Trying to decide which surgery is most effective?

Julie R.
on 1/10/14 10:26 am - Ludington, MI
  http://health.usnews.com/health-news/news/articles/2012/09/17/comparison-of-obesity-surgeries-turns-up-surprising-results                          
Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125

Gwen M.
on 1/10/14 10:40 am
VSG on 03/13/14

This article is almost 18 months old and it doesn't even mention VSG :(

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

Cicerogirl, The PhD
Version

on 1/10/14 10:43 am - OH

This is hardly new.  It has long been known that the DS provides the best long term statistics for weight loss and maintenance of any of the surgeries. It is also a significantly more drastic surgery in terms of the bypass than the RNY, though, so there is a significant trade off in terms of nutritional/vitamin needs and concerns.

Lora

13 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Amy Farrah Fowler
on 1/11/14 1:22 am

I know that both RNY and DS have bypassed intestines, just in different places, and that the DS has a sleeve stomach retaining it's own pyloric valve, and the RNY stomach is a "pouch" with a manmade stoma, and a remnant stomach. They both malabsorb nutrients for life, though somewhat different based on where they are bypassed. RNY regains most calorie absorption, while DS does not. 

So could you please clarify what/where the "a significanly more drastic surgery in terms of the bypass than RNY" comes from?  I know plenty of RNY folks that take far more supplements than I do, and deal with dumping and hypoglycemia, and that does indeed sound drastic. Studies show they have about the same post op risk.

 

MsBatt
on 1/10/14 1:45 pm

Hummm...I don't know that I'd use the word 'drastic'. Complicated, yes, at least for the surgeon. As for vitamins and supplements, I know many RNYers who take more than I do. This is truly an area where every body is different, and every WLS patient needs to determine their own individual vitamin and supplement intake based on their regular lab work, NOT on what anyone else takes or what their surgeon or nutritionist recommends.

AnneGG
on 1/11/14 1:44 am, edited 1/11/14 10:09 pm

Well, the DS is significantly more drastic, that is just a fact-  well over ½  the stomach and bypassing most of the small intestines. As well as requiring the highest surgical skill level. Which means the highest risk for complications.

Types of WLS all have trade offs with regard to benefit and risk. Depends on what a person wants to go for, but I think a person needs to know the facts from all different professional aspects and recommendations, not personal experience and opinion. They also should consider the risk factor.

I have gone with my surgeon's and Bariatric nutritionist's vitamin and supplement recommendations, and my blood levels have consistently been excellent. I agree with you that the numbers are what tells me if I am doing the right vitamins and amounts.

"What the caterpillar calls the end of the world, the master calls the butterfly." Richard Bach

"Support fosters your growth. If you are getting enough of the right support, you will experience a major transformation in yourself. You will discover a sense of empowerment and peace you have never before experienced. You will come to believe you can overcome your challenges and find some joy in this world." Katie Jay

Julie R.
on 1/11/14 4:40 am - Ludington, MI

MULTIPLE data sources cite the DS as being superior to any other surgeries in regard to EWL and long term maintenance.   The list of DS surgeons world-wide is growing because of this.   I do not understand where and how you arrive at the conclusion that "higher level of surgical skill needed" equals "more complications.".  One of the main reasons I chose the DS was because I noted that DS'ers seemed to have far fewer complications.   I added that to the observation that I noticed far less regain and a higher level of post-op quality of life, and I was sold.

Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125

AnneGG
on 1/11/14 5:38 am, edited 1/11/14 5:51 am

JAMA Surgery Releases for September 17, 2012: Study Compares Duodenal Switch vs. Gastric Bypass for Morbid Obesity   "Although researchers note a relative increase in the use of the DS, this procedure is still used much less in the United States compared with gastric bypass. The researchers suggest that is likely due to several factors, including the technical difficulty of the procedure, the higher reported rates of short-term complications and concerns about the longer-term nutritional consequences of a primarily malabsorptive procedure (where absorption of calories and nutrients is reduced)."

Pretty reputable source.

"What the caterpillar calls the end of the world, the master calls the butterfly." Richard Bach

"Support fosters your growth. If you are getting enough of the right support, you will experience a major transformation in yourself. You will discover a sense of empowerment and peace you have never before experienced. You will come to believe you can overcome your challenges and find some joy in this world." Katie Jay

SkinnyScientist
on 1/11/14 7:48 am

Well Said. Good use of the reference.

I entertained DS for a bit.

RNY Surgery: 12/31/2013; 

Current weight (2/27/2015) 139lbs, ~14% body fat

Three pounds below Goal!!! Yay !  

Cicerogirl, The PhD
Version

on 1/11/14 6:27 am, edited 1/11/14 3:21 pm - OH

I don't know about surgeons worldwide, but I know of three surgeons -- two in SW Ohio and one in Chicago -- who have STOPPED doing the DS because too many patients weren't being compliant with vitamins and were developing deficiencies.

Lora

(edited for autocorrect error...)

13 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

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