Jump to content
Are you looking for the BariatricPal Store? Go now!

Choosing between SIPS and traditional DS

Recommended Posts

I’m researching SIPS vs DS and I’m so confused on the correct choice! SIPS seems easier to live with less side effects possibly and an up and coming surgery while DS has been around longer and has more follow up data. My surgeons office only does SIPS and truly has not done that many of them so I’ll probably switch surgeons as well.

My story is that I had a nightmare band experience in 2011, didn’t lose much at all and regained all as well as port discomfort etc until being revised in 2017 to sleeve. I did amazing on sleeve for 2 years lost almost all my weight (112lbs) but regained about half. I’m desperate to find the right surgery and so afraid I will make another mistake!

I know I need a more powerful surgery than the sleeve and yes I’m doing the “head work” in therapy. Any advise on which I should choose or how I should make the decision?

Share this post

Link to post
Share on other sites

It is difficult to compare the two directly as few surgeons do both, (Mitchell Roslin in NYC is the main one I can think of that actively performs both) so there a lot of variables that get in the way. The DS is indeed the most powerful procedure commonly available, but it is also the most complicated to do, which is why few surgeons offer it. It has been around since the late '80's, it is one of the procedures endorsed by the ASMBS (along with the VSG, RNY and bands) and accepted by US insurance as a mainstream WLS procedure (they can't call it "investigational" any more since Medicare started paying for it.,) The SIPS (SADI, Loop DS, and other names that it goes by,) is newer and not as well established, nor quite as standardized, as everyone is still figuring out the optimum configuration. It is being promoted as being "almost as good as" the traditional DS, but "more accessible" - simpler so more surgeons can offer it. The hope is that it will fall somewhere between the RNY and DS in performance, with fewer side effects and limitations than either. If that holds true, then it will earn a spot in the WLS world, and if not, it will be another procedure that doesn't quite make it, like the "mini" bypass.

Most of the BPD/DS surgeons don't offer the SIPS as they don't need a simpler procedure, and already have the VSG for the less challenging patients. Here is one very biased opinion on it from one of those surgeons:


The position of the ASMBS on the matter:


and, here is Dr. Roslin's take on it:


Dr. Roslin is well quaiified on the BPD/DS (and is one of the few with the skills to do the very complex RNY/DS revision) but it seems that he is actively working on the SIPS for the greater good of the WLS community as a whole - that "almost as good as, but more accessible" concept that can hopefully benefit more patients over the long run.

At this point, only time will tell.

As an individual decision for right now, that's a tough one. With your regain history, I would be inclined to go the the well established BPD?DS, as that has proven to have the best regain resistance, but that would likely involve travelling for you (I don't know of any DS docs in MA, but there are several in the NY/NJ/PA area.)

It is good to see that you are doing the "head work" as that is an essential part of any of these procedures - one can "eat around" any of them, though it is harder to do with the DS. One of the things that I have found to be helpful is what this doc covered here -

One of the things that doesn't get covered much by other surgeons is that our eating capacity does increase slowly over time, and this is something we have to compensate for. One may or may not get along with this doc's prescription for a veg first diet, but it does make sense from the perspective of filling in that added capacity with bulky, low calorie veg. Think about it, discuss it with your therapist, and maybe you find a different approach to handling this problem.

Good luck!

Share this post

Link to post
Share on other sites

Dr. K is definitely a proponent of the traditional DS.

I’ve only met Sips patients at Lenox Hill (Dr. Roslin’s Practice) I don’t even know if he’d do the full DS anymore

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Recent Topics

  • Most popular:

  • Recent Status Updates

    • Krestel

      Me: Hey Siri, Is it raining outside? (for my morning walks with the dogs)
      Siri: I don't think it's raining at the moment.
      Wet Dogs: Then why are we wet? This damn Siri person is more stupid than we are.
      · 0 replies
      1. This update has no replies.
    • Billy Bob  »  lvidacovich

      Drink Muscle Milk. lol  Gt 60 to 90 gm quality Protein & daily vitimins, good sleep, walking & resistant ( weight /bands/squats ) You absolutely build muscle. 
      · 0 replies
      1. This update has no replies.
    • SabrinaGoddess

      I received my nutrition book and checklist today! I am so very excited (and a tad bit scared too) Each day this is becoming a reality!
      I created a new blog post about how BRAVE we all are for doing this. Because I think we are! Most of us know the horrors of people calling us nasty names, saying we can't control ourselves, we are easy targets for people's verbal attacks! But I feel we are BRAVE because we are taking control over our lives and creating a new world of happiness.

      · 0 replies
      1. This update has no replies.
    • SabrinaGoddess

      Today I scheduled my mental evaluation and my nutritionist appointments. Yes, we are moving along quiet nice.  December 9th will be here before you know it.
      I have informed my inner circle of family about the surgery and I will be keeping it in my CORE!

      · 0 replies
      1. This update has no replies.
    • drac2you

      Well, it has been a while since I posted here, but my journey continues. As for breaking my stall, I was able to get down to 214 with the help of a friend via our Fitbit fitness trackers which has made me ecstatic! Since that has happened I was fortunate enough to have my insurance company approve a panniculectomy to remove the panniculus (THIS is the correct term, NOT pannus, see this reference: https://www.merriam-webster.com/medical/panniculus) that has been deviling me for years, even before I had bariatric surgery. It was to the point that it was hanging down far enough to cover my pubic area, covered half my thighs when I would sit, and also drooped between my legs which I could hardly manage to keep together when sitting. For any males that may read this, for a woman that is pretty uncivilized, not to mention, unladylike especially when wearing a dress or skirt - just looks slovenly to say the least. Despite the numerous skin issues I had the last couple of years, my health insurance insisted the procedure was cosmetic... 🤐 . I would guess no one that is saying so has been in the bariatric patient's shoes. The damn thing was just getting to be a self-esteem killer in addition to a medical nuisance requiring many visits to my primary care physician, and interfering with my mobility. Now, I realize there are folks with more egregious panniculus sag issues, but the fact that it interferes with mobility is an important consideration.
      One thing I have to say is that this surgery is drastically different from any other I've had. Things occur that are deemed routine, expected even, after a panniculectomy that would be downright unacceptable after any other procedure. This plastic surgery experience is definitely a learning experience that is still unfolding as I key this entry. For one thing, the swelling is a story all it's own, I had no clue my abdomen could get so large, so quickly, without causing my skin to just split open - it's crazy! So far, I'm pleased to have been able to get this procedure despite may be perceived as drawbacks, just to get the pendulous adipose tissue demon off of my person. Here are a few links to information about this procedure for anyone considering it in the future:
      https://www.yourbariatricsurgeryguide.com/panniculectomy/ https://www.healthline.com/health/panniculectomy https://www.yourplasticsurgeryguide.com/tummy-tuck/panniculectomy/ https://www.plasticsurgery.org/reconstructive-procedures/panniculectomy/safety https://www.ncbi.nlm.nih.gov/books/NBK499822/ I hope you find this information helpful. I will provide updates periodically on my progress of this surgical recovery. Have a wonderful day! 
      · 2 replies
      1. Panda333

        Thank you and good luck to you!

      2. SabrinaGoddess

        WOW, thank you for sharing all this with us!

  • Trending Topics

  • Together, we have lost...