Is DS an option for a lightweight in Ontario?
"If DS is just not an option, I will try the RNY, "
Most surgeons are finding their VSG and RnY patients get similar results. The RnY is not a VSG with added malabsorption. It's enough different in other ways that it evens out the results.
Also, the VSG does have a metabolic component because it changes the hormones involved with digestion (i.e., it removes ghrelin and that starts a chain reaction of changes). So it really is more than a "restrictive only" surgery even though no intestines are removed or changed.
As for the distal RnY mentioned below, that has really fallen out of favor in recent years because there are often a lot of complications. My surgeon says it's like getting the worst of the DS and the worst of RnY and strongly encourages his patients to get a DS instead. In fact, he only does distals on people who already have a RnY who need more malabsorption (i.e., as a revision, not a virgin surgery).
Most surgeons are finding their VSG and RnY patients get similar results. The RnY is not a VSG with added malabsorption. It's enough different in other ways that it evens out the results.
Also, the VSG does have a metabolic component because it changes the hormones involved with digestion (i.e., it removes ghrelin and that starts a chain reaction of changes). So it really is more than a "restrictive only" surgery even though no intestines are removed or changed.
As for the distal RnY mentioned below, that has really fallen out of favor in recent years because there are often a lot of complications. My surgeon says it's like getting the worst of the DS and the worst of RnY and strongly encourages his patients to get a DS instead. In fact, he only does distals on people who already have a RnY who need more malabsorption (i.e., as a revision, not a virgin surgery).
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on 5/30/11 11:28 pm, edited 5/30/11 11:37 pm
on 5/30/11 11:28 pm, edited 5/30/11 11:37 pm
My husband had a distal RNY ten years ago in the US and it performs very much like a DS . He still has restriction in his pouch ( he can eat about a third of what i can ) .. and he still malabsorbs much of his fat ...
that may be a viable solution for you .
as far as reactive hypoglycemia .. yes he has blood sugar swings but hes a diabetic and that goes with the territory . He's able to control his diabetes well despite the lac k of pyloric valve .
I too wanted a DS because of the long- term statistics . I got a proximal RNY ( because I'm an extreme lighweight ) . Insurance would not have covered anything else without a fight and I was risking not getting any surgery at all by fighting .
Im very happy with my results right now . Would I have been equally happy with a sleeve ? honestly Im not sure ... I think the malabsorptive component is still something that factors in for me a bit and something im frankly glad i have ...
I would absolutely choose an RNY over no surgery at all ... I think a well done distal one acts essentially the same as a DS down to the continued malabsorption of fat - and the restriction presented by a tightly sewn up pouch is very akin to that of the sleeve component of the DS .
Personally I dont like to eat fat so maybe the DS wasnt the surgery for me to begin with ... .
that may be a viable solution for you .
as far as reactive hypoglycemia .. yes he has blood sugar swings but hes a diabetic and that goes with the territory . He's able to control his diabetes well despite the lac k of pyloric valve .
I too wanted a DS because of the long- term statistics . I got a proximal RNY ( because I'm an extreme lighweight ) . Insurance would not have covered anything else without a fight and I was risking not getting any surgery at all by fighting .
Im very happy with my results right now . Would I have been equally happy with a sleeve ? honestly Im not sure ... I think the malabsorptive component is still something that factors in for me a bit and something im frankly glad i have ...
I would absolutely choose an RNY over no surgery at all ... I think a well done distal one acts essentially the same as a DS down to the continued malabsorption of fat - and the restriction presented by a tightly sewn up pouch is very akin to that of the sleeve component of the DS .
Personally I dont like to eat fat so maybe the DS wasnt the surgery for me to begin with ... .
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