Lap band vs. the Switch

Just when I was positive I wanted one, after going to my information seminar, seeing my surgeon and getting the ball rolling per insurance requirements I'm now wondering about a diff wls.   Has anyone here has the duodenal switch?  I'm thinking it sounds a little less limiting to me via the doctor visits and such, as I don't know how long I will have insurance to cover medical visits after I get to my goal weight as hopefully the weight loss will make it so that I can get off of disability and go out and have a "normal" life.  Not many places can you find good health insurance that will cover anything pre-existing.  Thus, my thoughts are turning towards the Switch.  Can anyone tell me more about THEIR experiences with this?  Special diet after the surgery, successes, problems,  side effects they have experienced, etc.  I have done some research and have started doing a pros/cons page for both the switch and the band.  Grrrr....just when you think you know something.   thanks!   Laurie

Hi Laurie, you might check out the DS board. You can find out how they live. A duodenal switch is the most drastic of all the procedures. It works totally by malasorption. You have diarrhea and more difficulty with vitamin deficiencies. There are also other bad side effects with this surgery.  Do your research before deciding. Not many surgeons do this surgery. Good luck. Mona

Hi Mona,  thanks I will check them out. Actually my surgeon does do this surgery, he is the one who brought it to my attention and talked about it.  I live with some of the problems already that it entails so wouldn't be that much of a big deal to me.  I will do more searching.   Is there a reason that it isn't popular?  I know that it really is just the opposite of an RNY and that one seems to have malabsorption problems as well.  So why would the DS be worse than the RNY?   Laurie

Mona, Your information is not supported by what I'm hearing from people on the DS board, or the information I received from my surgeon. Do you have evidence to back this up? The DS works through both restriction and malabsorption, as does the RNY, only the malabsorption is greater. The side effects MAY include loose stools (usually from too many simple carbs) but  uncontrollable diarrhea is not expected. There is NO dumping syndrome, which seems to me to be a much worse side effect. Please don't discourage people from exploring all possibilities based on a lack of understanding. Had I taken your advice as gospel, I would not be scheduled for a DS. After researching all possible surgeries, I know now that the DS is the one best suited for me. I urge you to follow your own advice and spend some time on the DS board, learning the facts. Many people on this board consider you to be the resident expert, and I urge you to fully educate yourself on this choice, or to simply refer people to the DS board without adding unfounded negatives. Omaha has two of the most well respected DS surgeons, Dr. Anthone, and Dr. Sudan. Their contact information is listed in the "Find a Bariatric Surgeon" area, and I urge anyone interested to check them out. Dr. Sudan works at Creighton, which is a Medicare Center of Excellence. Dr. Anthone is expecting his COE certification soon. RJ

Hi RJ, I am not saying one surgery is better than another. I am saying that Laurie should do more research before making a decision. DS is a major surgery with a potential for more complications than banding and bypass. I feel you should be informed of all risks before risking your life having wls. Mona

I am not so sure that the DS has a potential for more complications than banding and bypass.  Perhaps different complications but more I am not so sure.  What are you basing this on?

Hi Mona, This is the part of your quote that is inaccurate and ruffling: You have diarrhea and more difficulty with vitamin deficiencies. There are also other bad side effects with this surgery. Your statement is too absolute and a little misleading.   The more correct version of your statement would be: "You have controllable loose stools and have to be very compliant to take a lot of vitamins.  There are also some other side effects that are dependent on the food that you eat that can be controlled." You're doing so well with the band, so I'm sure you have a lot to offer on that subject and that advice would be extremely valuable.   I'm sure you're not telling potential bandsters that the band is going to slip to a place where the only thing that can be done is surgically remove it or their stomachs will grow around the band and it will erode into the body.  These are two examples I've seen first had from people I know first hand, but knowing that these are isolated incidents and not the norm, I'm not sending messages of doom to everyone interested in the band.  Instead, I ask them to consider their own physiology and determine if restriction is all they need.  If so, it's the quickest and least complicated way to achieve their goal. That's all we ask from you about the DS.  If you really are curious and would like to know more about it, I invite you to come to the forum and ask questions or just lurk around.  Working together, we can help these newbies select the procedure that will help their individual situation and be the most successful.

Would you please contain yourself to your OWN surgery and stop spouting misinformation, please? I'll do my best to do the same. Thank you.

You are wrong.  The DS is both a restrictive and a malbsorbtive procedure.  The restriction comes from the partial sub gastrectomy (vertical sleeve gastrectomy) and the malabsorbtion comes from the re-routing of the intestines. Not everyone who has the DS has diarrhea, nor does everyone have vitamin deficiencies.  These two "facts" are myths about the surgery.  There are some people who experience these sorts of issues but these folks are not the majority.  And I am not sure to what you are referring when you say there are other "bad side effects with the surgery." I would urge the OP to post their questions on the DS board.

Hi Mona, Please, please ... don't give inaccurate info to newbies who might take your misinformation as "gospel truth" DS works by both restriction (the vertical sleeve gastrectomy) and malabsorption (the switch).   Diarrhea?  Maybe with the Biliopancreatic Diversion (an older, totally different surgery).  I think the whole Diarrhea issue is an overblown, urban myth.  I have less diarrhea now than I had as a pre op and I'm guessing if you polled the other DSer here on OH, you would find the same with the majority of them also. IMO, the DS is not more drastic, just more EFFECTIVE!  Late regain with DS is pretty much non-existent.  People get the DS and they are done.  No need to revise to another surgery because the DS just keeps on working!!  There is not necessarily MORE difficulty with vitamin deficiences, just DIFFERENCES.   DSers can get all their protein with FOOD.  No B12 problems because our stomachs secrete intrinsic factor.  I do heartily agree with you on researching BEFORE deciding.  But make sure the information you've been given is not a "sales pitch" by a doctor not performing that procedure.   IMO, peer reviewed medical literature is best and is what ins co's read in order to determine if they will cover a specific procedure.   Laurie