Question:
Has anyone had heard of the Duodenal Switch for WLS?
I was wondering if anyone was looking into the Duodenal Switch for WLS surgery and what they found out. Also if anyone has had this what is you opinion? — Rebecca K. (posted on January 31, 2002)
January 31, 2002
I had the Duodenal Switch on November 9th. At my two month weigh in I was
down 37 pounds and 24 inches.
Having the DS was the only way I would have had this done. Your pyloric
(sp?) valve is left intact. The stomach is left at usually 4 to 6 ozs.
You do not need to be concerned with the stoma as with the RNY. I can
basically eat anything I want so long as I can tolerate it. If you have
this option, I reccomend having the DS done.
Good luck.
— Jackie E.
January 31, 2002
Duodenal switch info can be found at www.duodenalswitch.com and there are a
bunch of Yahoo!Groups available if you search for "duodenal."
Since I have a history of ulcers, take NSAIDs for chronic pain and have a
history of panic attacks, I'm going for DS. No dumping which mimics a
panic attack. Lower risk of ulceration. And NSAIDs aren't
contraindicated.
Because it has a larger malabsorptive component, you have to take
supplements of the fat soluble vitamins (ADEK). But over time, the diet is
much closer to "normal" and you don't have to do liquid diet for
two-three months postop! ;-)
www.gr-ds.com has a comparison chart of the various surgeries. DS has a
slightly better success rate after five years...probably not enough to be a
deciding factor.
— Pamela B.
January 31, 2002
The hospital that I had my surgery in refuses to do the duodenal Switch
because of the risks involved with it. I don't know much about the side
effects of the surgery but I just went to a support group meeting and the
speaker had the duodenal switch done 3 years ago. She had several severe
problems and still can't consume enough calories to even maintain her goal
weight. She still has to drink protein shakes at three years out because
she has to get in 150 grams of protein. Please research everything
carefully. I wish you the best and hope whatever decision you choose works
out for you. P.S. I had LAP RNY on 10/29/01 and am down 70 pounds in 13
weeks.
— vbenedict0208
January 31, 2002
Hi there, I chose the DS myself. There is much research to be done if
you're interested, but it's the only surgery I found really acceptable for
what I want out of post-op life (I am pre-op). As for the previous post, I
think anyone could think of an example of someone with "several severe
problems" after any WLS. One nice thing about the DS is that they
don't remove any intestine, so if you really need to, you can often get put
back the way you were. Another option is that the common channel can be
lengthened to allow for more absorbtion. There is one person on this site
that got very ill after her DS and actually can't qualify to have surgery
to revise her WLS though, so that is a possibility too. I spoke to my DS
surgeon about the possibility of malnutrition and he said that his
experience is that only 2% - 4% of DS patients need their common channel
lengthened. Another nice thing is that you keep some of your duodenum in
the food path (for lack of a better term) which allows for greater calcium
and iron absorbtion. Another thing I've heard is that DS patients almost
never have B12 problems. I can't tell you all the pros and cons in one
post, but it is my surgery of choice. It's not very widely done though and
is a technically more complicated surgery, so it's important to research
the surgeons themselves. Good luck in your research and best of luck in
whatever you choose.
— [Anonymous]
January 31, 2002
Rebecca, I encourage to read the www.duodenalswitch.com website - lots of
patient stories, or join the yahoo duodenal switch group. Doing a search
on this site will also produce a large array of posts. The topic has been
hotly debated on this site in the two years I've been here. AMOS is more
heavily RNY oriented, and the discussions have been lively to say the
least. As for my own experience, DS was the best choice for me for a
number of reasons, although I would have had the RNY if I had no other
choice. My weight loss has been great (8 lbs. from goal), and my health
remains excellent (just had my 18 month blood draws, and they're perfect).
-Kate-
— kateseidel
January 31, 2002
I had the lap rny post-op 3 months. I won't debate the issue of DS vs.
RNY, however I would like to point out a couple of things Pamela stated
that I disagree with. Dumping DOES NOT in any way mimic a panic attack.
And I wasn't on a liquid diet. I had to eat a soft solid BEFORE leaving
the hospital, or they wouldn't release me. All surgeons do things
differently. I'm sure there are pro's and con's with each procedure, you
have to decide which one suits you best after researching both of them
completely. I couldn't be happier with the RNY. Whatever you choose,
enjoy your journey.
— Cheri M.
January 31, 2002
Just one more correction to the RNY myths stated below. They do not
"remove" initestines in the RNY. Just as in the DS, the
intestines are rerouted to create malabsorbtion. Nothing is removed in the
RNY, unless of course you have your gallbladder removed at the same time.
I still have everything inside that I started with. I don't think there
should be any contraversy over which one is better. The decision should be
"which is better for me". For me it was the RNY, simply because
noone in my area did the DS at the time I had my surgery. If I had the
option now would I have chosen differently? I don't know. I eat normally,
I take my vites, I have an occasional drink and I have lost almost 160
pounds. Who is to say I would have been any more successful with the DS?
Both are tools, and it depends on how they are used as to how your body
will react.
