. I already failed my sleeve. I would rather not have another revision down the road. Has anyone ever heard of this? Should I be worried? I don't know what else to say to him without offending his intelligence and coming across disrespectful.

Well first off this is your body and before he operates you need to be sure what he is going to do. If you offend him or make him angry then he is not the surgeon for you. No doctor should ever feel offended when a patient asks for clarification on a procedure.

Insist on speaking to him before surgery, and ask him to clarify the procedure and what he meant by his statement in the office.

Please do not go through with this if you have any doubts.

same thing just happened to me, I had the sleeve to bypass revision and my sleeve pouch was stretched because he left too much, so a neo fundus formed holding alot of food...after my surgery, actually friday when i went in he told me he just lopped off the bottom of my stomach and so when i got home and looked at the drawing i realized he left the enlarged fundus, and now he is on vacation and i cant talk to him!! I really freaking out...let me know how you make out...my starting BMI 35

Could not agree more with music about never hesitating to ask questions. Surgeons have big egos (and that's a good thing!) but few would fail to recognize your questions not as a sign of disrespect, but a need for reassurance. That just makes you human, not disrespectful.

Until very recently it was believed that most of the undisputed benefits from gastric bypass were "mechanical" in nature. Dramatically smaller stomach > eat less > fewer calories > malabsorption > lose weight. There is new and compelling evidence that what actually happens is considerably more complex and much more amazing than previously believed.

The surgery produces physiological changes in the body that go far beyond mechanics. Changes in things like the reduced production of the hunger producing hormone ghrelin, almost immediate changes in gut bacteria from those typically found in obese individuals to those found in folks who have had a healthy weight their entire lives, key changes in genetic markers that are reversed from "obese" to "normal", and within the last 90 days one of the most surprising (and promising) changes of all - the small intestine, formerly believed to be a "passive" organ, undergoes a pronounced change that results in the intestine itself utilizing a whopping 64% of blood glucose. Further studies are in the works but that appears to explain why gastric bypass is so successful in treating or preventing type 2 diabetes.

Medicine sometimes changes quickly. It has been suggested that in light of these new discoveries, more and more bariatric surgeons are modifying the surgeries they perform to "reduce" the amount of malabsorption. New findings suggest that it is not as big a factor in the success of gastric bypass as once believed. I'm most certainly not a doctor. But my impression is that your trust in your surgeon is well founded, he is on top of his game, and you are indeed in very good hands.

You're gonna love the new you!