RNY vs VSG + RNY

What are the benefits and reasons for getting a 2 part surgery (VSG, then RNY later on), as opposed to just a RNY?

Is there more or faster weight loss associated with the 2 part surgery (with diet and exercise)?

I have about 200lbs to lose, and the surgeon recommended both to me. Thought ins didn't cover VSG, so we mostly talked about RNY, but it turns out ins does cover both.

 Hi,
I think you may have them mixed up a bit, some people have a two part surgery the first being vsg and the second being the duodenal switch. You can find out more about the DS surgery at dsfacts.com.

Good luck in you research,
Trish

 I wouldn't recommend a VSG to RNY as a plan.  VSG is great, RNY is great, DS is great, but thinking twice and cutting once is the way to go.  With 200 lbs to lose, I would seriously consider the DS, but if you are thinking of either a back up plan or a two stage process, VSG to DS is a natural progression as the VSG is the first part of the DS anyway.

Do a lot of research and carefully consider what surgery makes most sense to you and all the best in your decision. 

I agree with the other posters- try to do surgery only once. I don't think it really matters whether you do the sleeve, rny or ds, as long as you are willing to committ. You must change your lifestyle period, no matter which you choose. I have the sleeve, which requires the least amount of compliance (for me-no nutritional deficiencies, ability to eat everything at this point), but I must be vigilant, because I think it is the easiest surgery to regain with. I must exercise daily, eat high protein, low carb, examine why I abused food, change how I deal with stress, etc. I did not want the dumping syndrome associated with rny, but I must be more careful because I can eat candy- with no reprocussions. The sleeve reduces grelin (hunger hormone) and reduced the size of my stomach- but that's it. If you need more, the sleeve may not be for you. Before you do any surgery, really research them all and decide which one has the biggest benefit to YOU, that YOU can live with. Again, I would not  just focus on weight loss- I would really be honest with yourself and focus on the post-op lifestyle before making your decision. I would also begin therapy or get some counseling on the emotional reasons you eat, before any surgery. Good luck! (btw highest was 308 then pre-op diet,  sleeved at 248 in Dec '11, currently 158- so the sleeve works, even for large wt loss, but you have to change your ways!) It is work, but so worth it. Best of  luck to you.

 The benefits of a two part surgery is that you have the option of only using one part if you need it.  In other words, if you can lose all of your weight with the VSG then you don't get the DS.  Lots of people, right here on OH, have lost more than 200lbs with just the VSG so it could happen (most don't, however).  The downside is you have to have surgery twice.  I view the body as a closed system in steady state; everything is working.  Probably best to do as little changing and rearranging as necessary.  That is, if the VSG is enough for you then there's no reason to live with malabsorption forever.  If the VSG alone isn't enough, you can get the DS later.  Pretty convenient and flexible, I think.

Thanks!!  Looks like the awful cold I had during the consult appointment made me get the surgery names mixed up in my head. The dsinfo.com site has a TON of information and I spent all morning reading it. :)

I am really weighing my options here now, whereas before, I was pretty set on the RNY.

One more question: When people say "DS", are they talking about the biliopancreatic diversion with duodenal switch, or JUST a duodenal switch?

DS, biliopancreatic diversion with duodenal switch and duodenal switch are all the same thing

Names are just awful. (*grin*)

Way back when, Dr. Scopinaro developed this procedure called trhe 'Bilio-Pancreatic Diverson', and shorted it to BPD.It worked really well, as far as weight-loss went, but it had some nasty side-effects. It looked liks this:


In 1988, Dr. Hess modified the procedure by changing the stomach portion from a big pouch into a sleeve gastrectomy. In order to honor Dr. Scopinaro, he called this new procedure the 'Bilio-pacnreatic Diverson witn Duodenal Switch', (BPD/DS) instead of just calling it was should have been called---the 'Duodenal Switch' (DS).

It looks like this:

Thanks!. I thought so, but wanted to know for sure.

Well, a glitch happened. (*grin*)

And just to make things even crazier, it is possible to get JUST a 'duodenal switch'---no stomach part---it you're a diabetic who can afford to go to Spain and self-pay. (*grin*) Dr. Baltazar has been doing just the switch on non-obese disbetics for about ten years now, with remarkable results.

I'm tickled with my VSG/DS (Vertical Sleeve Gastrectomy w/Duodenal Switch), and have been for almost 9 years.