Weight Loss Surgery Friendly Recipes & Rambling
Frank talk about the DS / "All I ever wanted to be was thin, like that Rolling Stones dude ... "
HW/461 LW/251 GW187 CW/315 (yep, a DS semi-failure - it happens :-( )
|Type of Operation||RNY, Gastric Bypass,Roux-en-Y, LAP, RNY||Duodenal Switch, BPD-DS,Distal Gastric Bypass with DS||VBG||Lap Band|
|Modality of Weight Loss||Restrictive 1-3 ounce stomach||Restrictive and Malabsorptive||Restrictive||Restrictive 1-3 ounce stomach (15cc)|
|Description||A very small pouch of fundus connected to a limb of small bowel. Pyloric Valve bypassed.||Sleeve gastrectomy, with ~8ounce pouch. Pyloric valve functional. The bilio-pancreatic secretions are kept separated from food to limit absorption except the last ~75cm of small bowel.||A silastic ring is used to create a small pouch of stomach.||An adjustable silicone constricting band is place completely around the very top part of the stomach creating a very small pouch.|
|Long term success||Average. 60-70% Peak results 18-24 months ,,,>30% regained >15% or lost <50% ||Above Average. 70-80% excess weight loss reported over long term follow up.,,,,||Poor. Only 26% of patients maintain >50% of excess weight
|No long term studies yet available. At best should be similar to VBG.|
|68.8% “continued” problem with vomiting, 42.7% plugging of the gastric pouch outlet. 12% stenosis & 12% ulceration, with over all stomac complication in 20%. Up to 76% of Patients develop Dumping Syndrome, with no association between severity of Dumping Syndrome and weight loss.||Fat soluble vitamin deficiency- Rarely seen with adequate dietary supplements, in addition to a normal healthy diet. Protein malabsorption- again with healthy well balanced diet far less common than seen in VBG or RNY patients with stenosis or who only consume high sugar/calorie drinks.||21% Vomit more that once a week.
14% have heartburn.
Binging and purging very common secondary to pain.
|89% of patients have at least one side effect.
Nausea and Vomiting 51%
Heart Burn 34%
Need for re-operation or removal as high as 25% 
|Opinion||“Gold standard” with frequent complications and hospital visits for patients 8.||Technically a difficult operation to perform. Division of the post pyloric duodenum is a difficult step and could be dangerous in an inexperienced hand.||Poor long term results with VBG||Actually not a new idea and was abandoned years ago. Some top surgeons in the field feel its resurgence will give bariatric surgery a bad reputation |
|Summary||A restrictive procedure rendering a patient to a very limited diet, with significant complications. Long term results acceptable.||The best surgical solution available for treatment of Morbid obesity. Allows a patient to lead a normal life with normal dietary intake of meals in smaller volume, without the side effect of dumping syndrome, continued vomiting, plugging, etc.||A restrictive operation with poor long term track record and numerous complications.||Restrictive procedure with no long term studies. Preliminary results disappointing.|
|Long Term Dietary Modification||Significant dietary restriction. The unhealthiest diet after any weight loss surgery. Meat intolerance in majority of Pt.Patients resort to high calorie drinks because can not tolerate “regular” meals||Most balanced diets tolerated well with no adverse effects. Patients tolerate “normal” diet.||Extremely poor diet- Patients are not able to consume any solids since it plugs the opening at the silastic ring.
|The same as VBG|
Individual patients requirements may differ. May also differ among physicians.
|Multivitamin, Iron, B12, Calcium for life||Multivitamin and Calcium for life.||Multi vitamin, Iron, Calcium For life||The same as VBG|
4 Years Post Op: At Goal And STILL Loving My DS!
340/180/180 ~ 5'11" ~ I lost 160 lbs!!
LBL & Hernia Repair: Done! Arm Lift: Done! Next Up: Thighs & Boobs!
Get the facts about Duodenal Switch at DSFacts.com