DS/RNY
What is the difference between DS and RNY? I had RNY in 2000 and am gaining. Looking at options. This whole weight issues is so discouraging. I exercise like crazy, have a good life, but struggle terribly with my weight. Dr. Schlessinger did my original surgery in IL but now he is AZ. I have sent two e-mails asking if he would review my upper gi disc, with no response. I am seeing a local MD now but don't know what else to do. This whole think makes me feel so depressed and hopeless.
Hi Pam
The differences are in how your insides look after each op. Instead of the sectioned off pouch you have now, a DSer still has a stomach, but a much smaller one - about 3/4 of the stomach wall is removed completely. This leaves a banana shaped stomach that varies between 1 to 6 oz capacity, and the pyloric valve at the end of it is left intact, so we don't have a stoma (or dumping).
The second difference is that part of the first section of small intestine, the duodenum, is cut into a long piece, and is used to transport digestive juices from your pancreas and liver - this is the switch bit. The rest of the intestine is reattached to the stomach, and the food goes down this tube. The two are reconnected and the food and enzymes mix - this bit is called the 'common channel', and digestion takes place here for the first time. It doesnt take place for very long though - only 100cm worth of tubing.
Because the food and enzymes only mix for a short time, you only absorb 20% of fat, 50% of protein and 80% of complex carbs but 100% of sugars. This is more malabsorbtion than a proximal RNY, but I don't know what the comparison figures are for the distal/extended RNY. The downside is that you have to take vitamins, but the upside is that you can eat high fat high protein and still lose weight.
Having a revision from RNY to DS is possible, but you need an experienced surgeon - look on duodenalswitch.com for an up to date list, or ask on the DS board to see if any work near you. At least it might be worth talking to someone and getting their opinion on what might be best for you - this often depends why you're struggling in the first place, and might take a bit of investigation like you say.
Best of luck
Sal
The differences are in how your insides look after each op. Instead of the sectioned off pouch you have now, a DSer still has a stomach, but a much smaller one - about 3/4 of the stomach wall is removed completely. This leaves a banana shaped stomach that varies between 1 to 6 oz capacity, and the pyloric valve at the end of it is left intact, so we don't have a stoma (or dumping).
The second difference is that part of the first section of small intestine, the duodenum, is cut into a long piece, and is used to transport digestive juices from your pancreas and liver - this is the switch bit. The rest of the intestine is reattached to the stomach, and the food goes down this tube. The two are reconnected and the food and enzymes mix - this bit is called the 'common channel', and digestion takes place here for the first time. It doesnt take place for very long though - only 100cm worth of tubing.
Because the food and enzymes only mix for a short time, you only absorb 20% of fat, 50% of protein and 80% of complex carbs but 100% of sugars. This is more malabsorbtion than a proximal RNY, but I don't know what the comparison figures are for the distal/extended RNY. The downside is that you have to take vitamins, but the upside is that you can eat high fat high protein and still lose weight.
Having a revision from RNY to DS is possible, but you need an experienced surgeon - look on duodenalswitch.com for an up to date list, or ask on the DS board to see if any work near you. At least it might be worth talking to someone and getting their opinion on what might be best for you - this often depends why you're struggling in the first place, and might take a bit of investigation like you say.
Best of luck
Sal
DS revision from failed lapband
Dr. John Rabkin, one of the top DS surgeons, comes to Chicago every month for our support group. He has a pre-op presentation that presents diagrams and explains all the surgeries. It's the third Monday each month so you just missed the last one. The next meeting is 9/16. For more meeting information go to: http://www.paclap.com
3rd Monday of the month. 6-8pm, informational seminar, group support. Union League Club of Chicago, 65 West Jackson Blvd, Chicago, IL 60604. Call or email Barbara Metcalf RN,1-888-848-8446. Dress Code:
3rd Monday of the month. 6-8pm, informational seminar, group support. Union League Club of Chicago, 65 West Jackson Blvd, Chicago, IL 60604. Call or email Barbara Metcalf RN,1-888-848-8446. Dress Code:
- Men: Collared shirt (including turtleneck) and slacks (without jacket or necktie).
- Women: Similar to above, including slacks or skirt with blouse or sweater.
- The following are NOT considered Business Casual Attire and are specifically PROHIBITED (except on Floors 10 and above):
T-shirt, sweatshirt, or other shirt without a collar; trading jacket and other work clothes/uniform; sweat suit and other athletic attire; jean jacket, overalls, cutoffs, shorts and jeans.
For more information about dress code and location go to www.ulcc.org.
Duodenal Switch with Dr. John Rabkin 12/01/2005.
Over 200 pounds lost.
Reconstructive surgery (LBL and lipo) with Dr. Lawrence Zachary 9/19/2008.
Al
Over 200 pounds lost.
Reconstructive surgery (LBL and lipo) with Dr. Lawrence Zachary 9/19/2008.
Al
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