Newbie question for the guys: RYN vs. DS..What's the difference?

I'm a 39 yrs old guy from Ontario Canada. I'm married. Have a 3 yr old son...(Love them both lots!) I am 5' ft 10'' and weigh about 300 lbs. (BMI about 42)...I also have Sleep Apnea.... I am seriously considering WLS... Newbie question for the guys: RYN vs. DS..What's the difference? In asking this question, I'm specifically interested in understanding more about the differences in 1) "risks" 2) "success rates" and 3) "Post-op lifestyles"... Also, Why is there a "wierd rivalry" between folks that had RYN vs. DS?? (Very odd...) I asked this question in another forum and got a TON of responses! (RYN is best, no DS is Best, RYN is best, No DS is best...) What's up with that?  The message of hope and support REALLY gets lost in that debate... This is a very helpful forum...Thank you!

Thats a touchy subject in some part of OH. From what I have read and I am sure you will get more detailed responses BUT the DS removes 75% of your stomach and removes it. That eliminate the ghrelin hormones, thats what makes you hungry. real hunger not the dreaded head hunger. The rest of the stomach stays in tact. With the RNY they cut the stomach but it stays inside you and they essentially make a new small stomach. Both bypass alot of the intestines, Both require a serious vitamins regime and dedication to the process IMO you need to look at the VSG as well, at a BMI of 42 you're a relative lightweight and the VSG while new has been very successful. It removes the stomach just like the DS but there no bypassing the intestines. Still requires work on your part but less malabsorbtion and fewer vitamins required. RNY from a Surgeons website  http://www.lapsf.com/roux-en-y-gastric-bypass-weight-loss-su rgery.php DS http://www.lapsf.com/duodenal-switch-weight-loss-surgery.php VSG  http://www.lapsf.com/vertical-gastrectomy-weight-loss-surger y.php Everyone thinks their choice is the best choice AND IT IS  FOR THEM, all you can do is research and read, talk to Drs and make your own decisions based on the info you have researched.  Good Luck

  A very fair and balanced explanation of the differences, btw ..       The only thing I would add is to be careful when evaluating information from a particular surgeon's website - they may have a vested interest in one form of WLS over another (either b/c they don't do or don't prefer to do the other, or can make a higher margin of profit on the ones that they do perform!)    As to a quite full explanation of DS and a comparison of it to RNY (and not from a particular surgeon's website) check out    http://www.duodenalswitch.com/procedure/procedure.html     Good luck on whichever form you may decide to go with ..

For the longest time up until very recently, I was wishing I had gotten the DS instead of the RNY.  When I had the surgery, DS wasn't offered anywhere near me. However, now that I look back, I'm glad I got the RNY.  Some info has recently come to light about potential problems with the DS for people who suffer from depression.  Since I've been diagnosed and am being treated for major depression, having the DS just wouldn't have been worth the risk for me.  The DS is completely irreversible.  A good portion of your stomach is gone.  If the depression problems had turned out to be real for me, I would have been screwed. Also, food had become an addiction and a crutch for me.  It was an addiction I had to break.  The RNY helped me do that.  Plus, when it comes right down to it, I can eat absolutely anything I want, just smaller amounts.  While this isn't the norm for RNY patients, it worked out well for me.  Now, I probably would have lost weight more quickly if I were able to dump, but I never had, no matter how much sugar or fat I eat. Now, while a several DS'ers over on the DS board will claim (and have claimed) that I'm just in sour grapes mode, or that we RNY'ers "just can't handle da truth that the DS completely RULZ!!!", that's just not the case.  Pretty much anyone that takes that attitude about ANY kind of surgery, you can dismiss EVERYTHING they have to say about the subject (or any subject) out of hand, and with extreme prejudice. Bottom line, DS is better for some people.  RNY is better for others.  VSG is better for others.  Lap band is better for still others.  Figure out which group you belong to before you commit to a specific surgery.  In retrospect, to be honest, I lucked out with my RNY.

