Why isn't the DS a more popular choice?

Voellinger trained with Gagner I believe.

 I have been researching wls for a long time and finally got the process started last Spring. Dr Sudan is going to do my DS and while he isn't a barrel of laughs he is a wonderful doctor :D  I talked to Dr Smith's office too and they were really helpful but because of insurance I went to Durham.

I have heard not very nice things about Dr Voellinger and the DS so unless something has changed with him I would steer clear.

Good luck on your journey...if you want to come talk to some other NC DS'ers we are on Facebook...give me a PM and I'll steer you in the right direction :D

I think that not only is it a more specialized surgery that requires more time and te*****ue from the surgeon, it also requires a complete commitment from the DSer. You have to take lots of vitamins for the rest of your life, you have to monitor your labs like a hawk,  you have to increase your protein and stay well hydrated (100+ OZ a DAY) and above all you have to be a self advocate!

Im not a DSer yet, but i will be soon and have already experienced some of the things that will be required of me later.

So even tho this is the best surgery out there for long term weight loss, it is not going to work for anyone who is not truly 110% commited.

Yes and I do think that there is not enough information out there for the DS:)

I think the complexity from an operational standpoint is a large part of it.  BUT I think the bigger issue is the litigious nature of the states and the fact that non compliance is a very serious issue.  If a patient is non compliant, and it may be difficult to ascertain who will and will not be compliant, they risk serious complications and death. 

That being said I did not know anything about the DS until my information seminar where is was casually said that this was the Cadillac of WLS.  When I looked into it further I knew it was the only choice for me in terms of WLS.

Follow the money...some insurers don't cover the Ds, or have bmi or other requirements for it that are totally unrelated to evidence based medicine. These can be appealed, but not everyone knows this or is willing to go to the extra effort.
     So from the surgeon's point of view, it's easier not only to do RNY, but also to get paid for it, the amount paid is about the same for less work...why bother?
     However, from the patient's point of view, it's pretty sad that people are not offered the wls with the best results for excess weight loss, best maintainence of that weight loss, and best resolution of almost all comorbidities. 
     Oh, and I would run for the hills from any surgeon who does the mini gastric bypass, which is (see a theme here?) quicker and easier for the surgeon but with potentially very serious complications with bile reflux that are NOT a risk of the standard RNY gastric bypass. To my knowledge this operation isn't covered by any major insurer, and rightly so.

Larra

 Follow the money.....exactly what I was going to say.  Those surgery 'mills' are like cattle calls and WE are the cattle.  A Nissan dealer is NOT going to sell you a Toyota.  Even if the Toyota will better meet your needs.

Why isn't the DS more popular?  Easy.  It's not as easy to get as the others.  When you're fat and disgusted with yourself, you finally make the decision and accept the fact that you can't do it on your own,  you just want to get it done.  Today.  Instant gratification and all that.  You just call up the doc who did your cousins nephew and sign up.  Chances are you are signing up for a RNY.  Or even worse, the band.  Those docs are conveniently located on every corner.

The only people who find out about the DS are those who are smart enough to do their research.  That's probably a good thing because DSers have to be smart and capable of self advocating.  The DS has the best results.  Period.  It usually CURES type 2 diabetes.  Period.  We have the most normal postop lives and we can still eat like normal people.  Why would anyone choose something else?  We suffer the least for the best results.

Most have to travel for the DS.  There isn't a doc with pretty, glossy, marketing campaigns on every corner.  But here's the real deal.  The pain and inconvenience of surgery is very temporary, but you have to live with your choice for the rest of your life.  You get to pick.  Temporary inconvenience with great results forever, or settle for an 'easy' surgery and live with the long term downsides.

One of the things I picked up on while researching (I am 2 weeks post-op) is that people thing the RNY risk of dumping syndrome is a good thing. They think it will make people choose not to eat carbs. Some people purposely chose RNY for that reason.

*like* 

I don't understand masochism.  I purposely wanted a surgery where I could have the most "normal" diet possible.  For me I know that type of deterrent wouldn't work long term.   

Oh and dont for get the DS is a "newer" surgery, 1st one performed in 1988. RNY has been around since 1967. So it will take time to get surgeons trained and also to show more long term results of the DS (well that just my opinion!!!)

I agree with the other posters.  I think there is a large combination of reasons why the DS is not more popular.  I know quite a few people that have had WLS (2 are nurses) and non of them ever heard of the DS when they had their procedures.  So imo that means there are a lot of surgeons that do not even bring up the DS!  I think someone posted a while ago about a lawsuit because a surgeon did not offer it to patients.   

I've seen a few comments from pre-ops stating they are afraid of all the supplements that need to be taken post-op.  Remember with any malabsorptive procedure you must get in proper supplementation or you run the risk of developing malnutrition, vitamin deficiencies or other health issues.  Also some people are afraid or don't have the resources to travel to have it done because there is not a surgeon in their area.  Some people do not fight insurance to get approval for the DS, either they don't know how or are afraid to try.  

I've also heard some WLS surgeons (that specialized in non-DS procedures) or other specialists say they thought the risk too great on both a surgery risk and long term health risk.  I needed approval from my PCP in order to be covered by insurance.  I had to switch PCP's (because the old PCP was against it), have a couple appointments with the new PCP, and bring in lots of proof that I had well researched my decision.  I literally had to recite how the procedure was done, the risks involved, and post-op care (supplements, labs, bone density scans, etc.) before my new PCP approved me...that took 6 months!  

The list truly could go on and on...

~Roxy