Which is better? DS or Lap Band???

I cant decide on the Duodenal Switch or the lap band.. I know the DS is much more riskier yet effective , and the lap band is just cool & there are no risks. I cant decide. Which have you had & what are the advantages/disadvantages. and thanx for answering

if you dont have any insurance, try to sign up for MEDICARE of texas. i was in your situation for years. then i saw someone who had medicare pay for their insurance. Medicare/medicaid covers wls. I applied for medi-CAL [californias version of medicare] and was accepted. so now i have full coverage. once you do this its a matter of finding a surgeon that accepts medicare. im not sure how its run in texas, but in california you must apply through your county. http://www.hhsc.state.tx.us/Medicaid/ once you sign up for it go here http://obesityhelp.com/morbidobesity/selectdocsbystatetype.php and click on the state of texas and look for surgeons. not many DS or LAP surgeons accept medicare patients. though some do. i found one but the waiting list for an appointment is 6 months alone. you dont have that much to lose so LAPband may work better for you. i would like to get a DS myself but an rny ill take. just try and work on getting medicare/medicaid and learn as you go.

Felicia, it really depends on you as a person and what you think your mind and body is capable of doing... I had the lapband and your more then welcome to read it and see if it is something you can do... There is also a LapBand Forum, and people will answer anything you ask.. We are very nice over there and try to help everyone as much as possible... I love that forum, I have yet to attend any support groups cause I know I can get all the support I need with the group of people who lurk at the WLS Lap-band Forums. Also, Gus just asked me why I picked Lapband also in another subject title... You can read my answer here: http://www.obesityhelp.com/morbidobesity/amosforums/any_wls_regrets/postdetail/126.html?vc=0

Wow, Felicia! Those two procedure could't be any more different! DS is a procedure that is typically reserved for those with super morbid obesity meaning at least 200 or more pounds overweight. It has dramatric results but can have dramatic effects on your metabolic status as well. In DS, more of the intestine is bypassed than any other procedure, meaning more malabsorption. Here is the breakdown: Lap BAnd - restrictive only. It restricts the amount of food you can eat at any one time. If you eat solids, you can only eat about 3-6 ounces at a time. If you eat liquids, however and like sugary liquids such as shakes, malts or other high calorie/ high sugar substances like cola, you can actually defeat the band. Gastric Bypass - malapsorptive and restrictive. It restricts the amount of food you can eat at one time to about 3-6 ounces AND it reduces the amount of food that is absorbed by your body. It reduces the amount of fat that is absorbed, but also reduces the amount of vitamins and nutrients that are absorbed. Thus, you have to take a multivitamin and calcium for the rest of your life. Even if you are a sweets eater, it is difficult to overcome the gastric bypass because overeating on sweets causes dumping syndrome which is an uncomfortable side effect of gastric bypass. Due to the rapid transit of the foods through the intestine, the sugars will not be tolerated well. You will get sweaty, have racing heartbeat and feel like you are dying. A few episode of that and you will no longer be a sweets eater. Duodenal Switch - very restrictive and very malabsorptive. This is the "last resort" of most patients. It produces extreme weight loss because you are absorbing very little of the fat, nutrients and vitamins of the food you eat. Depending on your weight and risk factors, this may be a consideration for you. It is only performed by a few surgeons in each state and candidates are carefully screened. Even Bariatric Surgeons are very particular in whom they choose for this type of procedure. Please check out ALL types of procedures before making your decision. Good Luck. If you want more information on the gastric bypass, I am the bariatric coordinator for the Obesity Surgery Center of Louisiana (www.obesitysurgeryla.com). You can check our our site. I know, for instance, that my doc, Keith Chung, M.D., always educates his patients on ALL procedures available prior to offering one or the other. You may not have a second chance, so be informed. Good Luck! Marcie Obesity Surgery Center of LA

