nicolelynn1986
New Member
Posts: 6 
Surgery Type: Revision
Surgery Date: 3/16/2015
Surgeon: Dr Paul Enochs
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Post by nicolelynn1986 on Mar 19, 2015 19:27:29 GMT -5
I just had a revision from RNY to SADI-S or SIPS my Dr calls it.
Has anyone else have this procedure done?
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Post by jpcello on Mar 20, 2015 15:18:50 GMT -5
You might want to post on the DS forum instead of the revision forum. More action on the DS forum. I know there are a few DSers who have done research on the SADI. I have not so I can't help you out.
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Post by goodkel on Mar 20, 2015 20:08:05 GMT -5
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Post by newyorkbitch on Mar 21, 2015 8:08:56 GMT -5
Lots of folks had a DS when it was considered "experimental," myself included. That's not a reason to avoid a SADI / SIPS. Perhaps those are better choices for you, but you have to do a lot of research to make that determination. Many people told me I was crazy to get a DS 15 years ago, told me to get an RNY because it was tried and true. I am very glad I went with the experimental procedure. |
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Post by goodkel on Mar 21, 2015 8:49:53 GMT -5
What concerns me is that they do not know what the long term results will be. Most bariatric surgeries can get the weight off, to lesser extents, but keeping it off is what is most important.
That is still an unknown with the SADI.
I hope it works long term. A wls that works as well as the DS, but with less struggle with deficiencies would be wonderful.
I paid out of pocket and an unknown future is too big of risk for that kind of money or the effort and risk of revision when there is a top notch surgery with known long term results.
They are seeing many patients with deficiencies because they do not provide the proper post op education. Their patients don't know how to eat or what vitamins and labs they need to take. Being surgeons, they created what they believe is a solution by cutting.
I don't think that the risk of a future revision is worth what a bit of education can fix.
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Post by newyorkbitch on Mar 21, 2015 9:05:21 GMT -5
I disagree somewhat. It's not the surgeons' job to track patients and make them compliant for a lifetime. We have seen many, many people get very good advice and then proceed to ignore it. If the SADI helps with longterm problems then it's a good thing, even if the weight loss is slightly different.
When I had the DS there were no long term guarantees either.
People need to understand the relative risks and merits of the procedures they are considering. The DS is a very difficult surgery to stay healthy with for a lifetime. And even now we don't have really long term studies as people age with the DS.
Perhaps (and I don't know) the SADI has a good weight loss result with fewer of the nutritional complications. That would be a really good thing, even if a little weight loss were sacrified.
Nobody needs to be "thin" - what we need is to be healthy.
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Post by goodkel on Mar 21, 2015 9:44:10 GMT -5
I agree that it is not the surgeons' job to follow patients for a lifetime or even beyond when their cutting has healed. That's just not how surgeons work or how they were trained.
And no one can force compliance, but sending post-ops out with RnY guidelines is a failure.
The SADI has food and vitamin needs of its own. Perhaps the deficiencies will be fewer in number, but without addressing those patients who are compliant, but with inappropriate information, the problem is not going to disappear with the SADI.
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Post by newyorkbitch on Mar 21, 2015 18:41:50 GMT -5
I agree that it is not the surgeons' job to follow patients for a lifetime or even beyond when their cutting has healed. That's just not how surgeons work or how they were trained. And no one can force compliance, but sending post-ops out with RnY guidelines is a failure. The SADI has food and vitamin needs of its own. Perhaps the deficiencies will be fewer in number, but without addressing those patients who are compliant, but with inappropriate information, the problem is not going to disappear with the SADI. Of course malapsorption problems are not going to disappear with the SADI. But if the SADI produces good weight loss results and cuts down on the malabsorption problems, that would be a good thing. I just don't think we should be telling people to insist on a DS because the SADI is "experimental." The DS was "experimental" not so long ago too. And it was an improvement in many ways over previous WLS procedures. Maybe SADI is a really good idea for some people, maybe not. But let's not criticize it as "experimental" and let's not tell people to insist on a DS. The DS has loads and loads of problems. If the SADI can help with some of those yet still produce good weight loss results - I'll be its biggest cheerleader. And to the other point - whose job is it to "address" patients who are not compliant? |
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Post by goodkel on Mar 21, 2015 22:44:13 GMT -5
I meant "addressing the issue" of patients who are not compliant. I thought that it was clear that we were talking about issues, not individual patients. I'm sorry.