— heidiinPA
January 31, 2002
I had the BPD/DS (duodenal switch) three years ago. I always seem to have
to put in my two cents to balance things out I guess. I am the person who
is 3 years out and has had numerous problems. I don't say not to do this
but I will say that this is the most drastic of all the surgeries. Yes,
there seem to be so many pros to it like eating and such but, like with any
of the surgeries, there can be pitfalls too. I say to research EVERY
surgery ahead of time. Ask questions and then ask more. Just by reading
my profile you can think of many questions to ask the doctor I'm sure.
Think long and hard about each surgery and then decide which risks you are
willing to take and which surgery will work best for you. you do NOT want
to be like me and find out things "after" the fact. Good luck in
whatever you decide.
— Barbara H.
February 1, 2002
Rebecca, I had the BPD without the ds, both surgeries are similar with just
a few differences. I choose this surgery over the rny for a couple of
reasons. First I am in the super morbidly obese category meaning i weighed
over 400 pounds. this provided a greater weight loss chance than the rny.
and secondly I know me, I needed that extra "leash" that the
malasorpotion provides. If I eat too much fat I know it wont stick arround
i will elimante it. I have to admit I need to do better with the sugar.
Also you can eat a wider selection of food with this type of surgery. I had
mine done on 10/02/01 and have lost 106 pounds so far and feel good. I had
a couple of complications (read my profile) but I would go thru it all
again. hope this helps. Definately ask your doctor any and all questions,
and remember that the best decision is an informed one.
— sherri W.
February 1, 2002
Hi! I had the DS 6.5 weeks ago and I am down 43 lbs. Please do lots of
research and be careful when you read posts as to what is fact and what is
opinion. I had originally planned on having the RNY. Why? Because I
didn't know anything else was out there. Doctors and hospitals that don't
do the DS aren't going to tell you about it. That is money out of their
pocket. Luck took me to a wonderful, caring surgeon who explained the DS
and RNY to me. He told me to go home, research the DS (I'd already down
extensive research on the RNY). I was to go back and tell him which
surgery I wanted and convince him why I thought it was better for me. I
choose the DS and had surgery 12/17/01. My reasons: Normal entrance and
exit from the stomach meaning nearly 0% chance of ulcers and with the
pyloric valve, my food and liquid is released slowly from the stomach.
Liquids, soups etc. wash on through the pouch with the RNY. Any
medications (over-the-counter) I took before surgery, I can take now.
Since I have a more normally functioning stomach, I absorb more of the
vitamins and minerals in foods requiring me to take only one multivitamin
(any) and two calciums tablets a day. With the nmalabsorption component, I
do not absorb most of the fat I eat. (I do absorb sugar). I can eat as I
did before surgery just much, much less. I think this is what scares many
people because we were so undisciplined before surgery. For me, it is not
a problem. None of these foods appeal to me anymore. I am so busy getting
in enough protein and water, there isn't room for anything else. The one
poster has told many people about her problems with her DS. On some posts,
she admits it could have been the surgeon not the surgery. I don't know
which surgery is best, but at my age and weight, the DS gave me the best
chance at a normal life. At 57, the more complicated surgery would not
seem like the best choice but I have had no problems, very little pain even
in the beginning and feel like the happy, positive person I was many pounds
ago. Good luck with your decision!
— grammie5
February 1, 2002
Hi Rebecca,<P> I had the duodenal switch almost 5 months ago and I am
very happy with the results so far. I have had no complications and am
losing weight weekly. So many people have answered your questions already
that I won't go into my reasons "why" here. If you would like to
know more about my journey, you are welcome to read my profile.
<P>Best wishes to you - Brenda
— artistmama
February 1, 2002
I had an RNY mainly because I hasdn't heard of the DS at the time I made my
decision. when I began reading about the DS after my RNY I regretted my
decision to have the RNY, but the more I thought about the DS the less I
regretted it. It just doesn't seem to be natural to not digest most of your
food. And the smell that results for BMs and flatulence is pretty gross! :)
But again, only YOU can decide what surgery is best for you. Make sure you
research everything. Also I would suggest finding a doctor who does both
surgeries, and get his guidance as to which is better for you! Good Luck!
— [Anonymous]
February 1, 2002
I had a DS about 3 1/2 months ago and am feeling fine, no problems what so
ever. I think it is a great procedure. I could not have the RNY for
medical reasons so for me the DS was my only option. I looked at your
profile and see you have BC/BS insurance. Blue Cross consideres the DS to
be "investigational" at this time and typically will not
reimburse for it. They did approve mine because of specific problems with
my health. I know there are some DR's that use the same CPT code for the
DS and the RNY. If you decide on the DS make sure you have authorization
from the Blues first or you may end up with an unwanted and unexpected
bill. Hope all goes well for you, Kathy
— kathleen S.
February 3, 2002
Wow. so many bad things said about the ds. I had the ds surgery 8 1/2
months ago, I have lost 137 pounds. I chose this surgery because there is
no dumping, you can eat whatever you want and dont have worry about
dumping. You dont have worry about food getting stuck. I likedd the idea of
my stomach working like it did before surgery and I didnt want a pouch. I
go go on and on . I am very happy with the ds, I have had no problems. Also
to the poster who said Blue cross doesnt cover the ds. it sure does because
that is the insurance i have. I had approval in 2 days. For me, the ds was
the best choice and I have no regrets.
— C. L.
February 5, 2002
— Donell D.
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