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Just had revision from Sleeve to SIPS



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A year ago, I went in for a Lap band to SIPS revision, but there were complications with the removal of lap band, so the surgeon cut things short and only did the sleeve portion of the procedure. I was massively disappointed (especially since I was self pay), but wasn't much I could do about it. I had good results initially. I lost 50 lbs during the first 'honey moon' 4-5 months, then things just stagnated. I dieted really really hard, went to gym every other day, and even tried Intermittent Fasting, but my weight would just bump around the same 3-4 lb range. I just was stuck. This went for 2-3 months, until I finally gave up, at which point the weight starting coming back pretty fast.

Kinda crazy (and very $$$$) but I decided to go back in and have the SIPS procedure completed. My surgery was a few days ago. I now have a ton of questions post-op, but for starters, I'm wondering if anyone else out there is Sleeve to SIPS revision. I figure there can't be too many of us...

My #1 question would be: Will there be another weight loss 'honey moon'? Or - since my sleeve wasn't touched - will my eating habits remain pretty much were they were pre-op? I ask because I've heard that the Sleeve is responsible for losing the weight, and the bypass part is responsible for keeping it off. Just curious.

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Id be interested to know what people's experiences have been also. I'm wanting a revision but totally unsure as to what as I've had very crappy results with my sleeve

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@AussieLiz . your avatar is what I will look like after a week or 2 of Protein Drinks Only difference is I may also have my,hsnfs clenched into claws.😉

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Finally dropped 1 more pound after 6 days stuck at the exact same weight (which is in itself, kinda weird. Normally I bump around 1-2 lbs day-to-day) . I still don't understand why it's this slow, given that my eating is significantly curbed, and I hit the bathroom at least 5-6 times a day with frothy orange diarrhea; I haven't had a solid BM yet. I assume this is the new normal, and is the DS doing it's malabsorption thing

Also, since posting, I spent some time reading through a ton of older posts, and it looks like sleeve to SIPS revisions is more common on this board than I would have thought (Is this a clue to anyone considering sleeve vs SIPS that Sleeve alone has high failure rate?) Seems like the results of SIPS revision are generally positive, but more Tortoise then hair. It's feels a little frustrating compared to how fast I remember the lbs dropping initially with the sleeve, but then again, those came back after 6 months. So if the DS lbs come off and stay off.... totally worth it.

Something to note: My BMI was under 40 when I got this latest revision, which is unusual. As a result, the Dr gave me a longer channel than he would have if I was in the 50's. Also, a couple of people have noted that speed of weight loss is slower the closer you started to goal weight, so I'm probably in that boat. Just gotta be patient i suppose.

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Thought I'd add a couple other observations specific to Sleeve to SIPS revision:

  • Compared to my VSG, the surgery and recovery for SIPS revision was a breeze. I was literally walking around a few hours after surgery and didn't feel the need to take a single pain or nausea pill afterward. Felt great the next day too. Back when I had the VSG, I slept for 3 days and was miserable. Stomach was fully bloated and entire lower portion turned an ugly black and blue a few days latter which lasted a week or so. I'm a little swollen after SIPS, but not as bad and no discoloration. Bottom line, the VSG procedure seems to be much more traumatic than the DS procedure.
  • Given that my stomach wasn't touched, I was able to go to solid foods way faster. To be honest, I probably pushed it, but at the same time, I have yet to eat anything that's really pushed back at me (except for the need for a quick trip to the restroom). This was not the case with VSG

Your milage may vary.

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On 4/23/2018 at 9:03 AM, disco stu said:

Finally dropped 1 more pound after 6 days stuck at the exact same weight (which is in itself, kinda weird. Normally I bump around 1-2 lbs day-to-day) . I still don't understand why it's this slow, given that my eating is significantly curbed, and I hit the bathroom at least 5-6 times a day with frothy orange diarrhea; I haven't had a solid BM yet. I assume this is the new normal, and is the DS doing it's malabsorption thing

Also, since posting, I spent some time reading through a ton of older posts, and it looks like sleeve to SIPS revisions is more common on this board than I would have thought (Is this a clue to anyone considering sleeve vs SIPS that Sleeve alone has high failure rate?) Seems like the results of SIPS revision are generally positive, but more Tortoise then hair. It's feels a little frustrating compared to how fast I remember the lbs dropping initially with the sleeve, but then again, those came back after 6 months. So if the DS lbs come off and stay off.... totally worth it.

