Trying to decide

[Berry78 4,261]

The DS has a large malabsorption component. Huge Vitamin requirements. Will get (and keep) the weight off, but may be more surgery than you need.

The DS can be added after the fact to a sleeve. But, once the DS is made, there really is no going back. Same with a bypass.

I agree with the others here. Bariatric surgery on an outpatient basis sounds scary.

Do your research so you will best know what questions to ask. Maybe watch duodenal switch stories on youtube.

[AnneElliot 79]

@Berry78 In reality the gsstric bypass can be reversed. It's difficult and dangerous but it's done.

[Berry78 4,261]

Well, ok. It CAN be done, but is so rarely that it's best to not use that as decision criteria. (Unlike the lapband.. which CAN be undone.. not that I recommend it either! Lol).

[CMDD71 9]

I had the DS on June 11th 2016. I am a huge proponent of the surgery. I started at 427lbs, now 215lbs. I have never felt better.

Dr Spiegel, in Houston Texas, is a DS specialist and has done more DS surgeries than any other weight loss doctor out there (his claim). He also teaches other Doctor's how to perform the surgery.

His claim is that the sleeve will get you 75-85% of your weight loss and 15% of patients put some weight back on. He calls the DS the Cadillac of WLS. Losing 95% of weight loss with very little weight regain.

I have had no issues absorbing the needed fats and Vitamins I need. But I do get tested every three months to make sure that remains that way.

One of the benefits of the DS over the sleeve is that you do not run the risk of having an unexpected bowel movement.

While I would say the DS is a great choice, I would say make sure you have the correct doctor. If a doctor says you can do this surgery as an outpatient, that is not the correct doctor.

Also keep in mind, with the DS you will need a second (minor - with the right doctor) surgery to remove your gall bladder.

What ever surgery you choose to go with it wish you great success and a smooth recovery. Good luck on your journey.

[Hollyhock 62]

I was conflicted about sleeve vs. gastric bypass and my doctor spent over an hour showing me weight loss v complication stats for someone my gender, age and race. He showed pictures of both operations and potential complications. He was extremely detailed. We also discussed all my fears regarding malabsorption. The other members of his team also spent a long time with me talking about the pros and cons of each surgery. In the end I opted for the sleeve.

I spent two days in the hospital since I live fairly far. I was really glad as I needed the push pump for pain meds the first day and the staff was extremely supportive. It seems really, really strange to me that your doctor was so terse, and I can't imagine doing a procedure that has potentially serious complications on an outpatient basis. I think you should look up the doctor's rate of complications and successes. My doc had a well below the national average rate of complications, and he also could tell me the average weight loss of former patients in my demographic.

[Peggy D 124]

21 hours ago, CMDD71 said:

One of the benefits of the DS over the sleeve is that you do not run the risk of having an unexpected bowel movement.

Since the sleeve does not alter your intestines there is not likely to be much change in your bowel habits. If anything you may be more constipated.

Any surgery that results in malabsorption is very likely to cause "unexpected bowel movements." Things move through quickly since the intestinal tract is shortened considerably. The shorter the common channel the more likely this will happen. The saying "never trust a fart" very much applies.

[CMDD71 9]

You are probably right. That does make sense, having said that, based on the the limited sample size of people I interact with on a regular basis. The three people I know who have had the DS have not had issues while several of the sleeve patients I know have had embarrassing cases of gastric emptying. I guess it also depends on what you eat. Since the DS folks I know eat a lot healthier, while the sleeve folks continue to eat the junk food just less of it.

[dragonfly2u 2]

Since first posting my uncertainty on surgery type, I have done a lot of reading up on the subject. My Surgeon Dr Tuggle turned me over to Dr Duncan who specializes in preforming the sleeve with the addition of the ds then adding on the sips procedure. The sleeve pouch is a little larger than the regular sleeve. You can eat 4 to 6 ounces verses the 2 with the regular sleeve. However, what you eat passes thru your system with less calories and less nutrition being absorbed. But, by having the sips procedure you have less bowel and smelly gas issues.

I researched my surgeon.He speciAlice's in this type of combined surgery. Yes, I'm nervous about doing outpatient. The insurance company approved it that way, but they can always admit me if there are complications. Part of the criteria for doing outpatient is your bmi. Mine is 41.

