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I am 225 pounds, 5ft 6 inches tall, have type two diabetes, high blood pressure and cholesterol. My mother died from morbid obesity, heart attacks and strokes. I have decided to have WL S but Am still doing research and trying to determine which surgery would be best for me. My BMi is 35. And I am going to have to self-pay. I only want to have to go through this once, even though this forum considers me a lightweight would a DS be a good option for me?

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What does your surgeon recommend? For me if I were 225 given MY health conditions I'd have the sleeve, the ds just seems too extreme for a small amount of weight.. For me personally given my medical history. It's always good to know what the experts (your bariatric team) recommend given your medical history. All I can say is personally I think the sleeve would be pleanty affective but either will work :)

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On a side note I had the bypass but if I did not have a large amount of weight to lose as a different personality lol I would have def not had something with malabsorption, I would keep my body as close to normally functioning as possible and that's just my personal opinion and beliefs.

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I haven't seen a surgeon yet or even had a consultation I'm waiting to gather information so that I am informed when I go. From what I am reading it seems that a fair amount of people once they have the sleeve end up going back in and have the DS done can you or anyone explain to me why this occurs?

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Do you mean the Bypass instead of the Duodenal Switch? As far as I was told, they will only do DS if other surgeries have failed in the past. Its like a last ditch effort because it is so extreme.

At your weight, I'd highly recommend the sleeve. I had it four months ago and I've gone from 315 to 221. With the sleeve you'd probably hit your goal weight in well under 9 months with fewer complications and side effects. The sleeve also has fewer nutritional deficiencies long-term and fewer complications.

Your surgeon will look at your medical history and recommend what they think is the best for you. :)

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"a fair amount of people revise to DS from sleeve"????

Uh, HUH?????? can you support this with some facts?

and as to your question, I ended up deciding on VSG and dropped almost 50 lbs in 5 weeks and have been taken off all of my meds.......and the sleep apnea is resolved as well. Your doctor will be the best adviser, but make sure they perform all the surgeries so they are objective about which one to recommend to you.

I haven't seen a surgeon yet or even had a consultation I'm waiting to gather information so that I am informed when I go. From what I am reading it seems that a fair amount of people once they have the sleeve end up going back in and have the DS done can you or anyone explain to me why this occurs?

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I think you are confusing the lap-band revisions with sleeve revisions. I've seen many people have their lap-band removed in favor of the sleeve. I had a very low BMI with many co-morbidities and was recommended to have the sleeve. Highly recommended!

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Some people revise from the sleeve to the DS. Some revise from the sleeve to the gastric bypass. Some are perfectly happy with the sleeve alone as it does the job for them.

It's hard to say whether or not you should have a DS. You need to know yourself. Can you keep a good count on your calories, etc. and watch what you eat? Because while your stomach is definitely smaller after the sleeve it does stretch somewhat as time goes by (never to its original size, though). If so, the sleeve should work well. If you're like me (a binge eater) & want to eat every 1-2 hours (Protein pretty much in the main) and worry about keeping the most weight off possible, then a DS might be right for you. However, the DS has cons along with the pros. It takes a lot of work: many, many vits/minerals per day for life, yearly or twice yearly blood work, there can be malodorous gas and/or stool (most of us watch our eating in public carefully and/or take a probiotic to keep this under control), etc.

After a lot of research and decision making I felt it was the WLS for me. But it's a very personal decision and all WLS have positives and negatives.

Edited by Postop

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i agree with above

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My surgeon won't even do the DS, believing RNY or VSG are effective, and the risk/side effects from DS are not worth it. That's just his opinion, but I tend to agree. The foul stools and gas just wouldn't be worth it to me. Having said that - it's certainly effective at keeping weight off. I imagine a surgeon will help you make that decision based on your personal situation.

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One way of looking at it is this: a sleeve is 1/2 of a Duodenal Switch procedure. You could add it on later if you had to, though admittedly it would mean paying for 2 surgeries. That said, the reason so many end up revising to a DS from Lap bands AND sleeves is because the lap bands have a high failure rate and are almost always converted to sleeves or DS's, and sleeves can have weight regain issues after 12-18 months as the stomach re-stretches. Most surgeons require a BMI of 40 to do the full DS, just so ya know. Best of luck to you in your decision! I know things will be great for you no matter which path you take. :)

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There is a group for lightweights on Facebook. I think the surgery you choose depends on you. I agree with what postop said. I had the sleeve, now I'm going through the process of revision. I need the malabsorption. Some people do great with all surgeries, it's about the regain, or the info years out of how much people keep it off after a certain period of time.

Also know the surgeon can tailor your common channel limb to match your age, and weight needed to lose with the DS. I have seen people as light and even lighter than you get the DS. It boils down to what you are willing to do. If you can commit to the Vitamins I think it's a great option. If you don't think you need malabsorption then go for the sleeve. You can't always go with how much other people lose because with all surgeries you can be the high average of losing well, and the lower average of losing, and I was at the bottom. GL, research research research.

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Sorry for hijack.

Take a look here on DSfacts.com. They've vetted him concerning the DS.

Edited by Postop

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Hi Paxie,

Some surgeons only offer and promote what they can preform. It does not mean they are not excellent but they have a vested interest in keeping you as a patient Money. Please do your research first. dsfacts.com is a great site. There are 2 surgeons in Mexico on that list neither of which offer discounts. Some times you get what you pay for. I am not implying anything negative just check out all your options. It's your life. Get all of the information you can.

With that said. I revised from RNY to DS Dec. 2012. I was considered a light weight (which seems unreal) at 240 and 5'6" and 39 BMI. I now have a BMI that fluctuates between 19 - 20

DS is a very complicated surgery. After care is a life long commitment to supplements and eating high Protein and fat. Not doing so is not an option. But it is a very effective WLS.

I am happy with my choice. Make your carefully.

Best,

Whit

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