Duodenal Switch vs Roux-en-Y

on 9/29/08 12:33 pm - St. Cloud, MN
Anyone care to give me some pros and cons that are easy to understand for each? I'm leaning towards the RnY, but am interested in hearing about both. Thanks!

on 9/29/08 12:42 pm - Sunny Southern, CA
Here is a link that will lead you to all of our OH Surgery type forums. There are wonderful people on each forum that have had the various surgeries and can tell you the pluses and minuses they have found as post-ops.


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

on 9/29/08 12:56 pm - St. Cloud, MN
Thanks, yes, I knew about these places. Just thought a quick answer on here would be good too. I appreciate your help!

on 9/29/08 1:30 pm - New Castle, PA
You'll get a lot more quick answers about the Ds if you post this on the DS forum...they are always ready and willing to give people insight into the surgery.
 Best Wishes,


Entered Onederland 01-03-2010
Century Club  01-29-2010
Goal    06-29-2010
on 9/29/08 1:53 pm, edited 9/29/08 1:53 pm - Garland, TX
 Check out the website www.duodenalswitch.com for a comparison of the two in detail ..   More specifically:

    http://www.duodenalswitch.com/procedure/ds_vs__rny/ds_vs__rn y.html

  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 GW187 CW/315 (yep, a DS semi-failure - it happens  :-(    )

on 9/29/08 1:54 pm
I chose the DS, because it just made more sense to me.

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.
on 9/29/08 2:30 pm
I chose the DS for the wonderful post-op life and the malabsorption to help me KEEP the weight off! I've been maintaining my 160 lb weight loss for about 8 months and it's been effortless!! I love my DS.

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 [8],[9],[10],[11]>30% regained >15% or lost <50% [12] Above Average. 70-80% excess weight loss reported over long term follow up.[3],[4],[5],[6],[7] Poor. Only 26% of patients maintain >50% of excess weight
No long term studies yet available. At best should be similar to VBG.
Non Surgical
68.8% “continued” problem with vomiting, 42.7% plugging of the gastric pouch outlet.[13] 12% stenosis & 12% ulceration, with over all stomac complication in 20%.[14] Up to 76% of Patients develop Dumping Syndrome, with no association between severity of Dumping Syndrome and weight loss.[15] 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.[1]

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% [17]
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[2] 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 [18]
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.[19]
Long Term Dietary Modification Significant dietary restriction. The unhealthiest diet after any weight loss surgery. Meat intolerance in majority of Pt.[16]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
Nutritional Supplement

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


[1] Balsiger BM, Poggio JL, Mai J, Kelly KA, Sarr MG, Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity, Gastrointestinal Surgery 2000 Nov-Dec;4(6):598-605.

[2] McLean LD, Rhode BM, Sampalis J, Forse KA Results of the surgical treatment of obesity. Am J Surgery 1993;165:155 - 59.

[3] Scopinaro N; Adami GF; Marinari GM; Gianetta E; Traverso E; Friedman D; Camerini G; Baschieri G; Simonelli A, Biliopancreatic diversion, World J Surgery 1998 Sep;22(9):936-46.

[4] Hess DS; Hess DW, Biliopancreatic diversion with a duodenal switch, Obesity Surgery 1998 Jun;8(3):267-82.

[5] Baltasar A; Bou R; Bengochea M; Arlandis F; Escriva C; Mir J; Martinez R; Perez N, Duodenal switch: an effective therapy for morbid obesity--intermediate results, Obesity Surgery 2001 Feb;11(1):54-8.

[6] Marceau P; Hould FS; Simard S; Lebel S; Bourque RA; Potvin M; Biron S, Biliopancreatic diversion with duodenal switch, World J Surgery 1998 Sep;22(9):947-54.

[7] Marceau P; Hould FS; Potvin M; Lebel S; Biron S, Biliopancreatic diversion (duodenal switch procedure), European J Gastroenterology Hepatology 1999 Feb;11(2):99-103.

[8] Balsiger BM et all, Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity. Mayo Clinic proc. 2000 Jul; 75(7):669-72.

[9] Oh CH, Kim HJ, Oh S, Weight loss following transected gastric bypass with proximal Roux-en-Y, Obesity Surgery 1997 Apr;7(2):142.

[10] Reinhold Rb, Late results of gastric bypass surgery for morbid obesity, J Am College Nutritio***** Aug;13(4):326-31.

[11] Avinoah E et all, [Long-term weight changes after Roux-en-Y gastric bypass for morbid obesity]. Harefuah 1993 Feb 15; 124(4):185-7,248.

[12] Brolin RE et all, Lipid Risk profile and weight stability after gastric restrictive operations for morbid obesity, J Gastrointestinal Surgery 2000 Sep-Oct;4(5):464-9.

[13] Mitchell JE, Lancaster KL, Burgard MA, Howell M, Krahn DD, Crosby RD, Wonderlich SA, Gonsell BA, Long –term Follow up of patients’ Status after Gastric Bypass, Obesity Surgery, August 2001,11(4) 464-468.

[14] Sanyal AJ, Sugerman HJ, Kellum JM, Engle KM, Wolfe L.,Stomal complications of gastric bypass: incidence and outcome of therapy, Am J Gastroenterology 1992 Sep;87(9):1165-9.

[15] Mallory GN, Macgregor AM, Rand CS, The Influence of Dumping on Weight Loss After Gastric Restrictive Surgery for Morbid Obesity. Obesity Surgery 1996 Dec;6(6):474-478.

[16] Avinoah E, Ovanat A, Charuzi I., Nutritional status seven years after Roux-en-Y gastric bypass surgery. Surgery 1992 Feb; 111(2):137-42

[17] U.S. Food and Drug Administration, FDA Talk Paper T01-26, June 5, 2001

[18] NIH, Working Group on Bariatric Surgery, Executive Summary, May 8-9, 2002

[19] Doherty C, Maher JW, Heitshusen DS., “Long term data indicate a progressive loss in efficacy of adjustable silicone gastric banding for the surgical treatment of morbid obesity”, Surgery, 2002, Oct.;132(4):724-8

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

on 9/29/08 2:43 pm - Burnsville, MN
You have already gotten some great information here.  I just thought that I would add in why I chose the DS over the RNY. 

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.


on 9/29/08 8:11 pm - Toledo, OH
Hi there,

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

Anne S.
on 9/29/08 8:36 pm
Please feel free to take a look at my profile. There's a comparison chart there. . . and lots of other information for newbies looking for info.

Good luck in your research.


Learning about the DS? An excellent resource is www.dsfacts.com
For scientific studies about the DS and more, "friend" me, and then click on my profile. Best of luck on your journey.

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