Just  slight corrections..... The person that posted on the main forum about the DS/VSG and bipolar disorder/depression, posted information from a very unreliable source, and there has yet to be any study that directly corrolated the DS with any problems.  I posted the link in case you wanted to read the commentary about it on the DS forum: http://www.obesityhelp.com/forums/DS/a,messageboard/action,replies/board_id,5357/cat_id,4957/topic_id,3461513/ BUT...here's the but, any malabsorbtion surgery that has the potential to cause vitamin deficiency can lead to psychological issues.  This is for both the RNY and the DS.   If you google vitamin deficieny and psychological problems, you will see a whole host of issues that can be caused by becoming deficient in 1 or more vitamin.   Also in terms of the surgeries being reversed......The VSG part of the DS is irreversible...although the post op DS stomach stretches out over time, to hold a substantial amount of food...about 1/2 of the origional stomach.   The intestinal portion can be rerouted back to the origional way ...although in most cases the common channel is just lengthened.  The RNY, which claims to be reversible...is not always reversible.  We have had many RNY to DS revisions on the DS forum, where people could not get a VSG portion of the DS, because the surgeon found that when they tried to put the stomach back together, there was either too much scar tissue, or the tissue was too weak to be reconnected. ...meaning that in those cases that particiular person was forced to keep their pouch instead of getting the full DS. I agree though....some surgeries are better for some people then others.....personally I would have liked to have had just the VSG...but I was a failure as a dieter...and I knew I needed restriction and malabsorbtion. Scott

I've heard about the brain / stomach serotonin thing long before that post on the main board.  I've also been looking for suicide statistics on the different types of WLS, but unfortunately, I haven't found any.  If it turns out there isn't any correlation after peer reviewed studies, GREAT!  If I ever need a revision, I'll go with the DS.  However, since the DS is irreversible, that is something that gave me pause, given my history already with major depression. Now, if I hadn't battled depression most of my life, I wouldn't be worried about this issue in the least.  Getting the RNY gave me pause considering the list of possible complications.  However, it ended up being the best choice for me. And I'm very glad your DS is working out well for you, sir!

I have read articles that suggest that post op WLS patients are more likely to commit suicide and/or die as a result of dangerous activites.   I have a theory on that...... I think in general WLS can be a let down for most people.  Not that our lives aren't infiinitely better post op...we are more mobile, we are freed from the slavery of having to buy all of our cloths at the casual whale, women find us more attarctive..and in some cases men too...lol.   But with all of the "pluses" that come with losing weight, I think many go into WLS with the idea that being thin means you are happy..and being fat means you are sad.  Even if on the logical surface  of our minds we say "oh no, I understand WLS won't solve all of my lifes problems", I think there is a certain amount of brain washing that we have had  as americans....from TV, news papers ads, tabloids..that have convinced us that  thin equal happy.   When you get WLS and lose weight, you eventually hit a "bump" in the road where you say...hey WLS didn't solve all of my life's problems.  People start to realize that not every issue in their lives is realted to obesity, but in some cases the obesity was a symptom of their other problems.   Bad marriages dont' get better because you lose weight, some health conditions don't improve, and in general most people's life out look doesn't change they are the same fat person in a thin body. What WLS gives you is the opportunity to change and the opportunity to be happier.....and sometimes realizing that it's not a given is a let down.  Scott

I've seen the same studies, that WLS patients are sometimes as much as 7 times more likely to commit suicide... I think.  I may be remembering the wrong study.  Anyway, I'd like to see the numbers broken out by type of WLS.  Hopefully someone will eventually do said study.

I read the articles she posted as well. One thing that I haven't seen mentioned is that the mortality statistics were listed for "Accidental Death and Suicide", vs  natural causes or diseases in the control group. We have two groups they're comparing, group A is obese people who have had WLS and group B is obese people who have not. More people in group B have died from medical issues than group A. More people in group A have died from accidents and suicides than group B. So first of all, it's not just a "higher suicide" rate with WLS patients. It's accidents too. But if you think about it, this could just mean that group B people tend to die sooner because of medical issues related to being overweight, and don't have the same time to statistically die of accidents or suicides. In fact, I really don't think you can draw any strong conclusions from this one study.

Scotty make a really good point here.... if anyone presents RNY as reverible they are doing a great msinformation... where technquely RNY is reversible, it is a big, big operation, and would only be donein extreme conditons....as would the reversible portion of the DS My personal opinion...if you are thinking about any WLS and an important part of your decision is that it is reversible ...I don;t think you are a good candidate for WLS..you need to be commited.. Russ