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VSG to DS - Scared to Lose Too Much



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Hello all,

This is my first post here so if I mess up on etiquette I apologize.


I am two years out from a very successful VSG surgery. I went from 265lbs to 175lbs - I’m 24 and 5’2, barely any loose skin, and I’m very happy with the results. However I have PCOS and was estimated to be able to lose more if I didn’t have that to contend with, and I wasn’t able to hit my realistic OR ideal goals.

I know I’m much better off than I was by far, but I still wasn’t fully happy, so I put down a deposit for a DS revision surgery. Because of Covid I had to reschedule it to January 2023. But now I’m suddenly worried and having doubts. I can’t seem to find anyone who has revised from VSG to DS, and I’m worried about losing TOO much weight. My surgeon has had me come entirely off Vitamins as my labs are perfect without them, and admittedly I don’t miss them, so that’s a downfall but one I’m willing to accept.

My surgeon does also perform RNY and reconstruction but my sleeve hasn’t stretched back out, and he has told me that DS is often referred to as the second stage to VSG.

Mostly I’m looking for advice and anecdotes from this forum! Is there anyone who did it in two stages instead of one? Pros and cons? Tips? I’m desperate for anyone who has any experience with this.

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VSG is actually stage one of the DS. Years ago many surgeons did the DS in two stages (first, the sleeved stomach, then a few months later, the bypassed small intestine). Some patients did really well just with stage 1, so they started offering the sleeved stomach as a standalone surgery. Ta da! The VSG was born!

so yes - lots of DS'ers had their DS done in two stages (esp those who had it done several years ago), and there are definitely people who've revised from VSG to DS. It's a more straightforward surgery than going from VSG to RNY, since you're already halfway to the DS when you have a VSG.

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The DS was recommended to me by my best bud. He had the sleeve and 4-5 years later he went back for the DS. He's totally happy with it, enjoying life and even suggested it to me when I asked him about surgical options. So there's that.

I went to the same surgeon he got the DS from and asked about about it. As you were told, the sleeve is actually the first part of the DS, My surgeon said years ago, the DS was done in two parts. They would do the sleeve and have the patient come back for the second part. What they found out was that the sleeve was all that was needed for many/most. At least that's the story he told me and that's how he talked me into going with the sleeve. By doing so, I know we can always come back and complete the DS.

Bottom line, I can only say that my best friend had the DS after having a sleeve and recommends it.

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1 minute ago, catwoman7 said:

Some patients did really well just with stage 1, so they started offering the sleeved stomach as a standalone surgery. Ta da! The VSG was born!

You literally beat me with that by seconds! :D

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1 hour ago, catwoman7 said:

VSG is actually stage one of the DS. Years ago many surgeons did the DS in two stages (first, the sleeved stomach, then a few months later, the bypassed small intestine). Some patients did really well just with stage 1, so they started offering the sleeved stomach as a standalone surgery. Ta da! The VSG was born!

so yes - lots of DS'ers had their DS done in two stages (esp those who had it done several years ago), and there are definitely people who've revised from VSG to DS. It's a more straightforward surgery than going from VSG to RNY, since you're already halfway to the DS when you have a VSG.

That’s wonderful to hear, my surgeon said the same but when I couldn’t find anyone to speak to I became very nervous, and that’s how I found this forum. I’m still nervous to lose too much weight given my stature and current size, but I’m relieved to know how common it is!

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My doc's perspective on this, when we were discussing this leading into my VSG 11-12 years ago (the prospect of "completing" the DS as a plan B to the stand alone VSG, was that you are in the ideal situation - do it before any substantial regain sets it. With the added metabolic issues that you are having with your PCOS, the extra metabolic strength of the DS would seem to be appropriate,

When we discussed the two procedures in the pre op groups "back in the day" one of the rules of thumb factoids was that one should think of the sleeve as getting the weight off, while the switch keeps it off. That's not entirely true, (maybe 80/20) but illustrates what the doc was telling me later, which is not to depend on the switch part to provide substantial reversal of a regain problem (or implicitly, count on it to provide some additional weight loss, but not a substantial amount. It sounds like it is consistent with your goal of some more weight loss without going overboard.

This assumes the traditional BPD/DS rather than the SIPS/SADI/Loop DS, which I would assume to yield a similar result, if not quite as extreme owing to its usually lesser malabsorption.

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I had the sleeve 2010 and then I asked could I have the bypass 2021 a long road but worth it in the end but I did get told I wouldn't lose as much because of the previous surgery they said I'd only lose 3 stone and I'm now here 112 pounds lighter got saggy skin but no one sees it good luck

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On 8/5/2022 at 4:13 AM, Jue said:

I had the sleeve 2010 and then I asked could I have the bypass 2021 a long road but worth it in the end but I did get told I wouldn't lose as much because of the previous surgery they said I'd only lose 3 stone and I'm now here 112 pounds lighter got saggy skin but no one sees it good luck

Oh wow that’s incredible! So you lost the 112 pounds after the bypass? 3 stone would actually be perfect for me to lose even if that was the maximum amount, so even that is great news. Did you find the recovery was easier or harder than the sleeve?

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