http://health.usnews.com/health-news/news/articles/2012/09/17/comparison-of-obesity-surgeries-turns-up-surprising-results                          

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

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

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.

 

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.

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.

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.

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.

Well Said. Good use of the reference.

I entertained DS for a bit.

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...)