I can not recommend this surgery until the long term results are available. If someone is willing to take the risk, I will support them in any way that I can. But that 300cm common channel and the unknown long term viability makes me believe that it would be unethical for me to encourage someone to get it. There just isn't enough information, yet, for me to endorse it.
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Post by newyorkbitch on Mar 22, 2015 7:22:17 GMT -5
But how should the issues of non compliant patients be addressed?
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Post by goodkel on Mar 22, 2015 11:16:14 GMT -5
Through education. As has often been mentioned, there should be a qualifying test pre-op DS to ensure that a patient knows how to eat, what vitamins to take, how often to get labs, what labs to get. And the consequences to their health for not being compliant with the demands of their surgery.
Whether or not they drink is out of everyone's hands. But, at the very least, they should be shown the water.
I'm not talking classes, but a comprehensive booklet would suffice.
Most patients are released with nothing much beyond RnY guidelines and/or sold a line of insufficient vitamin supplements.
Since they are not adequately educating their DS patients, I don't see that changing for the SADI.
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Post by newyorkbitch on Mar 22, 2015 17:47:23 GMT -5
Through education. As has often been mentioned, there should be a qualifying test pre-op DS to ensure that a patient knows how to eat, what vitamins to take, how often to get labs, what labs to get. And the consequences to their health for not being compliant with the demands of their surgery. Whether or not they drink is out of everyone's hands. But, at the very least, they should be shown the water. I'm not talking classes, but a comprehensive booklet would suffice. Most patients are released with nothing much beyond RnY guidelines and/or sold a line of insufficient vitamin supplements. Since they are not adequately educating their DS patients, I don't see that changing for the SADI. But who is responsible for patient education? It would be good for the surgeons to distribute good and accurate information, and for their nutritionists to actually know enough about the DS. But point about the SADI is this - if it does produce a good weight loss result and it also decreases some of the malabsorption issues, then it's a good thing. |
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Post by goodkel on Mar 23, 2015 10:43:07 GMT -5
On this I completely agree with you. This is why I haven't dismissed it out of hand and created its own forum and data. As we have already had at least one member with a SADI who wasn't told the vitamin requirements for their surgery, I extrapolated it myself from a study to help them out: weightlosssurgery.proboards.com/thread/9150/vitamins-protein-requirements-sadiIf the surgeons believe that the SADI alone is going to prevent deficiencies, their patients will prove them sadly mistaken. |
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nicolelynn1986
New Member
Posts: 6
Surgery Type: Revision
Surgery Date: 3/16/2015
Surgeon: Dr Paul Enochs
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Post by nicolelynn1986 on Mar 23, 2015 14:21:34 GMT -5
SADI-S is not a DS. I was informed it was a cross between RNY and the Sleeve. The mechanics are done differently.
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Post by newyorkbitch on Mar 23, 2015 14:36:13 GMT -5
SADI-S is not a DS. I was informed it was a cross between RNY and the Sleeve. The mechanics are done differently. Informed by whom Nobody said that the SADI is a DS. Of course not. But in order to make a decision, one needs to really understand the differeces. When a leading DS surgeon like Roslin changes direction, it is highly recommended to listen, pay attention, understand, and then decide. |
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Post by Joanne on Mar 23, 2015 16:59:25 GMT -5
SADI-S is not a DS. I was informed it was a cross between RNY and the Sleeve. The mechanics are done differently.
