Considering Options...

I am still preop and I am looking at all of my options... What was it that drew you to DS vs VSG or RNY? Any helpful info is greatly appreciated!

I worked in an office full of fat women. I was one of them. 10 of us had WLS over a 2 year period. 8 RNY, one band, and 1 DS(me). Fast forward about 20 years.

The band person never lost an ounce. Total fail. 7 of the RNY people are now as heavy or heavier than when they had surgery. Another fail. Today 1 of the RNY people and the one DS person(me) are still pretty normal looking.

I think the RNY is cruel. We adapt over time. The standard proximal RNY doesn't bypass much. Around the 2 year mark your body adapts to the bypass and many patients start gaining. The DS bypasses so much your body can't adapt completely. This is why DSers have the best long term results. The DS also has the most 'normal' post op life. There is nothing I can't eat but I still have to diet just like almost every other woman on the planet. I can gain weight.

But... There is a tradeoff. You have to be willing to take the supplements for life. I take a small handfull of pills twice a day. To me it's no big deal and it's a habit just like anything else I do every day. I took daily vitamins before surgery so it wasn't a huge adjustment for me.

Today I am 65 and still very healthy. I take no prescription meds and I can do anything I could when I was 25. I am happy with my decision. Now it's your turn. Choose wisely!

I will have to see if DS is an option for me. I am not sure who I will be referred to for my insurance so I will see if that's even a possibility! I always thought it was going to (only) be bypass or sleeve.

Thank you for your feedback!

I probably would have gone with the DS if my insurance covered it, but it didn't. It only covered bypass, sleeve, and band (that was five years ago, so I doubt it covers the band anymore)

I chose bypass over sleeve for a couple of reasons: 1) I had GERD, and surgeons usually recommend bypass for patients who have GERD. Sleeve can make it worse (certainly not always, but often enough that it's a pretty well-known risk), whereas bypass often improves if not outright cures it. Second reason is that at the time of my surgery, bypass was the gold standard and had more research behind it than the sleeve did. I was a little worried that the sleeve would end up being "Lapband 2". However, it's been around long enough at this point - and it's done enough - that it's proven itself. I don't think that would be a concern at this point. But because of my pre-op GERD, I'd still choose bypass if I had to make that choice today.

Thank you. You bring up many valuable points. I think with my BMI, when I see the surgeon he/she will probably lean toward bypass since I have more weight to lose

I had a co-worker who had the RNY just when I was starting my research. She lost about 100 pounds but never changed her eating habits so she slowly began to gain everything back. The more I learned about the DS the more I knew this was the right surgery for me (it was all about long-term). Any surgery with work as long as you are willing and able to make the appropriate lifestyle changes. The main thing with the DS is the LIFETIME commitment to vitamins, labs, eating right for the DS. You also have to understand the risks of the DS - iron deficiency anemia, osteoporosis, and other potential health issues related to malabsorption. Some people, no matter how compliant (me), still has to face anemia and osteoporosis. It's just the tradeoff I was willing to make. My primary pre-op co-morbidity was severe sleep apnea, which is now completely gone.

I'm 17 years post-op and I'm still at my goal weight. I had gained about 15 pounds a couple of years ago and with commitment, I was able to lose those 15 pounds and keep them off.

You have to make the right decision for you and your lifestyle.

I thought there were malabsorption issues with bypass too? and I know I've read in other places that supplements/vitamins are mandatory for life with bypass too? Same with labs, isn't it a requirement to get labs done yearly?

My priorities were 1) losing all the weight, 2) keeping it off, and 3) leading as close to a normal life as possible post wls. Eventually I had a modified version of the DS called a SADi DS. The guy who performed it is a wls rock star which may be as important as the actual procedure you have. All my objectives were met, but I do take some vitamins, and have to watch certain foods that cause gas or bloating. Ultimately you can be successful with any procedure if you work the program. I'm flawed enough that I need help even now almost 6 years out, which the wls surgery still provides effectively.

RNY malabsorption can change depending on the length of the common channel. In the old days they would refer to as either a proximal (standard) or distal RNY, the distal having a much shorter common channel. I don't think many surgeons do the distal anymore because with the RNY the pouch is so small that the combination of a very restrictive surgery with significant malabsorption is just asking for health problems. The sleeve part of the DS is much larger than the pouch of the RNY so you can eat more. I think the average pouch is 1 oz (at the beginning) while the average sleeve of the DS is about 6 oz.

I've known people who had an RNY who only have to take a multi-vitamin, and maybe some extra calcium or iron or D. Nothing like the laundry list of vitamins I take for my DS. Same with labs - I know a few RNYers and they all get labs done once a year (like me). My list of labs requires approximately 15-20 tubes of blood - this list comes from my DS surgeon's office and I will follow it.

Main differences between DS and RNY:

• Sleeve as opposed to pouch
• No bypass - my duodenum is still intact - no dumping
• Significant malabsorption

i had the ds 18 years ago it is called the rolls royce of ops here in Australia and my son has just had the moderfird version of it called sips he is 26 i think it is the best of couse im biased but it keeps the pyloric valve in where as the other ops dont that closes your stomach and you dont have dumping syndrome and reflux.