Are D.S and Gastric sleeve the same thing ? How they different from the Gastric -By- Pass? .

   I was just wondering and try to figure out if D.S. is the same thing as the Gastic Sleeve.  And How much better are they  than just Gastic -By- Pass. 

How much more Dangerous are they?  Problem wise and Has anybody had any bad  medical complication with it.

 Do you really lose more weight with the sleeve?

   I know it is two different surgeries with the D.S.  But, Is it the same for the Gastric Sleeve?
 Does any know if Medicare paid for the D.S or Gastric Sleeve?

I know they pay for the Gastric -By- Pass.

One good word of advice, check the Forums that are specifically for these different surgeries.

VSG is Vertical Sleeve Gastrectomy - dumbed down to what I have learned - removal of 85% of the stomach, no involvement with bowel modification, and depending on surgeon, has success of 60 - 80% of EXCESS weight loss (if you have 100 pounds to lose, you should expect to lose 60 - 80 pounds).  My understanding, it is a lot like a permanent band without having a band - or pouch.

Now Duodenal Switch is an area I really do not have enough information on, so I suggest the DS Forum!  I have heard from some fabulous DS Patients, but it seems a little too excessive to me -- note: I said to me.  Many patients over 50 BMI are considered for DS because of the amount of weight they have to lose, and possibly a bad track record of losing effectively (no hate mail, please - I have stated I am NOT against DS).

VSG, from what two surgeons have explained to me, can be converted into a RNY, if the Sleeve is not "working".  I am unsure the process of DS, but it is noted as being a quicker procedure as far as losing "excess weight," but also takes more nutrition to meet your daily recommended nutritional goals.  It is extreme, so ask your surgeon/primary care doctor if you are in need of a more "aggressive" surgery.  Again, I am NOT saying DS is wrong, I am saying it works well for some patients.

VSG does NOT have "malabsorption," which is why I am choosing RNY.  I briefly looked at DS, asked my surgeon, and agreed RNY is my preferred surgery.  I have been diagnosed with having metabolic issues, so I need a certain amount of malabsorption, DS is a little too extreme (I already have Pernicious Anemia) for me.

Whichever surgery you choose - DO YOUR HOMEWORK!  This is a tool, not a solution to the problem.  You really need to look inward. What are your issues with weight? Are you able to be compliant with supplements & protein? Have you worked through eating/grazing/bindging?  Have you gotten a Psych evaluation?  Are YOU ready?  I have seen 17 friends go through various surgeries, and I pulled out of one program because I knew I wasn't ready. 

GOOD FOR YOU!  You are asking the RIGHT questions!  I hope you make a thoughtful decision & have GREAT sauces!!!  Oh, and if you haven't joined a Support Group or gone to a WLS Seminar, that is a REALLY good place to start your research.

Brenda  : )~

The VSG is a surgery where they remove a good portion of your stomach, and that's it.  The DS includes the VSG but they also reroute the intestines to make malabsorption.  There are pros and cons to each surgery of course.

I chose the VSG because I was/am a volume eater, not a junk food eater.  I like junk food but long ago changed my life and habits, but never could get portions under control for both physical and emotional/habitual reasons.

For those who have a high BMI, the VSG alone might not be enough to lose to goal.  I am not sure if I'll get to goal but I figure I'll give it a shot.  Some people find they can eat anything in smaller amounts, others like me have to eat a low carb diet along with the VSG to lose.

The DS pretty much guarantees weight loss, but also may have other unwanted side effects.  Since the VSG is essentially the first step to a DS, you can have the VSG done and then decide later if you want to add a DS. 

Some people say that it's a bad idea to get two surgeries and that the efficacy is not as good as if you start with a DS.  However I felt like I wanted to give the VSG a shot given my eating style.

I'm not sure about medicare, but these surgeries are becoming more well known and are being performed more often nowadays. Plus you could always file an appeal to get the procedure you want (and need).
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There are alot of misconceptions about the DS...Please check out http://www.dsfacts.com/ for more information.

The Sleeve (VSG) is a great surgery for restriction. There are less worries about malnutrition because you have a full functioning stomach which is now a small tube shape with no intestinal switch. If overeating is your main issue and you can follow a strict diet and exercise routine, then it may be a good choice for you. As the other poster mentioned before, the intestinal switch of the DS can be performed later if it is needed (to help get the weight off).

The Duodenal Switch (DS) is basically the sleeve stomach with a switch in the intestions, therefore restriction and malabsorbtion in one surgery. It is a good option for those of us who have a higher BMI and have metabolic or thyroid issues. It is also one of the best options out there for people with diabetes (cure rate is over 90% for type 2). You will hear stories about bad gas (and/or bowel movements), but it is not as bad as they make it sound (poop doesn't smell good) and it is very manageable by diet (you learn what your system doesn't like, very individual). High protein diet and requires lifelong vitamin supplements (as do the other surgeries). Basically of what we consume we absorb about 20% of the fat, 50% of protein, 60% of complex carbs (beans, veggies) and 100% of all simple carbs (bread, pasta, sugar). So you can actually eat, jus****ch your carbs if you want the maximum weight loss benefits.

Each surgical option has its pros and cons. Please do your research and pick the surgery that you feel you can live with in the long term. Also read the failed weight loss and revisions forums, I know that opened my eyes a bit.

Good luck!

I don't know anyone whose poop smells good... lol.

LOL...I know, the comments I read about DSer's BM's just kill me sometimes so I just had to say that.  I know with the malabsorbtion it can be a bit more pungent, but honestly nobody's BM's smell that great to begin with.  I find the whole thing kinda funny :)

I had the VSG and medicare paid for it. It all depends on how your doctor words the reason for the VSG over the Rny.