RNY vs DS

Which surgery is best for me? I am confused.

Why is RNY called the Gold Standard and DS not?

Thank you

RNY has been around a lot longer than DS and there are much fewer doctors that do the DS.  It is an excellent surgical option but because of lack of study time, many insurances will not cover it.

That's probably a question best answered by a surgeon that can actually do both of the surgeries but ultimately it is YOUR decision. From what I have heard/read, the DS is much better for those that start out at higher BMI's like in the 50's I believe. Again, that's what I have heard. 

I am 43 BMI with diabetes and heart stents. I have Medicare and bcbs. I have a consult 6/12 with the drs nurse pract. This will be on my list. DS seems like a good choice...some are happy with the results...it seems.

Katie K - Thank you. Back to the RNY.

ONLY you and your surgeon can decide which one is best for YOU.

The reasons that RNY was better for me, and DS was not included the following:

• RNY was better because my biggest comorbidity was GERD - and RNY is better for GERD in general
• My insurance wouldn't pay for DS
• I was super-morbidly-obese. This is generally an indicator for DS over RNY - but my BMI was 50 on the day of my surgery, and typically the literature suggests that if your BMI is over 50, DS has better statistics. (I had a BMI of 60 when I began to look into weight loss surgery).
• I looked at the possible complications that were specific to RNY and that were specific to DS (complications from surgery alone wouldn't change, except you're under the knife longer with the DS)... and I felt that the possible issues that MIGHT go with DS were less acceptable - I'm a high school teacher and smelly or loud flatulence can be an issue when teaching teenagers. So this precluded the DS, even though I knew it was something that not all individuals with DS experience, and that it WAS something that individuals with RNY sometimes face as well. 
• I looked at the typical menu of someone with an RNY and someone with a DS, and the DS menu was not appetizing. I did my best to live like someone who had the RNY and was 6-months to a year out, and I found it to be a satisfying life-style for me.
• I'm a big fan of choosing the surgical option that changes the body the least. To my way of thinking, the VSG is the best surgery, the closest to how our natural physiology is. Next in line, to me, is the RNY, sure it's an extreme alteration of the body, but is still less "extreme" than a DS. DS is third in line for surgical options, to me, and I believe that it is an EXCELLENT choice for many folks. I would never recommend the lap-band to anyone, not even my worst enemy.

Ultimately, FOR ME, the best choice was RNY, not least of which because it was the only one my insurance offered, and best of all worlds because it had the greatest possible resolution of GERD of all weight loss surgeries, so there really wasn't a choice beyond "have it," or "don't have it."

People will tell you why it is a good choice FOR them. But you need to look at EVERYTHING... the good, the bad, the extreme in both surgeries. Asking people tends to result in a focus on why people like the choice THEY made for THEMSELVES.... and it often includes a lot of justification and a sense of "this is the best surgery". However I would NEVER presume to think that what is perfect for ME is perfect for others.

My suggestion is to read through all the posts for the last week or two on both the RNY and the DS board, if those are your two choices. Don't ask people what they would suggest is best.... SEE what it is like to live with both, and decide which one sounds like it will result in a lifestyle you can live with - both in food choices - and in complications or daily difficulties. RNY worked (more or less) for me, but I generally suggest VSG as the best option. But it depends on how much you have to lose and what your self-analysis says is the best for who you are. MY success has nothing to do with you. The same is true of anyone else who has had any other surgery or the same as me.

Good luck in your search for the best choice. But choose what you want to do based on self-knowledge.

Very good info! And wonderful weight loss!!!

Lady – thank you for all the information. I will continue to research. I am beginning to suffer from information overload. The email from Dr Keith Kims staff say the nurse pract would help me decide on the surgery. I hope she can correctly answer the questions I’ll have. I think Medicare covers the DS if I go that way. Blue Cross may not handle the 20%. Fortunately I can pickup the balance…so insurance will not be an issue for me…knock wood. Looks like the gold standard RNY worked for you.

I'm about 105 pounds lighter than when I had surgery. I'm down about 163 from maximum

It is important to understand that a surgeon who does not do a particular surgery might not be the best place to determine the right surgery FOR YOU. Make sure you get some unbiased information. (in other words, from sources other than surgeons who don't perform a particular surgery, and from people who may not have had the surgery you are asking about.) Obviously I'm biased. If you WERE me... I'd know that the RNY would do a pretty good job for you. But you aren't me, and NOBODY who you speak with is YOU... so ultimately you must get the best information and then decide based on self knowledge.