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Sleeve to...? Revision seeker



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Hi all, so glad they added this

forum! I was sleeved in 2017 and lost 90lbs. Unfortunately I experienced great loss and trauma in 2019 to recent and find myself meeting the criteria for weight

loss surgery again. I’ve done a lot of work on myself since and learned how to cope without using food. I’m starting the approval process for a revision on 11/19/20.

Anyone on here get a second surgery due to weight gain? I know they do revisions for GERD and other issues but I want to hear from anyone who had a revision for gain.

Did you sleeve to bypass? Resleeve? Sleeve to DS? Bypass to...?

Did insurance cover it? Make you do a diet program first? Did it take months?

tell me all the things!

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Hey I revised to DS 4 weeks ago tomorrow. I was 6 years out from sleeve. Insurance paid as it was treated as a new surgery and so I just had to do a regular qualification. No diets or anything, just whatever the insurance required.

I think it took about 6 or 7 weeks to get scheduled from my initial consult.

Do you know what procedure you are leaning toward?

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1 hour ago, Circlesis said:

Hey I revised to DS 4 weeks ago tomorrow. I was 6 years out from sleeve. Insurance paid as it was treated as a new surgery and so I just had to do a regular qualification. No diets or anything, just whatever the insurance required.

I think it took about 6 or 7 weeks to get scheduled from my initial consult.

Do you know what procedure you are leaning toward?

I thought I was leaning towards bypass, but a very wise soul on this board suggested I look into DS, as it’s seen as a gold standard for weight loss surgery. I have done very little research on DS, but I plan on asking my surgeon (hopefully surgeon that is) what their thoughts are on it! I’m open to whatever can help me get these extra 100+ pounds off.

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My thing was that DS has the best long term result, having had regain already.

Does the doc you are consulting offer the DS? Only asking cause not as many do it. I asked dr why that is and he said it’s mostly to do with training and familiarity.

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For a regain problem I would not generally go from a sleeve to a bypass, as metabolically the two are too similar and one usually winds up in the same place after a couple of years. Indeed, most revisions don't yield a lot of additional weight loss; those that do mostly seem to be those who really crack the whip and get their dietary and psych acts together for the second try. One will usually lose a few pounds, typically twenty, give or take - mostly what one would expect from having to go through all the diet restrictions associated with going through the surgery again.

The simple minded way I like to think of the reasoning for the general poor results is that our stomachs started out being able to hold 32-64 oz before our original WLS, and now, a few years post op, our stomachs, even after some adaptation and stretching, hold 4-6 oz (maybe 8 in some cases), we have gotten used to living with that, so there isn't nearly as much of a difference going through the surgery again.

The DS will usually provide better results, particularly in being more regain resistant. As with the others, it is hard to expect as good results as with virgin DS, but it should still work better than the others. When I discussed this matter with our surgeon when I had my VSG - the prospect of using a DS revision as a "plan B" backup to the VSG, he cautioned about the problem of losing that regain; he said that the revision works best if you catch it early, before substantial regain has occurred, as the biggest strength of the DS is its ability to resist regain.

You are fortunate in starting with the sleeve, as that has maintained more options for you - revising an RNY to anything else that may work better (like the DS) is a very complex undertaking that few surgeons can do; as the sleeve is the basis of the DS, changing to the DS is more of a "completion" of the DS rather than an outright revision and is a pretty straightforward procedure for any DS qualified surgeon.

You seem to be doing the right things, in working out the problems that led to your regain, as that will be a key to your future success. Good luck!

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I had a sleeve and kept off my 90 pounds for 6 years. But! I stoped using my tool thinking since I can’t eat that much I won’t gain well for married and are small but bad then more and stretched my sleeve. Still ate well at times but because of health problems I. March could not work out and I gained 10 pounds in honeymoon and 28 since covid. Bad I know. Anyways I also had acid reflux but wanted to lose and keep off. Did the bypass and I’ve dropped 17 pounds already. I’m happy I did it. Just got it Monday and I’m in pain it’s WAY worse than the sleeve. But hey we can all get seconds chances we just have to stick to it so I’m joining a support group Monday and I’m logging all my fluids and food In myfitnesspal it’s the only way I can do it.

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On 11/7/2020 at 7:17 PM, Christina760 said:

I had a sleeve and kept off my 90 pounds for 6 years. But! I stoped using my tool thinking since I can’t eat that much I won’t gain well for married and are small but bad then more and stretched my sleeve. Still ate well at times but because of health problems I. March could not work out and I gained 10 pounds in honeymoon and 28 since covid. Bad I know. Anyways I also had acid reflux but wanted to lose and keep off. Did the bypass and I’ve dropped 17 pounds already. I’m happy I did it. Just got it Monday and I’m in pain it’s WAY worse than the sleeve. But hey we can all get seconds chances we just have to stick to it so I’m joining a support group Monday and I’m logging all my fluids and food In myfitnesspal it’s the only way I can do it.

This is so encouraging to hear! I'm in almost the exact same place. I'd lost the weight and kept it off for years after my sleeve, then new relationship, Covid, blah, blah. The GERD was already out of control and now the gain has got me thinking about revision. I'm researching Bypass vs Switch debating what's best. Just had to cancel my appt with my surgeon when I got Covid, now going to get this going in the next few months. I'm glad to hear it's going well for you. But the pain makes me nervous. I had considerable after my sleeve!

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My thing was that DS has the best long term result, having had regain already.

Does the doc you are consulting offer the DS? Only asking cause not as many do it. I asked dr why that is and he said it’s mostly to do with training and familiarity.
Could someone who has had the DS Loop tell me about this? I had a gastric bypass in 1980, due to regain I want to get a revision. I'm not sure what kind of surgery is possible after so long. I know I have a lot of scar tissue built up. I don't know if anything can be done. If anyone else has had this please let me know thank you in advance.

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