Question:
What does RNY, DS, BPD, VBG & LAP RNY stand for? Please help.

   — Rebecca B. (posted on October 24, 2000)

October 24, 2000
They are all different types of Gasrtic Bypasses, but I am not sure what BPD stands for. RNY= Roux-en-Y DS= Duodenal Switch BPD= ??? VBG= Vertical Banded Gastroplasty LAP RNY= Laparoscopic Roux-en-Y I would tell you exactly what I know but I don't want to give you any wrong information, some of the other more knowledgable people can answer that part. Good Luck!
   — imano1momy

October 24, 2000
BPD=biliopancreatic diversion
   — [Deactivated Member]

October 24, 2000
RNY is currently the 'gold standard' of gastric bypass in the US. It stands for 'roux-en-y' and is the same procedure as 'lap rny'. It can be done 'open' with one large incision rather than with five small holes and instruments (this is lap, or laparoscopic, surgery). The RNY involves creating a pouch out of the upper stomach (the stomach is either stapled in half or 'transcected', actually cut in half and stapled. This is considered better b/c there is less risk of leakage. If you chose RNY - be sure to ask your surgeon about this). A portion of the small intestine is attached to the bottom of this pouch. The area between the new 'stomach pouch' and the intestines is called the 'stoma'. Since the pouch is so small, one really has to chew food very carefully b/c it won't be processed as much in the pouch and food particles can block the stoma. One can also experience 'dumping syndrome' (sweating, dizziness, nausea) when eating sweets or other foods. There are more restrictions on what one can eat with the rny, but many find this a positive reinforcement. The lower portion of the stomach remains, but doesn't process food (it only provides acid, etc. into the intestines). An RNY can be either proximal (short), medial (in between) or distal (long). This refers to the amount of intestines that are bypassed. The greater the length bypassed, the greater the risks of malapsorption and need for vitamin supplements. Now, BPD stands for 'billio-pancreatic diversion' and is an older surgery that carried pretty heavy malapsorption risks. D/S (or duodenal switch)is a revision and improvement of the bpd (it is also referred to as 'BPD/DS'). It is more popular in Europe and not as many surgeons perform it in the US. It can be done laparoscopically, but even fewer surgeons are capable of doing it this way since it is more complicated/invasive than RNY. It involves the partial removal of the stomach. The stomach is cut length-wise, leaving the pyloric valve (the natural valve between the stomach and small intestines) intact. Thus, the stomach is made smaller, but it isn't as small as the RNY pouch. The 'bypass' is made lower in the intestines and a certain amount of the 'common tract' (where fat is absorbed) is bypassed. Thus, the BPD/DS is both a restrictive and malapsorptive surgery. I've heard of the possibility of 'medial' bypass with D/S, but many say this really defeats the purpose since the stomach isn't as small as RNY and the malapsorption is needed to maximize weight loss and maintain it. The amount of common tract bypassed depends from doctor to doctor and individual, but it is almost always considered a 'distal' procedure. There aren't restrictions like the rny, but some experience loose bowels, odorous gas, etc. when eating certain foods with bpd/ds. Usually, varying diet helps this. Those who have experienced serious gastro-intestinal or colon problems pre-surgery may not choose this procedure because their symptoms *may* worsen. One has to be especially careful with vitamin supplements, etc. so as not to become anemic or experience other serious deficiencies. This would be true of a proximal RNY as well. :) There isn't as much information readily available about BPD/DS, so if you want to learn more, www.duodenalswitch.com is an excellent source of information! It also has background information about the BPD, which is not performed and how the BPD/DS is an improvement over it. NOw, the VBG is something I know little about -- it stands for 'vertical band gastroplasty' and is the least invasive of all the surgeries. It involves a band which tightens around the stomach to create an artificial pouch. It is a purely restrictive procedure. I've heard of more VGB's 'failing' long term (that is, weight loss isn't optimized or after the ideal weight is maintained, it can't be sustained). Of course, this varies by individual, their eating habits, exercise routine, etc. There is something called the 'lapband' which hasn't been approved in the US, I think. The other procedure I've heard about is the 'mini-bypass'. However, it seems a little risky in that it *may* be a version of an older loop surgery. It is advertised as being the least invasive (requiring only a one day hospital stay) and having good long-term weight loss and maintenance results. You can check it out at: http://clos.net/ Hope this helps! :) All the best, Teresa
   — Teresa N.

April 30, 2003
Someone posted that VBG (vertical banded gastroplasty) is a band around the stomach. This is incorrect. The band around the stomach is called the lap band. VBG is where a part of the stomach is stapled off creating a small pouch, but it is does not have as good a results and RNY.
   — Tabatha W.

April 30, 2003
Tabatha - actually, the VBG does involve a band around the stomach. This is from HUP's website at http://www.uphs.upenn.edu/surgery/bariatric/procedure.html : <p> Vertical Banded Gastroplasty <p> Vertical Banded Gastroplasty is a procedure that is performed to restrict food intake. This procedure reduces a normal sized stomach into a small pouch by partitioning the stomach with staples. At the lower end of the staple line, a permanent band is placed at the bottom of the pouch and acts as a sphincter into the remainder of the stomach. It is a purely restrictive procedure and does not induce malabsorption. The band causes food to be retained in the smaller stomach for a longer period of time. The patient feels full for a longer period of time, and tends to eat less. Patients must chew their food well and avoid high calorie liquids. <p> You are right that, in general, VBGers do not have as much weight loss as RNYers. However, I will caution you that everyone is different. A friend of mine, Dave Levy (an Obesityhelp.com member), had an RNY on 4/17/02 at the weight of 711 pounds. Dr. Williams at HUP decided to perform the VBG first to get same weight off Dave (because the VBG is a shorter operation, Dave would have less risk on the table). And then when he stopped losing from the VBG, Dr. Williams would (will) perform a revision to an RNY. However, Dave is still losing - over 240 pounds so far in the last 12 1/2 months!!! In a way, he is disappointed because Dr. Williams will not perform the RNY until he has stopped losing weight...JR
   — John Rushton

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