Don't listen to this lady. She works for a surgeon who does the RNY, so of course she's gonna put down the DS and Lap-band simply because her boss doesn't perform these proceadures. It's also pretty obvious that she really doesn't know that much about the DS, because she is incorrect about almost every thing she said about it. With the DS, It's LESS restrictive because you still have a real stomach, just much smaller. With the RNY you have a tiny pouch about the size of a thumb.. And anyone who qualifies for an RNY or Lapband would also qualify for the DS. It is NOT reserved for ONLY people over 200 pounds nor is it anymore a "last resort" than any other WLS surgery. About the only thing she IS right about is that the DS is not performed by near as many surgeons as the RNY is. Obviously the surgeon she works for is one that does not perform the DS. I'm certainly not telling you what surgery to have, as it's a decision YOU have to make. As for me, I had the DS and could not be happier.. I feel wonderful with NO complications. Just do A LOT of research and get your info from NEUTRAL sources.. Asking a surgeon who only does RNY's about the DS is like... Asking a Ford dealer what he thinks about Chevy's.. Or the Cable guy what he thinks of Sattelite TV... See what I mean?? Good luck on whatever you chose. If you need any more truthful info about DS, ask us..

Mike, I am sorry that you saw my post that way. I was trying to offer sound advice about the advantages and disadvantages of each procedure. As I read in your biographical section, you too, had doubts of the Lap Band due to slow or insufficient weight loss. As I said, the RNY and the DS both have a significant higher amount of expected weight loss. As for my comments about the DS - the surgeon I work with performs ALL types of weight loss surgery. However, as you will see from the documented study in the Obesity Surgery Journal, DS DOES carry a higher amount of malabsorption than does the RNY. This is why most surgeons will reserve this procedure for only those patients who clearly understand the risk and are dedicated to following strict guidelines of taking daily multivitamin, calcium and iron if indicated as well as participating in regularly scheduled laboratory testing to ensure prompt identification of any abnormalities for quick resolution. I was not recommending or disuading any procedure. Each procedure is a good procedure for the RIGHT PATIENT. Proper selection and education is necessary to ensure that the procedure you choose is the right one for the individual and that all necessary precautions are understood and taken by the individual. I am glad that the DS is right for you. It is not that way for everyone. We are revising just as many DS procedures as we are RNY and Lap Bands. I did not mean to offend you. You seem to be well educated about the possible risks and complications of the procedure, so clearly you chose and made an EDUCATED decision. I was simply trying to offer her the same opportunity, not trying to sell her a Chevy or a satellite. I will be more careful in my wording from now on....thanks for putting me on notice. Marcie Title: Nutritional Markers following Duodenal Switch for Morbid Obesity Author(s): Robert A. Rabkin MD, FACS ; John M. Rabkin MD, FACS ; Barbara Metcalf RN ; Myra Lazo MS, PA-C ; Michael Rossi PA-C ; Lee B. Lehman-Becker BA Source: Obesity Surgery Volume: 14 Number: 1 Page: 84 -- 90 DOI: 10.1381/096089204772787347 Publisher: FD Communications Inc. Abstract: Background: Laparoscopic duodenal switch with gastric reduction (LapDS) is a minimally invasive hybrid operation combining moderate intake restriction with moderate to high malabsorption for treatment of morbid obesity. In LapDS, both the quantity of food ingested and the efficiency of digestion are reduced. Methods: A cohort of 589 sequential LapDS patients had laboratory studies drawn annually. Serum markers for calcium, iron and protein metabolism and for hepatic function were analyzed using SAS statistical software. Results: There were 95 men and 494 women. Mean age was 44 years, mean BMI 50 kg/m2 and mean preoperative weight 142 kg. Although mean hemoglobin decreased below reference and mean parathyroid hormone (PTH) increased above reference, both hemoglobin and calcium in LapDS readily returned to within the reference range following supplementation with iron and calcium respectively. Mean iron, corrected calcium, alkaline phosphatase, albumin, total protein, aspartate aminotransferase (AST), alanine transaminase (ALT), and bilirubin remained within the normal range. Conclusion: LapDS, is not associated with broad nutritional deficiencies. Annual laboratory studies, which are required following any type of bariatric operation, appear to be sufficient to identify unfavorable trends. In selected patients, additional iron and calcium supplementation are effective when indicated.