No, this isn't true at all. The SADI or SIPS is nothing at all like an RNY. It has more in common with a sleeve and a DS. All three of those share the same stomach configuration and maintain the pyloric valve. The sleeve is a stomach only surgery. Both the SADI and DS offer an intestinal component, which provides some malabsorption of calories and a metabolic shift. The way they do it is different because the routing of the intestines is different. Both the SADI and the DS can be modified to create more or less absorption based on limb lengths. Nothing is a cross between anything. The RNY is a different animal altogether. The other three share the same stomach but vary in what is done to the intestines - from nothing with the sleeve, to two different options with the SADI and DS. But whoever told you the SADI is a cross between an RNY and sleeve is absolutely incorrect. That doesnt even make sense to me. |
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JRo
New Member
Posts: 6
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Post by JRo on Aug 18, 2015 11:42:56 GMT -5
I don't know too much except that I was advised by the PA with Dr Coirin in Modesto that SADI is still considered experimental and many hospitals won't even allow it performed in their facility, however, doctors will advise the DS was "unable to be completed" (note, air quotes were used in this discussion) and that way they can justify the bait and switch. I know every surgery has started off new and experimental, but disguising it as something else is not the way to do it. Get as much info as you can!!
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Post by goodkel on Aug 18, 2015 23:51:48 GMT -5
Yes, we have had members who have gone into surgery expecting to come out with a DS only to find that they were given a SADI. That is wrong on many different levels and should never happen. But, unfortunately it has.
To be safe and prevent this, we recommend that you add a line above your signature on the surgery authorization form that your authorization is for the standard Duodenal Switch only.
I was in the ER with a blockage and half out of my mind with pain when the bariatric surgeon who was to operate on me offered to "fix" my DS to an RnY. I wrote on the authorization that my DS was not to be touched unless the only other option was death. The blockage had nothing to do with my DS. I had a hernia that caused it. In his ignorance, he just wanted to tinker with something that wasn't broken.
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Post by west4thavenue on Aug 19, 2015 9:33:40 GMT -5
I was in the ER with a blockage and half out of my mind with pain when the bariatric surgeon who was to operate on me offered to "fix" my DS to an RnY. I wrote on the authorization that my DS was not to be touched unless the only other option was death. The blockage had nothing to do with my DS. I had a hernia that caused it. In his ignorance, he just wanted to tinker with something that wasn't broken. I have nightmares about things like this! |
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Post by jpcello on Aug 19, 2015 13:15:21 GMT -5
I knew someone years ago from the Elariny group who moved away and had to have emergency obstruction surgery. The surgeon on call reversed her switch to "help" her out. She didn't know until she started gaining weight.
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Post by goodkel on Aug 20, 2015 9:23:58 GMT -5
I knew someone years ago from the Elariny group who moved away and had to have emergency obstruction surgery. The surgeon on call reversed her switch to "help" her out. She didn't know until she started gaining weight. How horrible. I hope she sued. If that were me, that surgeon would have paid to put it back and then some. This is a good example of why you should always get a copy of surgical reports. |
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Post by jpcello on Aug 21, 2015 6:29:28 GMT -5
Unfortunately I don't know what happened. This is back in the Elariny yahoo boards days  |
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Post by Melinda on Aug 21, 2015 14:36:09 GMT -5
Oh Janet I do remember her! Her name was Monica (?) Such a sweet, cool lady. The surgeon took down her switch not knowing any better thinking it would help clear the blockage, something like that. She was devastated and didn't know how to go about getting it "put back". I had met her a few times back in the day. I always wondered if Dr. E could have or did help her out in any way.
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Post by jpcello on Aug 22, 2015 15:32:36 GMT -5
Oh Janet I do remember her! Her name was Monica (?) Such a sweet, cool lady. The surgeon took down her switch not knowing any better thinking it would help clear the blockage, something like that. She was devastated and didn't know how to go about getting it "put back". I had met her a few times back in the day. I always wondered if Dr. E could have or did help her out in any way. Good memory. |
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