Is ok to have the ds 4 years later after the gastric sleeve?

Hello.
Thank you for your time, question and photos.
The Duodenal Switch after gastric sleeve is the best options for those patience who didn't reach the expected weight loss or weight regain. I would recommend you to visit a certified bariatric surgeon to discuss the best option for youGod bless you, and good luck on this journey.
Dr.Pablo Garcia

Hello, 
Yes! It is perfectly adequate  to consider a revision from the sleeve to a DS 4 years out if you did not lose enough weight and/or are regaining.   Your surgeon may decide to redo your sleeve too. We perform a barium swallow x ray to check the sleeve as part of the pre op tests and decide if a resleeve is needed to optimize results. 

DS is a good option for inadequate weight loss or weight regain after gastric sleeve.  I only offer this option in highly compliant patients as the consequences of non-compliance after the DS is severe vitamin/mineral deficienies that can lead to permanent disabilities.  There is a lot of upkeep with the DS so you need to really do your research before making this decision.  
Good luck!
Dr Houston