Question:
Why is the DGB/DS said to be more dangerous than the RNY?

I am planning to have WLS and have been researching to select the procedure I wnat to have done. It appears to me that the most dangerous part of either surgery is the intestinal rearrangement (due to the potential for malnutrition). As far as I can see, the malabsorption measures in the intestinal rearrangement are the same for both procedures, with a common tract of 100cm or more being reasonably safe. The difference I see between the two surgeries is in the volume restriction measures in the stomach with the RNY creating a pouch and the DGS/DS leaving a sleeve shaped stomach with the pyloric valve still functional. My questions are: 1) Is my summary above correct? 2) If so, what is the advantage of the RNY? Why are there so few DGB/DS surgeries?    — A. E. M. (posted on April 19, 2001)

April 19, 2001
Your summary is correct. I believe the "danger" of DS is perceived because of the malabsorption principle. With the RNY, you may have a 'distal' or 'proximal', indicating the length of small intestine that is excluded for absorption. The DS involves figuring out what percentage of the small intestine should be excluded, based on individual factors. I have an extreme exclusion, having only 8.93% of 'common channel'. But then, I was 42, very strong genetic tendency to morbid obesity and almost 500 pounds. I will have to be vigilent with my nutrition and calcium intake for the rest of my life. As for why more RNY are done then DS, it is a simple matter of economics. Insurance reimburses the same for both. Surgeons can do 2-3 RNY procedures in the time it takes to do 1 DS procedure. Only docs who dedicatedly believe that the DS is a superior procedure are doing this type of procedure. Hope you find this helpful. Good Luck to you...
   — merri B.

April 19, 2001
There are less DBG/DS (also called BPD/DS) surgeries because it's a more complicated procedure and some people consider it experimental. There are reports going back 11 years on the BPD/DS (DBG/DS) proving that this is a safe and effective surgery. People consider it 'risky' because it a more distal procedure, so you have to be much more diligent with taking your vitamins and supplements, however, because you do not have all of your duodenum bypassed in a BPD/DS like you do in a distal RNY (or any other WLS surgery) you would have to have the ability to absorb more nutrients and protein than a distal RNY or any other distal procedure, but of course less than any proximal procedure. For more information goto: http://www.duodenalswitch.com You'll find more information on the surgery, it's history, it's pros and cons, patient stories and information about surgeons that can perform the BPD/DS. (Surgeons with an asterisk by their name are able to perform the BPD/DS laproscopically). Also, if you see any negative posts that are supposed to be regarding the BPD/DS or the DGB/DS and they reference the Scopinaro method that is inaccurate information and just tells you results for the BPD as it was performed by itself a long time ago. It is no longer performed as just the BPD only but as the BPD/DS (DGB/DS) and Dr Hess's report will attest to the excellent success achieved with this surgery based on his 11 yr study. (Dr Hess was the Dr who pioneered the BPD/DS in it's current form.) Good luck with your research! Anita
   — Anita N.