Pasadena, CA 91105
A significant portion of my practice involves the revision of the Gastric bypass and Adjustable Gastric Banding procedures to the Duodenal Switch operation. The re-operations are necessary to correct the complications that have been caused by these procedures. There are also instances of required revisions due to inadequate weight loss or weight regain. Our website contains detailed information regarding reasons for revision and the reversal of weight loss surgical procedures. I think it is important to mention that these complications are very common and almost never have anything to do with the patient’s behavior.
Duodenal switch operations may also require reversal or revision. The general reasons for a revision or reversal of the Duodenal Switch is the same as for all weight loss surgical procedures and include a variety of reasons. The reversal or revision of the Duodenal Switch operation is one of the simplest revision surgeries that I perform.
Let’s review a few facts about Duodenal switch.
The Duodenal Switch procedures has two components:
1.) The sleeve gastrectomy
2.) The separation of the biliopancreatic secretions from the food to limit its absorptions.
Clearly, the portion of the stomach that has been removed cannot be reintroduced to the abdominal cavity. The second part of the operation can, however, be easily “undone.
The assumption is that the bowel needs to be divided again and re-anastomosed to reconstitute its continuity. This revision or reversal of the Duodenal Switch operation is done by simply creating a new connection between a new anastomosis, located between the biliopancreatic limb, and the alimentary limb.
If a complete reversal is needed, then the connection is made just distal to the ligament of Treitz. Ligament of Treitz is the transition point between the duodenum and Jejunum. This single anastomosis is safe and simple to perform and does not involve removing the previous staple lines.
If a partial revision is needed, or the common channel needs to be lengthened, then the anastomosis is made further proximal to the junction of both the alimentary limb and the biliopancreatic limb, but distal to the ligament of Treitz to allow for increased absorption of the calories and nutrientsIn my opinion, the revision and reversal of the Duodenal Switch operation is, from a technical perspective, the simplest of all revisional weight loss surgical procedures.
In my opinion, the revision and reversal of the Duodenal Switch operation is, from a technical perspective, the simplest of all revisional weight loss surgical procedures.
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Both my daughter and I had DS surgery. Mine in 2003, my daughter around 2005. Both done by Pacific Laparoscopy in San Francisco. I have done ok. I am able to take my supplements. My daughter has been plagued with malabsorption issues, severe anemia requiring multiple emergent blood transfusions, severe vitamin and mineral deficiency. She is interested in a revision. At 5’8″ she weighs less than 110 lbs. in my opinion, this would be a necessary operation. I would be paying out of pocket. Can you tell me the approximate cost?
Hello, Please contact our office by completing the form https://www.dssurgery.com/contact-forms-new/ and our office staff will contact you.
Hi Dr/Team
What is the data from full reversal to revision (also sharing the length CC was extended to. I am a DS patient, 17 years in. My concerns are now for my future as to how my body will be impacted especially on effects which are not noticed straight away. I am aware the negatives are weight gain. However if I take on board new life lessons and address that then what does it look like for me to have a reversal vs a revision. Please know the toiletry habits and flatulence at times are unbearable for me – how do these look under both options.
Thanks
Manisha
Hello, the reversal or revision is based on the actual labs, weight loss, health condition now. This disucssion should be had with your surgeon with your weight history, labs, health condition at hand.
Hello
In our experience majority of the GI-bathroom issues are caused by dietary choices. In the handful of the cases that we have revised due to purely GI issues that have no identifiable food correlation, the result has solved the GI issues with weight regain.
How much weight regain occurred after revision?
I do not have a specific weight regain number; the concern, however, is the return of the comorbidities that occur with varying degrees of weight gain.
I need help!!! I had the duodenal switch done back in 2007 and from then until now it seems my health has gotten worse and my doctors can’t figure out why, I am having blood issues that even the blood specialist doctor at Penn blood disorder center can’t figure out and this all started after my duodenal switch and I also have read that people that had a full cut from rib cage to belly button have been having scare tissue problems with tissue forming around a major organ and some cases the people are dieing before the doctors can figure out why they have any health issues they cannot figure out. I have doctors telling me they DON’T THINK that’s the problem but I hate when doctors say I don’t think it is when I do everything they think it was only not to be what they think. I need a doctor that is going to at least look at what I think it might be only because that’s when this problem started. Can someone please help because I don’t want to be one of them people that they can’t figure out what’s wrong health wise until it’s to late😢
As a weight loss surgical patient with health issues, your first contact person would the weight loss surgeon who did your operation.