Something to note: My BMI was under 40 when I got this latest revision, which is unusual. As a result, the Dr gave me a longer channel than he would have if I was in the 50's. Also, a couple of people have noted that speed of weight loss is slower the closer you started to goal weight, so I'm probably in that boat. Just gotta be patient i suppose.

I started with a BMI of 40, so my doctor gave me a longer common channel also. I was losing about 8-11 pounds a month to begin with. Now at 10 months, I lose maybe 3 pounds a month. I'm 20 pounds from goal, but it's the hardest weight to lose. The weight is still coming off nevertheless. Hopefully, I'll drop faster this summer when I'm more active. The BM of a DS patient is always interesting. They will never again be what they were pre-op, but that's the DS doing its job of keeping the weight off (not diarrhea but always soft). Yikes, kind of gross but we since we were on the topic, I thought I'd add to it. My recovery was pretty much a breeze. I had very little soreness. The Lap-band was lot more painful.

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19 hours ago, Strivingforbetter said:

I started with a BMI of 40, so my doctor gave me a longer common channel also.

Were you a sleeve revision, or did you go from lap band to full SIPS in one shot? In other words, how many surgeries? I've had three: Lap band, VSG, then mini DS.

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UPDATE: Happy to report for the last 4 days, I've lost a pound each day, so looks like the "three week stall" is a real thing, and I was a victim <grin>.

Not expecting to maintain this pace forever, but glad to go along as long as it does.

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On 4/25/2018 at 12:30 PM, disco stu said:

Were you a sleeve revision, or did you go from lap band to full SIPS in one shot? In other words, how many surgeries? I've had three: Lap band, VSG, then mini DS.

I went straight from a lap band to the traditional duodenal switch. They don't call it SIPS unless it's a single anastomosis. So, two surgeries for me. This one had to work. I couldn't afford a third one.

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On 4/26/2018 at 7:55 PM, Strivingforbetter said:

I went straight from a lap band to the traditional duodenal switch. They don't call it SIPS unless it's a single anastomosis. So, two surgeries for me. This one had to work. I couldn't afford a third one.

Totally makes sense. I was supposed to do the same thing (although single anastomosis), but my lap band was stuck to my liver, and the surgeon ran out of time to do the full procedure. Ended up with just a VSG.

I ask, because you had what looks to me to be pretty rapid weight loss, which is expected with DS. I'm trying to figure out what to expect speed-wise in the case of revision from VSG.

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On 4/28/2018 at 8:16 AM, disco stu said:

Totally makes sense. I was supposed to do the same thing (although single anastomosis), but my lap band was stuck to my liver, and the surgeon ran out of time to do the full procedure. Ended up with just a VSG.

I ask, because you had what looks to me to be pretty rapid weight loss, which is expected with DS. I'm trying to figure out what to expect speed-wise in the case of revision from VSG.

I've always felt my weight loss has been slow, so thiank you. Right now, I'm lucky if I lose 3 pounds in a month. I don't know about the amount of weight a person loses with a revision, but the DS is the mac daddy of weight loss surgery so I would think it would be just as powerful as a revision unless you've stretched out your sleeve. I still have pretty good restriction.

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17 hours ago, Strivingforbetter said:

I've always felt my weight loss has been slow, so thiank you. Right now, I'm lucky if I lose 3 pounds in a month. I don't know about the amount of weight a person loses with a revision, but the DS is the mac daddy of weight loss surgery so I would think it would be just as powerful as a revision unless you've stretched out your sleeve. I still have pretty good restriction.

Not sure to what degree I stretched out my sleeve. I definitely can't eat as much as I used to pre-VSG all in one sitting, but at the same time, I can drink beer or other carb beverages without any problem which isn't supposed to be the case.

What's interesting is that I asked my surgeon pre-op if he was going to tighten my sleeve while he was in there adding the DS, and he said, "No, it's been proven that revising an old sleeve doesn't work."

Things are just really strange right now. I feel better. Things are looking better in the mirror. I'm getting compliments about losing weight. I know for a hard fact that my appetite is way down (in part because I feel nauseous pretty much all the time). I'm in the restroom 6 to 10 times a day and have yet to have a single solid BM (which tells me the DS is working.) But the scale is stuck again. Hasn't moved in the last 4 days. Sigh.

Take yesterday: I'm a dude and I ate probably around 1000 - 1500 calories tops... and it wasn't even hard. One of the people we were at brunch with even said "You eat like a chick." Nothing to eat past 5:00. Got on scale this AM.... nada. No change.