I have my edg on Tuesday maybe they will decide to change it from outpatient to hospital stay after that.

[ChaosUnlimited 559]

I'm glad you got more information about the surgery. I would still be worried about doing it outpatient, I wonder if your insurance company approval had anything to do with it? My guess is that while in recovery if you are having too much pain or are not feeling comfortable enough to go home they will keep you.

My surgeon discussed the bypass, the sleeve, and the DS procedure, drew pictures, and discussed dietary and Vitamin requirements after all three. He encouraged me to research the DS procedure and we can talk further at our next visit.

I'm worried about bowel problems after the DS surgery, and I've seen the sips procedure mentioned here, can anyone explain what that is and how it helps? I don't know if my surgeon does that, but I can ask about it.

[dragonfly2u 2]

I had an EGD done today. I met another lady at the hospital and she said she was having the sleeve plus done. I knew immediately that she was using the same surgeon. We talked about it in depth. I did find out i will be staying over night 1 night. I think the insurance company said out patient with option of being admitted if needed.

[dragonfly2u 2]

You can read about the SIPS procedure, not all surgeons do this. It is said to solve bowel issues. I at least hope so. Im glad that is being done with my procedure.

[janedoe92 260]

I'm glad you got more information about the surgery. I would still be worried about doing it outpatient, I wonder if your insurance company approval had anything to do with it? My guess is that while in recovery if you are having too much pain or are not feeling comfortable enough to go home they will keep you.
My surgeon discussed the bypass, the sleeve, and the DS procedure, drew pictures, and discussed dietary and Vitamin requirements after all three. He encouraged me to research the DS procedure and we can talk further at our next visit.
I'm worried about bowel problems after the DS surgery, and I've seen the sips procedure mentioned here, can anyone explain what that is and how it helps? I don't know if my surgeon does that, but I can ask about it.

I got the SIPS procedure which is basically the same as a regular DS with the difference being a longer common channel (the portion of the bowels that absorbs stuff). Before surgery I had bm problems ALWAYS going to the bathroom. I'm only a month out, but so far this has been solved I now have one bm a day. We do require more Vitamins than Sleeve patients less than regular DS patients, but Vitamins are more vital and become a part of our lives because we can become malnourished faster than a sleeve patient. Our sleeve is typically longer, so we can eat more than a sleeve patient in the long run, but once again we do not absorb all the calories or nutrients. We also have higher Protein requirements (80-100gm) because of malabsorption. Hope this answered some questions you have.

[dragonfly2u 2]

What Vitamins and amount do you take daily?

[KattattaK 45]

On Saturday, February 18, 2017 at 6:09 PM, CMDD71 said:

I had the DS on June 11th 2016. I am a huge proponent of the surgery. I started at 427lbs, now 215lbs. I have never felt better.

Dr Spiegel, in Houston Texas, is a DS specialist and has done more DS surgeries than any other weight loss doctor out there (his claim). He also teaches other Doctor's how to perform the surgery.

His claim is that the sleeve will get you 75-85% of your weight loss and 15% of patients put some weight back on. He calls the DS the Cadillac of WLS. Losing 95% of weight loss with very little weight regain.

I have had no issues absorbing the needed fats and Vitamins I need. But I do get tested every three months to make sure that remains that way.

One of the benefits of the DS over the sleeve is that you do not run the risk of having an unexpected bowel movement.

While I would say the DS is a great choice, I would say make sure you have the correct doctor. If a doctor says you can do this surgery as an outpatient, that is not the correct doctor.

Also keep in mind, with the DS you will need a second (minor - with the right doctor) surgery to remove your gall bladder.

What ever surgery you choose to go with it wish you great success and a smooth recovery. Good luck on your journey.

Thanks for this info! I had no idea. I've actually been told the opposite by both surgeons and friends who have had the DS. On the other hand, my friends who have the sleeve have never mentioned unexpected bowel movemmets.

[janedoe92 260]

What Vitamins and amount do you take daily?

I take Celebrate Vitamins 4 Multi Vitamins adek, 1 probiotic, 2 calcium citrate, an Iron and B12