He has retired and I can’t find any doctor in my area that will even look at me because they say they don’t and will never do the DS surgery because of the complications.
Contact our office, and the staff will help coordinate a telehealth if you wish.
https://www.dssurgery.com/contact-forms-new/
I need help!!! I had the duodenal switch done back in 2007 and from then until now it seems my health has gotten worse and my doctors can’t figure out why, I am having blood issues that even the blood specialist doctor at Penn blood disorder center can’t figure out and this all started after my duodenal switch and I also have read that people that had a full cut from rib cage to belly button have been having scare tissue problems with tissue forming around a major organ and some cases the people are dieing before the doctors can figure out why they have any health issues they cannot figure out. I have doctors telling me they DON’T THINK that’s the problem but I hate when doctors say I don’t think it is when I do everything they think it was only not to be what they think. I need a doctor that is going to at least look at what I think it might be only because that’s when this problem started. Can someone please help because I don’t want to be one of them people that they can’t figure out what’s wrong health wise until it’s to late😢
I would like more information on reversal. I think I am about 10 years out since surgery. The malabsorption is a huge health problem for me. My esophagus hurts despite taking 2 prilosecs a day. I have 4 hernias now, Three large incisional from the surgery and 1 hiatal. I look pregnant they are so big. My organs are seared together with scar tissue and my surgeon states no one should do any further surgery in me. I have esophageal cramps daily and during the night while I sleep. I have them even though I have not eaten. I am showing signs of kidney and liver disease, deficient in A E Zinc, Iron, Calcium and vitamin D. I barely have the energy to work let alone bathe. I have chronic headaches and burning pain in my gut all day. I have begun throwing up more as well. Water sometimes makes me nausceous. I feel if I could just have the absorption part of my intestine back, I could get better. Is that a possibility?
Several issues are raised in your question. All these concerns need to be studied and addressed. A common theme may be a conversion to the gastric bypass to address the reflux and the weight gain. The problem with the gastric bypass is the lack of durability of the weight loss.
Can you get a revision after having a single astmosis deuodenal switch?
Hello, The short answer is yes. However, the complexity and the risk associated with it depend on where it was done and who did it. Single anastomosis duodenal switch is drought with complications that are not discussed openly. We do revise them.
21 Years ago I had a duodenal switch, in the past several years my weight has increased substantially. Is a revision something that could assist me with my weight?
Hi, you and are looking for the same question if there is a revision to the ds. I had my ds 20 years ago. I went from 315 to 180 I am 5’4. I am now I’m at 233. We should get to know one another.
Hello, weight gain after the duodenal switch may be due to several reasons. 1- Was the bowel length done as a percentage of the total length or just a random standard setting? What was the start weight? What was the lower weight? How old is a patient? Any significant change in the volume of the food? Are there any other surgeries since the duodenal switch? Any metabolic (thyroid, adrenal, infertility issues), any pregnancy since then? In a Female patient, any pregnancy, hysterectomy, Depo shot, or Norplant type of birth control, etc…
The point that I am trying to make is that the short answer from an anatomical perspective is “Yes.” It is possible to provide a surgical solution for weight gain after the Duodenal switch. However, a workup is needed to explain why substantial weight was regained.
I had my DS in 2001. My highest weight was 285lbs and I got down to 140lbs. I had bowel problems but been on the FODMAP diet which has improved the problem 90%. Two years ago I fell and suffered a head concussion. Since then I’ve gotten down to 114lbs and been unable to regain any of it. I’ve been working with my primary, who is familiar with surgery, but nothing works. I’ve even tried scheduling meals every 2 hours. I’m 74yrs now and wonder if a revision would be appropriate for me.
Hello, Weight loss years after DS is very uncommon. There are other than DS-related reasons why some patients experience malnutrition and weight loss, including Covic infection and not being vaccinated; a low protein diet, high fiber, high carbohydrate, high-fat diet, and a diet rich in artificial sweeteners will all cause or contribute to weight loss. I strongly recommend that you get in touch with your bariatric surgeon for further advice. Revision of a DS for malnutrition is a relatively straightforward and simple operation, where a single “kissing X” anastomosis reverses the physiology of the DS and will improve the nutritional status and result in weight gain.