Duodenal Switch vs Roux-en-Y
There is NO ONE SURGERY FITS ALL. It's definitely an individual choice. You can really select the "tool" that most fits you and your lifestyle.
I wish you the best in your fact finding,
Weight Loss Surgery Friendly Recipes & Rambling
And good luck whichever you choose ..
Frank talk about the DS / "All I ever wanted to be was thin, like that Rolling Stones dude ... "
HW/461 LW/251 GW190 CW/320 (yep, a DS quasi-failure - it happens :-( )
I liked still having a fully-functional stomach, no stoma (or the problems associated with a stoma, like strictures, marginal ulcers, and the possibility of a stretched stoma), no dumping, no danger of getting food 'stuck', and no 'blind pouch'.
I knew I'd always need to be able to take NSAIDs.
I wanted to be able to drink with meals, and to be able to chug-a-lug a big ol' glass of water when I was hot and thirsty.
Diabetes runs in both sides of my family, and since the DS has the best 'cure rate' for diabetes, I figured it would do the best job of protecting me against ever becomng diabetic.
High cholesterol also runs in my family, and the DS targets fat absorption. Since I've been absorbing only 20% of the fat I eat, my cholerterol numbers are WONDERFUL!
I knew myself well enough to know that I am NOT good at dieting. I felt that with the RNY, I'd just be signing up for a life-long low-fat, low-carb diet, and I knew I couldn't stick to that. With the DS, I eat a high-protein, high-fat, 'normal' carb diet, and I have enough malabsorption to allow me to eat enough to be emotionally satisfied as well as physically satisfied.
I'm better at "doing" than at "not doing". In other words, it's a lot easier for me to actively DO something like taking vitamins and supplements than it is for me to resist, or "not do" things like eat what I want when I want it. (Gee, if I could have done THAT, I wouldn't have needed WLS. *grin*)
And---I'd read studies that convinced me that the DS was my best hope of KEEPING the weight off, long-term.
My profile has several studies compaing the DS and the RNY and lots of pictures of how I can eat now! It's pretty amazing!
This is a nice comparisson chart from www.dssurgery.com
Best of luck to you with your decision and keep doing your research!
|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
I had failed at dieting, at every diet and I wanted a surgery that I was going to be able to live like a normal person. I did not want to have to diet the rest of my life. I wanted a few rules to follow and then go. The DS provided that for me. You need to eat a high protein, a little higher fat (which means full flavor), and limit the amount of carbs. I knew I could do it. This surgery made so much sense to me. A normal functioning stomach, just smaller and three simple rules. Easy. Then the other items were to make sure to take supplements for life and have labs taken for life. I knew I could do that as well. It was a no brainer.
If this sounds like something you can do then it is the surgery for you.
I chose the RNY over DS because of the deficiences associated with DS. I felt like the malabsorption issue was so much greater with the DS. I also felt like anemia would be a much larger problem with the DS. The RNY is a simpler surgery, is a great tool to help you loose the weight. I was also afraid of the diarrhea the comes with DS because of the malabsorption. You do have lots of restrictions with the RNY, but I thought that would be a small price to pay to be healthier. Which ever you choose, you have to choose what is right for you. Both surgeries can have great outcomes!!! Good luck to you in your decision
on 9/29/08 8:36 pm
Good luck in your research.