Question:
Duodenal Switch vs. Roux-en-Y
I am considering weight loss surgery and am trying to decide which is best for me. Does anyone know of specific guidelines to be a canidate for the Duodenal Switch? From my readings it seems to be done much less than the Roux-en-Y, but sounds like a great option. I wonder why it is done less. I wondered if it is for people with extremely high BMIs. I appreciate any information you can share. — dtnash (posted on January 16, 2009)
January 16, 2009
I don't know what the thought is now. I had surgery 9 years ago, and at
that time the duodenal switch was more often used with patients 350# or
greater.
Juliana James-Thomas
— jjames-thomas
January 16, 2009
I am glad to see you researching your options!!! I went through the process
to get RNY but then found out about the DS one month before my scheduled
surgery. My BMI was 45.3 and I went to the DS forum to find out more
information. There are several helpful people that will give you FACTS and
allow you to make up your own mind. Once you research the different
options and the longterm results the DS has been more successful then the
other WLS. If your insurance covers the RNY it will cover the DS - the DS
forum has information on codes for the procedure to call insurance with.
There are several helpful people who can help you if your insurance denies.
There is a website DSfacts.com that is helpful. The procedure takes a LOT
more time then the RNY and thus doctors can do at least twice as many RNY's
in that time and the RNY's are less complicated. I had my DS on Oct 29th,
2008 still feel no hunger and have lost 68 lb in 11 weeks. The hard part
is finding a physician that will do the procedure. I am not sure what
state you live but post on the DS board and everyone can help you from
there!! Smiles!
— Happytall1
January 16, 2009
DS has far more mal-absorption than any of the GB surgeries...Many
Insurance companies won't approve it and so many people don't even have
that option if they can't afford to pay it out of pocket. The cold hard
truth is that even if it were THE BEST surgery (Which I have no experience
to say one way or the other)...Surgeons will go where the money is and
that's with the surgery that insurance companies are approving because it's
guarenteed payment! Sorry but that's the truth! I don't know many RNYers
(after a year) that hate their surgery...and the same goes for the DSers
that I know... which are far fewer! SO...You really have to research and
make sure you KNOW/ understand the surgery and all the rules that go with
the one you decide to have...Go to the forums and lurk on the boards and
see how others are doing...and what problems they've encountered...I had
RNY and had smooth sailing til year 4 when I had malnutrition from
malabsorption...So I had to get on extra supplements and have to watch my
labs and vitamin levels much closer...It's common for RNYers to become
deficient in something or many things around 3-5 years...So you learn to
take care of yourself and listen to symptoms and go get labs when you feel
bad or weird! Prevention...Key to staying healthy...Moderation the key to
keeping your weight off with RNY...At year 5...I worry more about my health
than my weight...My body just stays where it is with the lifestyle changes
I made in that first year post op. But malabsorption is real and because
of it malnutrition happens frequently! So you really have to stay on top
of that diligently with full vitamin labs and popping vits all day on a
schedule...every day! What a chore it can be for a busy person...I keep
vits in my car...In snack baggies... in my purse...I can't tell you how
many times I washed my calcium tablets in pockets because you have to chew
2-4 a day at 2 hours apart for each one! So you have to try to remember to
get them all in by day's end! So...My point is that once weight loss
stops...You have to keep healthy...and so WL is only a part of the
lifestyle change...KNOW what you will have to do every day of the rest of
your life... for each surgery! Just a suggestion! :) Good luck! I wish
you success in whichever WLS you have!
— .Anita R.
January 16, 2009
Looking at your profile i see you are not an extremely high BMI and thought
I'd mention that perhaps the Sleeve Gastrectomy might be a good option for
you. It is the first part of the DS but without the malabsorption issues
that causes malnutrition. Recent studies are seeing that the sleeve has as
good a weight loss as the RNY and that the patients are much healthier in
the long term. I had the Sleeve at the beginning of November, am losing
nicely, feel fantastic, had no pain post op and still feel no hunger to
this day. The beauty about the operation is that it preserves the function
of the stomach but removes the part that signals hunger. What a bonus! And
although i do take vitamin tablets - it's only because i eat so little that
i supplement. I'm very happy with my Sleeve as I am sure others are equally
happy with their choices.
Good luck with your choice!
— Sharzi
January 17, 2009
I had this surgery DS in 1988-so almost 21 years ago when this surgery was
really in its infancy and they did it for other problems than weight loss.
It works more effectively than some of the things they do now. I am now
considering a revision but doing research is smart. I would talk to
several surgeons and then make my decision. Good Luck and God Bless,
vinnigirl, retired RN
— vinnigirl
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