DS one Surgery or two

Is the Duodenal Switch one procedure or two? I realize part of it is the vertical sleeve surgery but do they do the rest at the same time?

They're supposed to do it all at once. If they're telling you 2 procedures, they're hoping you lose enough with just the sleeve. I was a lightweight starting this journey and I'm so glad I got the DS done all at once rather than waiting to regain and having to go back for another surgery after being made to feel like I was a failure.

--gina
 

Sometimes it is necessary to do the DS in two parts for someone with, for example, severe medical problems who just can't undergo so much surgery at once. For the most part, though, it is done as one procedure.
     the sleeve as an intentional stand alone procedure has been done for several years now, but if someone is signing on for the DS, it means the whole thing, not just the sleeve.

Larra

 Ask your doc, but generally is all at one.  I had the same concern bc I was a revision from a Lap-Band (aka Crap-Band,) but he did it all at once.

 Unless there is a medical reason you cannot do it all at once, do it all.  Why subject yourself to twice the risks, twice the recovery, time off, cost, etc.  

Dr Kemmeter, said the D.S. should be done as one surgery. If done in 2 parts, the body doesnt lose as much weight. It is easier to get to goal with a full D.S. from the start. you run the risk of not getting to goal if done in 2 parts. my insurance- BCBS of Mi would only pay for one WLS in a lifetime, so I had no choice on 2 counts. I had the full virgin D.S., am 20 lbs away from my goal in 6-7 months post surgery. Happy I had it all done and over with in one procedure !!!

Hi Sandra,  I'm very interested in Dr. Kemmeter's opinion.  Can you (or he) direct me to any longitudinal studies, or any other research, so I can read more about this?  Thanks,  Mary  C

 Hi Mary,
I can ask my PA to send me any studies, if there are any. May be Dr.K's many years of experience with his own findings that lead him to this conclusion. I am always searching for more technical information about the D.S. and would like to learn more too. Thanks for your interest.

Hi Greg,
If you have a lot of weight to lose, then Dr.'s prefer to do it in 2 stages. I believe I read that more co-morbidities make the surgery riskier than it already is and it can also be more difficult to navigate laproscopically if there is a lot of excess weight.  If Dr. Hong wants to do the surgery in two stages, maybe you could ask him if an open DS could be done to make it easier and result in less time under anesthesia than if done laproscopically.  If someone didn't have a lot of weight to lose but wanted the DS, I would do my best to argue for a single stage procedure, as I have also read the same article that says that weight loss isn't as rapid if done in two stages, the metabolism changes.  Lightweights also run the risk of not being approved by OHIP, in Canada, if too much weight is lost with the first stage sleeve procedure, so a virgin DS (the DS in one single stage) would be preferable. I don't know about the U.S. but the sleeve is done as a stand alone procedure in Canada.

 Can you guys please point me to the study that says you will not lose as much if you do the DS in two steps?  I had the sleeve in 2009 but have lost much less than what I needed to - only about 75 pounds.  I am considering converting to a DS, but I sure don't want to go through all that if I'm once more not going to lose the weight.  I had researched this issue back in 2009, but saw nothing suggesting that 2 steps was an issue with the ultimate amount of weight lost back then.  And it is very common for people with very high BMIs to have the DS as a two step procedure.  I have to say that I really wonder whether any such evidence exists - hoping it doesn't.