First off, the DS is not as scary as some make it sound. If you have a good surgeon, and you are willing to comply with taking supplements the rest of your life, you will live a long, healthy life. It is not reserved for only the super-morbidly obese. Anyone with a BMI over 40 or 100 lbs. overweight can have a DS. A lot of surgeons will discourage the DS because they don't perform it, and they don't want to lose your business. That being said, choosing between the lap band & the DS depends on your situation. How much weight do you have to lose? What is your expectation of eating quality after surgery? Do you tend to eat a lot of carbohydrates? The lap band is NOT without risks. A Detroit city councilwoman died several days after getting a lap band two years ago. However, it IS less risky than a DS. Of couse, I went with the DS. The advantages are: larger % of weight loss, smaller chance of weight regain & I can eat carbohydrates on occasion. The disadvantages are: daily supplementation, smellier BMs & a chance of diarrhea on a more-than-normal basis. These disadvantages have not been a problem for me so far, except for smelly BMs, but doesn't everyone's sh*t smell? LOL With the lap band, the advantages are: no bathroom issues, easier recovery, and easily adjustable. The disadvantages are: less weight loss, difficulty eating meats/proteins, vomiting, no malabsorption of carbohydrates. I'd base my decision on how much weight I had to lose. If it was less than 100 lbs, I'd go with the lap band. If it is more than 100 lbs, the DS is more likely to get you to goal. Good luck. I'd love to hear what you decide!

I don't understand why people think weightloss with the band is less. There are people out there that reach goal and stay with it when they get the band. As for eating issues, the worst offenders are bread and rice. Studies show that at 2 years out both RNY and Lapbanders have the same weightloss although lapbanders lose slower at first. There are people that beat RNY, after a while the body compensates and people will regain. As for the Lapband, there have been reported 5 deaths, one on the table with heart attack and the rest had a problem and didn't go to their surgeon to have it fixed. That is 5 deaths since 2001 but I've seen at least that many here on the board with RNYers since January 2004 and read of many more that have been in ICU for months after the surgery. Also there are RNYers that have regained too much weight and have had the Lapband placed to help lose the weight again. With the lapband you can have it 'tightened up' for years to come if you start to regain, the 'window of opportunity' for weightloss with the RNY is within the two years, after that you are back to exericse and diets. Yes, RNY is a weightloss tool also but some think that they can eat whatever they want and not worry about nutrition because they won't absorb it anyways. When the body levels out this type of eating will cause weightgain. Yes, if you are a devoted milkshake drinker or eat ice cream by the box full you will defeat any WLS in the long run. I'm basing my weightloss on the Lapband being the safest thing around right now and if something in the future comes up that is better, I can have the band removed and do the other WLS or pill.

I started out wanting the Lap Band, and in my mind, I wouldn't even consider anything else. Then, I found that insurance wouldn't cover it. During the "research time" I met people that had the DS. I also had a consultation with a very skilled DS surgeon. So now, I am glad I could not have the band. The weight loss is less. I could not stand vomiting if I ate a bite too much. I am 5-9/292 BMI of 43, and he said the open DS would be the "most reliable surgery for me." I chose not to have it laparoscopically as that would more than double the anesthesia time.... Again, a few months ago I would never have considered this route, but I have tried to keep an open mind and trust those that have gone on this journey before me. Good luck with your decision!! Sheryl E./Omaha

Hi, Like you I was considering the DS. When I first started researching WLS that is all I would consider, it sounded so good, but after checking out this website: http://gastricbypass.netfirms.com/rnyvsds-wesclark.htm and then learning of the band I knew that was the only choice for me. Any decision you make has to be a personal one. My best advice is research, research, research . At this point in my life I was not willing to accept the risks of the RNY & the DS has even more risks & they are much more serious & I have 2 small children to live for. Good luck w/whatever decision you come to. Candi