RNY -vs- DS
The simple reason is that the RNY is more easily performed and takes less time than the DS .. On the DS forum, we liken it to hamburger vs. steak .. Training in performing the DS is quite complex and not as readily available for surgeons .. Due to the complexity of the surgery, the DS usually takes longer to perform and, as a consequence, that = less WLSes per day, week, etc. that a surgeon can bill for, vs. performing RNYs instead .. Also, keep in mind that the RNY historically came first and was around for a long time before the DS, and as such was the gold standard for many years .. Ins. co.s seem to, in general, "trust" the RNY more as a consequence, but hopefully that attitude is changing. Some day maybe the DS will become the gold standard of WLS .. 
btw, the DS is also reversible, as far as the intestinal switching portion of the procedure, but is almost never needed. However, the sleeve is, like the pouch, of course a permanent "creation" resulting from removal of a good deal of the stomach. As to dumping, my thing for sweets makes me at times wish I had no pylorus like the RNY patients, but then I've read that the majority of RNYers in fact do not dump on sugars, so that would be a fairly weak reason to opt for the RNY, in and of itself, it would seem ..
btw, the DS is also reversible, as far as the intestinal switching portion of the procedure, but is almost never needed. However, the sleeve is, like the pouch, of course a permanent "creation" resulting from removal of a good deal of the stomach. As to dumping, my thing for sweets makes me at times wish I had no pylorus like the RNY patients, but then I've read that the majority of RNYers in fact do not dump on sugars, so that would be a fairly weak reason to opt for the RNY, in and of itself, it would seem ..
Frank talk about the DS / "All I ever wanted to be was thin, like that Rolling Stones dude ... "
HW/461 LW/251 GW/189 CW/274 (yep, a DS semi-failure - it happens :-( )
There is some strange belief that doctors have no idea what will happen 15 + years out from surgery, well thank GOD that is a lie. There are plenty of long term studies of the DS and RNY, you can check out www.dsfacts.com
In the two longest term studies long term (10 and 15 years out) DSers maintain their weight loss at a rate of 90 percent or beter; RNYers maintain their weight loss at a rate of about 50 percent. That is a significant difference if you ask me. In addition, obviously with the more weight loss, more comorbidities are resolved.
Honestly the RNY is very old technology, the DS (and pyloric maintaining surgeries) are becoming the preferred WLS's. Losing your pyloric valve in the RNY seems to make you much more likely to get reactive hypoglycemia (basically like diabetes in the sense that you need to keep your blood sugar level), just check out the WLS grad forum. RNYers develop this quite often.
Both surgeries (RNY and DS) require blood work several times a year, you'll probably need a few more vits with the DS because we malasorb A,D,E,Ks much more then a RNYer, on the other hand we absorb iron, calcium, and B vits much better because we have part of our duodenum nad part of our stomach in the digestive tract.
My surgeon (when I had my DS) did the RNY on most patients, and the DS on the SMO or those that really wanted it. Now, he pushes the DS and basically shys away from the RNY, because weight regain is such a HUGE problem with the RNY. They've even created several surgeries invented to fix stretched out stomas, something that never happens with the DS.
Scott
In the two longest term studies long term (10 and 15 years out) DSers maintain their weight loss at a rate of 90 percent or beter; RNYers maintain their weight loss at a rate of about 50 percent. That is a significant difference if you ask me. In addition, obviously with the more weight loss, more comorbidities are resolved.
Honestly the RNY is very old technology, the DS (and pyloric maintaining surgeries) are becoming the preferred WLS's. Losing your pyloric valve in the RNY seems to make you much more likely to get reactive hypoglycemia (basically like diabetes in the sense that you need to keep your blood sugar level), just check out the WLS grad forum. RNYers develop this quite often.
Both surgeries (RNY and DS) require blood work several times a year, you'll probably need a few more vits with the DS because we malasorb A,D,E,Ks much more then a RNYer, on the other hand we absorb iron, calcium, and B vits much better because we have part of our duodenum nad part of our stomach in the digestive tract.
My surgeon (when I had my DS) did the RNY on most patients, and the DS on the SMO or those that really wanted it. Now, he pushes the DS and basically shys away from the RNY, because weight regain is such a HUGE problem with the RNY. They've even created several surgeries invented to fix stretched out stomas, something that never happens with the DS.
Scott
I chose the DS because I felt it was the best for me. My doctor preforms all 3 surgeries and recommended the DS but did go over each surgery, including VSG, with me. I did my research and picked the VSG but got denied all the way by my insurance company. I then opted for the DS after plenty of research and I am very happy with it. I had my surgery in January and reached goal in July. I take daily vitamins that are no big deal and I am in the best shape of my life. My point is that it really doesn't matter to me what surgery you have, what matters to me is that you don't get scared off by what somebody tells you about a surgery they never had or can't perform. Please do your research on your own and also talk to a doctor that truly performs all of the surgeries. I would visit both the DS forum and the RNY forum as well as the revision forum. Also a good website for the DS is DSfacts.com. Maybe somebody could give you a good website for RNY.
Basically what it comes down to is that the DS is a more difficult surgery to learn and perform and it takes longer on the OR table at about the same cost as the RNY.
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