Sleeve to bypass question

[ShoppGirl 3,428]

When you convert from sleeve to bypass do they make your stomach smaller? Or do they just do the portion where they bypass part of the intestine while leaving the sleeved stomach? I was looking at SADI and my surgeon said he wouldn’t touch my stomach because of the high risk of leak with a resleeve but now I am not sure if I’m getting SADI or bypass and I’m curious about whether I will still be able to eat the same amount volume wise with the bypass too.

[NickelChip 812]

They will create a small stomach pouch, same as in a regular bypass. But be aware that even with bypass, the ability to eat more returns over time. If it helps for comparison, though, I can tell you that at 3 months out with gastric bypass, I can eat about 3/4 c yogurt with a little bit of fruit, or 2-3 oz chicken with maybe 1/4 cup cooked veg in one sitting. In both cases, this would take me about 15 minutes to eat.

[catwoman7 10,933]

I don't think there's really a difference in how much you can eat. At first you probably won't be able to eat as much because you'll be swollen from the surgery for awhile, but after that - I don't think so because I've known several people who've had revisions, and I don't remember people mentioning that.

[ShoppGirl 3,428]

11 minutes ago, catwoman7 said:

I don't think there's really a difference in how much you can eat. At first you probably won't be able to eat as much because you'll be swollen from the surgery for awhile, but after that - I don't think so because I've known several people who've had revisions, and I don't remember people mentioning that.

Hummm. I was thinking that maybe if they do change it then it would be smaller for me because I swear my sleeve was left too big from day one. The surgeon thinks I just have fast gastric emptying and that’s why I feel like I can eat more but I hope we will know for sure when he does the scope in a couple of weeks. It will be nice if I do finally get an answer as to why I was always able to eat more than everyone else. I was just thinking that even though statistics say I will lose more with SADI revision that I may be differnt if one involves changing the stomach and the other does not.

[catwoman7 10,933]

On 5/14/2024 at 8:26 PM, ShoppGirl said:

Hummm. I was thinking that maybe if they do change it then it would be smaller for me because I swear my sleeve was left too big from day one. The surgeon thinks I just have fast gastric emptying and that’s why I feel like I can eat more but I hope we will know for sure when he does the scope in a couple of weeks. It will be nice if I do finally get an answer as to why I was always able to eat more than everyone else. I was just thinking that even though statistics say I will lose more with SADI revision that I may be differnt if one involves changing the stomach and the other does not.

they do create a pouch at the top of your sleeve - so yes, physically it'll probably be smaller. Although pouches (and sleeves) can temporarily stretch to accommodate food. So I don't know - maybe in your case, you'll notice a difference. Hard to tell.

[ms.sss 14,806]

courtesy of google:

you can see that the stomach is in fact smaller after a revision to bypass. and main diff is bypass also "bypasses" the pyloric valve, while sadi/ds still makes use of it (as does the original sleeve).

...but how your surgeon would do either surgery "without touching" your stomach is a head scratcher.

can you go back to your surgeon and have them explain your surgery to you (with pictures, if need be!). dont leave until you completely understand. while we can offer our knowledge and experience, we are not doctors...and you may get conflicting info on here that confuses you more.

[ShoppGirl 3,428]

yea I’m gonna have to ask the doctor to dumb it down for me because I don’t understand my normal anatomy, nevermind enough for that to make sense to me from just looking at the picture. When I said he won’t touch the stomach though I guess I should have said he won’t resleeve it for the SADI revision. So my thought was if he doesn’t do anything to make it smaller then I would still be able to eat as much as I can now post SADI (which is a lot more than most people on here). I would still have the benefit of less absorption but no real restriction. So maybe the bypass would be a better choice for me after all if it would add the restriction too. I could be overthinking it.

[SleeveToBypass2023 1,930]

As you know, I had the sleeve to bypass revision. They do make your pouch a little smaller, but it will stretch out a little as time goes on. I noticed I have more of a hard stop with the bypass versus the sleeve, and I definitely have to make sure I chew thoroughly and eat slowly way more with the bypass. You can lose weight with a revision, but not nearly as much and not nearly as fast as with the original surgery. You also have to take accountability for what you eat and how much. If you're eating slider foods and stuff not compliant with your diet, if you're grazing all through the day, if you're not watching your salt, sugar, Protein, carb, and Fluid intake.....no surgery is going to fix the problem.