DS in Missouri?

on 4/8/09 11:08 am - doniphan, MO
Hi, has anyone here in MO had the DS?  If so who did yours?  Thanks?
Jan C.
on 4/8/09 11:36 pm - Cedar Creek, MO
I dont think there is anyone in Mo,. that does the DS.....Closest might be Ok or Tex not really sure.



on 4/9/09 2:56 am - Blue Springs MO
Hey there, I replied to you on the DS board.  Check it out! 

Basically, there's not anyone here in Missouri!  Had one a few years back in Shawnee Mission, but he passed away 1 1/2 years after my surgery.  I'm trying to find someone too, and I think I'm going to Dr. Hustead, he's in KY & TN.  He's a pro on the DS and has a lot of good information.

Keep in touch!
Toni M.

My adivce, do it right the first time and stay with it.  Results - long term success!
on 4/9/09 6:55 am - Cape Girardeau, MO
What is DS?  I am new to this and I am trying to learn all the code words and initials for stuff.
There is a fantastic Bariatric hospital and weight loss management program in St. Louis call New Start at St. Alexius Hospital.
on 4/9/09 9:12 am - doniphan, MO
I am new to it as well and am in research mode thus far.  DS stands for 'Duodenal Switch'.  I can't tell you all about it off the cuff, but if you type ds in the search bar, it should point you in the right direction, that's where I found my info.  As far as I can tell from my research, St Alexius does not do the DS.
Guate Wife
on 4/9/09 5:29 pm - Grand Rapids, MI
For one of the best sources of information on the DS, which will include long-term, peer reviewed, clinical studies, please check out DSFacts.com.  There you will get not only find factual data on the DS, but also true insight into the post-op DS life.

       ~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight  =  370#  /  59.7 bmi  @  5'6"

Current Weight  =  168#  /  26.4 bmi  :  fluctuates 5# either way  @  5'7"  /  more than 90% EWL
Normal BMI (24.9)  =  159#:  would have to compromise my muscle mass to get here without plastics, so this is not a goal.

I   my DS.    Don't go into WLS without knowing ALL of your options:  DSFacts.com

on 4/9/09 12:40 pm
Since you asked, here's the quick answer on Biliopancreatic diversion/duodenal switch.  The operation was devised in Italy by a surgeon named Scopinaro (who is still active in bariatric surgery).  It is touted as the most effective in terms of total weight loss, BUT it also carries the highest risk of complications, both short-term and long-term.  Patients are prone to liver failure and renal failure up to ten years after duodenal switch, and the likelihood of developing iron deficiency and vitamin deficiencies is significant.  These patients should have blood testing every 3-6 months on a PERMANENT basis to ensure their tolerance to this relatively severe change in intestinal function.  And while patients like the sound of "being able to eat more", this is tempered by the fact that if they do continue to binge on processed carbs long-term, they develop a distinct aroma reminiscent of a Missouri outhouse.  In truth, the operation generally is reserved for patient who weigh at least 550 pounds; this operation is the ONLY chance these patients realistically have to achieve anywhere close to normal weight.  BUT, for the typical patient with morbid obesity who weighs less than 450 pounds, the gastric bypass has a much higher safety profile, and is almost as effective.  This is also why the duodenal switch is only offered at a few select sites in the US; NONE in Missouri.  Nearest is Chicago.  I tell patients who are determined to have a duodenal switch that they seriously need to plan on MOVING to the city where they have their operation, to ensure long-term followup.  Hope this helps!  Best wishes!  Sincerely, Phillip M. Hornbostel, M.D.
Kerry J.
on 4/9/09 1:37 pm - Santa Clara, UT
 Dear Dr. Hornbostel M.D. 

You are full of crap. Shame on you for posting such a load of BS on this board. What you are describing is not a DS, it's an early procedure named after Dr. Scopinaro. This procedure hasn't been done for a very long time because of the problems you describe. 

I suppose you're one of the RNY mill doctors, so you don't want people to really find out about the DS, because when they do, you have no chance of collecting any fees for your RNY work.

I lived with RNY for 28 years and it sucks, I was revised to DS last year and it's great, I've never felt better and only wish I had done the revision 10 years ago.

You are a disgrace, you lying sack.

Kerry Johnson
on 4/9/09 1:38 pm - Mouseville, FL
There are numerous studies that document the DS is a safe and effective surgery for those with lower BMIs.  As to the aroma as you put it, that is just simply not true.  Oh, and the Scopinaro procedue is the biliopancratic diversion (BPD) not the biliopancreatic diversion with duodenal switch (BPD/DS).  These are two very different surgeries.  The Scopinaro procedure is rarely done anymore because it caused so many issues. 





on 4/9/09 2:13 pm - Middle of, TN
You know, this post is simply disgraceful. You would rather spew outright lies to potential patients than paint the surgery you do, the RNY, in its best light. The DS is not reserved for people with a 70+ BMI, far from it. There is no statistical difference in surgery survival rates between RNY and DS. Or are you simply so ill-informed that you have never read these peer-reviewed articles:

Marceau et al 2007
Conclusion: Survival rate was 92% after DS. The risk of death (Excess Hazard Ratio (EHR)) was 1.2, almost that of the general population. After a mean of 7.3 years (range 2-15), 92% of patients with an initial BMI < or = 50 kg/m2 obtained a BMI < 35 and 83% of those with an initial BMI > 50 obtained a BMI < 40.

The Biliopancreatic Diversion with the Duodenal Switch: Results Beyond 10 Years.
Hess et al. Mar 2005
PubMed Abstract

The BPD/DS, if properly performed, has the best long-term weight loss of any bariatric operation. It is easy to reverse or revise, has the least marginal ulcers, cures the highest percentage of co-morbidities, has the least failures, and permits normal although smaller meals. It is our opinion that the BPD/DS should be considered as the gold standard bariatric operation.

Bowel Habits after Gastric Bypass Versus the Duodenal Switch Operation.
Wasserberg et al. Aug 2008

BACKGROUND: One of the perceived disadvantages of the biliopancreatic diversion with duodenal switch operation is diarrhea. The aim of this study was to compare the bowel habits of patients after duodenal switch operation or Roux-en-Y gastric bypass.

RESULTS: The duodenal switch group was heavier (body mass index 53.5 vs 47.0 kg/m(2), p = 0.03) and older (47.5 vs 41.0 years, p = NS) than the gastric bypass group. Median time to 50% excess body weight loss was 22 months in the duodenal switch group compared to 10.0 months in the gastric bypass group (p = 0.001). Patients after duodenal switch surgery reported a median of 23.5 bowel episodes over the 14-day study period compared to 16.5 in the gastric bypass group (p = NS). There was no between-group differences in any of the other bowel parameters studied.

CONCLUSIONS: Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.

Copies or links to of all these studies (and many more) can be found at www.dsfacts.com, a website developed by a DSer who is not affiliated with any medical provider of any kind.

ANd for newbies to the idea of the DS, yes, you absolutely must commit to supplementation and regular labs. To me, that's a small price to pay for a surgery that, unlike the RNY, allows me to take ibuprofen if I have cramps. to avoid dumping, and to not worry about food getting stuck in a stoma and having to barf it back up. RNYers need regular labs, too, and have their own issues with vit. B-12 deficiencies.
I'm not saying that one surgery is better than another, but I am horrified that an MD who absolutely knows better is getting on here and trying to deceive patients and potential patients. I really hope someone decides to report you to an ethics board, doctor. What you posted is unconsionable.


Type 1 diabetic, 26 years
With great power (the DS!) comes great responsibility.

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