Comments on: Revision or Reversal of the Duodenal Switch

By: Danielle Shevack

Danielle Shevack — Fri, 29 Aug 2025 23:47:28 +0000

Hello, first off thank you for any info you can provided. Here is my surgery histroy
2018: Duodenal Switch (DS)
2020with pyloroplasty
end of 2020-start of 21hernia repair
*first year after ds was great then a flip switched and since then ive delth with chronic nausea, vomiting, kidney stones, malnutrition, and fatigue.Muscle mass loss, inability to hold down any oral intake at times. mutiple instances of anemia and electrolytes so bad hospitalization was required, sometimes for days.
Then all, including, intake my body rejected. Had some tests done and surgery in 2022 was for a Blind loop correction and at that time my dr lengthen my common channel from 150cc to 400cc. It failed
→ Attempted to fix severe malabsorption from multiple aspects, my surgeon has a lot of different departments all working together but symptoms persisted: nausea, vomiting, nutritional deficiencies etc etc but i was able to sustain oral intake enough to get by.Until
June this year. By time I got admitted to te hospital i could barely walk: had surgery to Repair of stomach sliding into esophagus (similar to hiatal hernia repair)
→ Continued severe nausea, vomiting, and pain. Required TPN for nutrition. It started June second, i returned to work july 31st on tpn but a lower time and formula. able to hold down about 400 calories orally a day. Then around Aug 3rd my body rejected absolutely everything again. Admitted on the 8th. my esophagus had mobility issues out of no where. when i would swallow instead of sending it towards my stomach it would spasm and send it back to my mouth. Also, an adhesion caused my stomach to twist and it was almost obstructed. This was aboutto be my 6th surgery. my dr said he knew in a few months he would end up having to revise my ds to bypass so he was going to fix my twisted stomach, do the revision, dilated my esophagus and place a g tube.This happened last Wednesday.
I advanced t protein shakes after a few days and my dr suspected i had an obstructions at the end of tjhe intestine into my small pouch but thankfully it started clearing. Got released from the hospital yesterday the 28th on tpn, g tube for my meds and liquid only diet. I am struggling getting past 20oz of protein and water combined I know its been only a day but im terrified of an obstruction
another surgery and going back to the hospital. Home health for my central line, which i had since june so whatever. but also now getting it for the G tube plus physical therapy because of muscle loss and inability to move much. I know thats a lot of history thank you if you got to this point. My question is do you know of anyone who has the ds revised to bypass. my kind of complications and had a full/good recovery?

By: Rosa

Rosa — Sat, 19 Apr 2025 20:17:16 +0000

In reply to Dr. Ara Keshishian. Thank you so very much for your reply. Also for your illustration of the two versions of revision. Much appreciated!

By: Dr. Ara Keshishian

Dr. Ara Keshishian — Wed, 16 Apr 2025 21:51:17 +0000

In reply to Tonja. The short asnwer is yes. The long asnwer is what is contributing to the weight regain?

By: Dr. Ara Keshishian

Dr. Ara Keshishian — Wed, 16 Apr 2025 21:50:36 +0000

In reply to Tonja.

Hello, Where was the surgery done? is this DS or SIPS/SADI procedure. They are not the same and the weight gain is much more common with the SIPS SADI, and rarely seen with the primary two ansatamosis DS. https://www.dssurgery.com/weight-loss-surgery/compare-procedures/duodenal-switch-compared-sadi/

By: Dr. Ara Keshishian

Dr. Ara Keshishian — Wed, 16 Apr 2025 21:48:22 +0000

In reply to Rosa.

Hello,
The common reversal for malnutrition is to double or completely reverse the duodenal switch component. this decision is based not only on the weight but also on the laboratory studies, micro and macro nutrition levels, other health conditions (osteoporosis)
Your surgeon should be contacted to review your operative records, labs, and current health status and then proceed with a plan.

By: Rosa

Rosa — Wed, 16 Apr 2025 18:23:06 +0000

I had a DS 19 years ago, after decades of not being able to solve a thyroid issue, which caused me to keep gaining weight despite proper diet and exercise. The DS moved my weight from 250 to 123 lbs, which stayed like that for 9 years. Then a colonoscopy prep messed up my biome so badly I lost the ability to function well. This has gone on for 10 years: I have had tons of issues, I’ve spent years in bed, nearly died, and now have gone on TPN after not being able to gain weight despite months of trying. The original common channel is 125 cm long. Should it be revised to twice, or to three times its length? Would three times its length cause me to become obese again?

By: Dr. Ara Keshishian

Dr. Ara Keshishian — Wed, 12 Mar 2025 18:09:25 +0000

In reply to Tonja. Hello, Revision of a DS is possible. Work up would be 1- What procedure was done and where, 2-Upper GI to evaluate the stomach size, 3- Complete lab work, 4- Complete physical exam, and then formulate the surgical options if possible. Recommend seeing the original surgeon.

By: Tonja

Tonja — Wed, 12 Mar 2025 17:43:10 +0000

Can you have a revised DS to aid in the regaining of weight? I had DS surgery in 2020 and want to know if there is a revision option?

By: Tonja

Tonja — Wed, 12 Mar 2025 17:41:45 +0000

Can you have a revised DS to aid in the regaining of weight?

By: Dr. Ara Keshishian

Dr. Ara Keshishian — Sat, 06 Jul 2024 21:27:42 +0000

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.