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8 hours ago, disco stu said:

Not sure to what degree I stretched out my sleeve. I definitely can't eat as much as I used to pre-VSG all in one sitting, but at the same time, I can drink beer or other carb beverages without any problem which isn't supposed to be the case.

What's interesting is that I asked my surgeon pre-op if he was going to tighten my sleeve while he was in there adding the DS, and he said, "No, it's been proven that revising an old sleeve doesn't work."

Things are just really strange right now. I feel better. Things are looking better in the mirror. I'm getting compliments about losing weight. I know for a hard fact that my appetite is way down (in part because I feel nauseous pretty much all the time). I'm in the restroom 6 to 10 times a day and have yet to have a single solid BM (which tells me the DS is working.) But the scale is stuck again. Hasn't moved in the last 4 days. Sigh.

Take yesterday: I'm a dude and I ate probably around 1000 - 1500 calories tops... and it wasn't even hard. One of the people we were at brunch with even said "You eat like a chick." Nothing to eat past 5:00. Got on scale this AM.... nada. No change.

Sometimes your body needs time to think. It's wondering what's going on with all of the new changes, so give it time. I remember weeks when I didn't see a change on the scale until day 6 of the week, and then it would always drop. I didn't hit a stall until I was 7 months out. Are you tracking your Protein levels? With the DS, protein is very important and key to losing weight. How much Water are you drinking? That's also important. If you're doing well in both of these areas, then it's only a matter of time. The DS does work. The malabsorption component is very effective. Oh, and another thing, I've been dropping sizes but my scale says I've only lost 4 pounds this month. How does a person lose two sizes with that little weight loss? At this point, I haven't been exercising, so it's not that I'm toning up. It's bizarre. I'm wondering if that's also happening in your case. Get out your tape measure and start keeping track.

Edited by Strivingforbetter

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16 hours ago, Strivingforbetter said:

Sometimes your body needs time to think. It's wondering what's going on with all of the new changes, so give it time. I remember weeks when I didn't see a change on the scale until day 6 of the week, and then it would always drop. I didn't hit a stall until I was 7 months out. Are you tracking your Protein levels? With the DS, Protein is very important and key to losing weight. How much Water are you drinking? That's also important. If you're doing well in both of these areas, then it's only a matter of time. The DS does work. The malabsorption component is very effective. Oh, and another thing, I've been dropping sizes but my scale says I've only lost 4 pounds this month. How does a person lose two sizes with that little weight loss? At this point, I haven't been exercising, so it's not that I'm toning up. It's bizarre. I'm wondering if that's also happening in your case. Get out your tape measure and start keeping track.

THanks! Good advice. Yes, I do focus on protein. Also been drinking a ton of Water (for some reason, I found that I like the taste of distilled water best, which is great because it's cheap!)

I weighted in this AM and am down a pound, so I guess I'm just being impatient.

But this brings up an interesting question: Daily weigh-ins? Yes or No? I've read differing opinions on the board. Here are my thoughts:

Why not to daily weigh in: If I've "been a good boy" the day before, worked really hard to avoid temptation and cravings, and then see the scale not move the next morning - or worse, bump up a pound or two, It is TRAUMATIC. Screws my whole day.

Why to do daily weigh-ins: Even though these WTF? moments are traumatizing, in a sick way, they are motivating. For instance, yesterday I was so pissed off at the scale, that I ate even less than I had the day before.... and now the scale finally moved.

So even though it's emotionally devastating to get on the scale every day, I guess it's worth it? The medicine tastes horrible but leads to the cure? Thoughts?

or...

The DS is so powerful, I'm gonna lost weight no matter what, so might as well just chill out and let it do it's thing, and only check in on the scale every month or so...

Edited by disco stu

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I personally still weigh every day, even though I'm 11 months out. I have to know where my body is at. Just like you mentioned, I'm either very encouraged by what I'm seeing (today I was down another pound!), or I stay the same. I've never had a gain so far. This helps me see a pattern with my weight loss and I feel more in tune with it. I know at this stage post-op that my body will do a "whoosh" after maintaining for two weeks. I freak out a little before the "whoosh" because I'm worried I'm not losing, but then I drop 2-3 pounds. So, for me, the daily weighing has a purpose, not just to torture myself. I can't imagine only weighing once a month. Not for me.

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