So I'm 3 years post-op. I got the sleeve and I'm looking into getting the bypass. I have been busting my butt working out, eating right up until the last few months because I started to give up hope. Anyhow, I have Thyroid issues that were finally diagnosed as hypo after a year and I'm struggling to lose more. I lost a total of 80lbs and it's slowly going up and down. I had acid reflux here and there but didn't think it was due to the sleeve the longest time. smh. Well, now I'm in the process of getting approved by my insurance. I should know my requirements this week. Has anyone got a sleeve to bypass revision done? If so can you share your stories, whether it was a success or fail, wins, and complications. What to expect. Anything you can share.

• HW - 283
• LW - 208
• CW - 230
• GW - 160

Sleeve did on 05/26/2017

Is it medicallyy necessary? Some insurance won't cover it otherwise

Strictly on a weight loss basis, from what I have seen over the years, I would not revise from a VSG to an RNY, simply because the two are so close metabolically that one doesn't really work any better than the other for weight loss. One may lose a bit more, maybe 10-20 lb, during the early post op stage when the diet is so limited during recovery, and the RNY malabsorption makes the loss a bit faster, but overall on winds up in the same place. In 2-3 years, you will likely be struggling to maintain your weight as you are now. If you need to keep yourself at, say, 1200 calories to maintain weight now, that will also be the case long term with the bypass.

The RNY does tend to help with reflux problems (not guaranteed - some will still have it post RNY, or develop it later - but statistically better) but I wouldn't go through that unless it can't be controlled with medication. That is something to be medically evaluated, and if appropriate, that may be a good reason for such a revision.

For weight struggles as the primary problem, I would look seriously at the DS as a better alternative as that is a metbolically stronger procedure than either the VSG or RNY. It is also a straightforward revision as it starts with your sleeve and adds the intestinal malabsorption to it. If appropriate, as resleeve can be done at the same time if there are any problems with your sleeve. The downside is that since the DS is more technically challenging for the surgeon, not as many surgeons offer it, so one sometimes has to look around to find one.

Good luck!

What is the DS option? I had sleeve 7 years ago and am now struggling. Have "only" gained 20 of the 150lbs I lost, but everything just feels so different. My relationship with food feels like it did pre-sleeve. I now crave food all the time, am never satisfied, and am really struggling - like the fat person I was before surgery? I am afraid of the bypass, and (maybe) would entertain a sleeve tuneup if such a thing exists. Yes I do have terrible stomach pain/ heartburn, but not reflux? And that is well documented, yet they say that I do not have hernia...?

On 06/01/2020 at 12:24, RickM said:

Strictly on a weight loss basis, from what I have seen over the years, I would not revise from a VSG to an RNY, simply because the two are so close metabolically that one doesn't really work any better than the other for weight loss. One may lose a bit more, maybe 10-20 lb, during the early post op stage when the diet is so limited during recovery, and the RNY malabsorption makes the loss a bit faster, but overall on winds up in the same place. In 2-3 years, you will likely be struggling to maintain your weight as you are now. If you need to keep yourself at, say, 1200 calories to maintain weight now, that will also be the case long term with the bypass.

The RNY does tend to help with reflux problems (not guaranteed - some will still have it post RNY, or develop it later - but statistically better) but I wouldn't go through that unless it can't be controlled with medication. That is something to be medically evaluated, and if appropriate, that may be a good reason for such a revision.

For weight struggles as the primary problem, I would look seriously at the DS as a better alternative as that is a metbolically stronger procedure than either the VSG or RNY. It is also a straightforward revision as it starts with your sleeve and adds the intestinal malabsorption to it. If appropriate, as resleeve can be done at the same time if there are any problems with your sleeve. The downside is that since the DS is more technically challenging for the surgeon, not as many surgeons offer it, so one sometimes has to look around to find one.

Good luck!

DS I assume is duodenal switch.
I’m unsure what it is. Just
Know the term :-)
I had a RNY 2 weeks ago.
It wasn’t for weight loss, please consider the reasoning for it.
Insurance might Not, almost
Guaranteed not to, will not cover for weight loss. Make sure. It’s a hard coverage and some allow one WLS per policy etc.