Why do surgeons that do both choose RNY vs DS

I live in Northern VA. and don't have any surgeons that do the DS around here. I am considering coming to NYC to have Dr. Gagner perform one. I have a BMI of 40. I've called his office and found that he sometimes chooses the RNY over the DS. Why is this? The DS seems to have a much smaller lifestyle change after surgery with little to no future weight gain. Is this true? Why do more surgeons not do the DS? My insurance company says that since it has not caught on over the last 5 years ( only 11 surgeons do it in the US ) that it can't be as good because this is a competitive business and all surgeons want the best long term results, even though the DS is more difficult. Could you help me understand? I'd prefer the DS even though it requires that I go out of network and pay $2500 out of pocket, but perhaps its not right for me. I've called the National Institute of Health, they didn't know much about the DS. I've called the American Society of Bariatic Surgeons and they knew very little and said it was a much more extreme surgery, and said they agreed that more surgeons would offer it if it was so great. It really does sound easier. Also please don't just send me to duodenalswitch.com as I've asked questions there but gotten no answers and can't find info there on specific questions very easily. I'll probably end up with a RNY but want that to be the right surgery for me not just the most convinient one. Thank you for your time and effort. Marilyn Marilyn

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