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

The DS is the ideal operation if your weight loss after sleeve as been inadequate or if the weight has come back. I usually require patients to wait at least one year before doing the duodenal switch. Waiting longer will not have any affect. I have converted gastric bypasses 10+ years post op to duodenal switch and had fabulous outcomes. hope this helps. 

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

I agree with all of the answers above.  Beware of a surgeon that tells you that you need a gastric bypass after your 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

Duodenal Switch is a great choice for revisional surgery after sleeve gastrectomy.
This can be done laparoscopically.  This requires usually one night stay after surgery, and the return to work will be about the same as your sleeve.