Question:
Duodenal Switch vs. Roux-en-Y

I am considering weight loss surgery and am trying to decide which is best for me. Does anyone know of specific guidelines to be a canidate for the Duodenal Switch? From my readings it seems to be done much less than the Roux-en-Y, but sounds like a great option. I wonder why it is done less. I wondered if it is for people with extremely high BMIs. I appreciate any information you can share.    — dtnash (posted on January 16, 2009)

January 16, 2009
I don't know what the thought is now. I had surgery 9 years ago, and at that time the duodenal switch was more often used with patients 350# or greater. Juliana James-Thomas
   — jjames-thomas

January 16, 2009
I am glad to see you researching your options!!! I went through the process to get RNY but then found out about the DS one month before my scheduled surgery. My BMI was 45.3 and I went to the DS forum to find out more information. There are several helpful people that will give you FACTS and allow you to make up your own mind. Once you research the different options and the longterm results the DS has been more successful then the other WLS. If your insurance covers the RNY it will cover the DS - the DS forum has information on codes for the procedure to call insurance with. There are several helpful people who can help you if your insurance denies. There is a website DSfacts.com that is helpful. The procedure takes a LOT more time then the RNY and thus doctors can do at least twice as many RNY's in that time and the RNY's are less complicated. I had my DS on Oct 29th, 2008 still feel no hunger and have lost 68 lb in 11 weeks. The hard part is finding a physician that will do the procedure. I am not sure what state you live but post on the DS board and everyone can help you from there!! Smiles!
   — Happytall1

January 16, 2009
DS has far more mal-absorption than any of the GB surgeries...Many Insurance companies won't approve it and so many people don't even have that option if they can't afford to pay it out of pocket. The cold hard truth is that even if it were THE BEST surgery (Which I have no experience to say one way or the other)...Surgeons will go where the money is and that's with the surgery that insurance companies are approving because it's guarenteed payment! Sorry but that's the truth! I don't know many RNYers (after a year) that hate their surgery...and the same goes for the DSers that I know... which are far fewer! SO...You really have to research and make sure you KNOW/ understand the surgery and all the rules that go with the one you decide to have...Go to the forums and lurk on the boards and see how others are doing...and what problems they've encountered...I had RNY and had smooth sailing til year 4 when I had malnutrition from malabsorption...So I had to get on extra supplements and have to watch my labs and vitamin levels much closer...It's common for RNYers to become deficient in something or many things around 3-5 years...So you learn to take care of yourself and listen to symptoms and go get labs when you feel bad or weird! Prevention...Key to staying healthy...Moderation the key to keeping your weight off with RNY...At year 5...I worry more about my health than my weight...My body just stays where it is with the lifestyle changes I made in that first year post op. But malabsorption is real and because of it malnutrition happens frequently! So you really have to stay on top of that diligently with full vitamin labs and popping vits all day on a schedule...every day! What a chore it can be for a busy person...I keep vits in my car...In snack baggies... in my purse...I can't tell you how many times I washed my calcium tablets in pockets because you have to chew 2-4 a day at 2 hours apart for each one! So you have to try to remember to get them all in by day's end! So...My point is that once weight loss stops...You have to keep healthy...and so WL is only a part of the lifestyle change...KNOW what you will have to do every day of the rest of your life... for each surgery! Just a suggestion! :) Good luck! I wish you success in whichever WLS you have!
   — .Anita R.

January 16, 2009
Looking at your profile i see you are not an extremely high BMI and thought I'd mention that perhaps the Sleeve Gastrectomy might be a good option for you. It is the first part of the DS but without the malabsorption issues that causes malnutrition. Recent studies are seeing that the sleeve has as good a weight loss as the RNY and that the patients are much healthier in the long term. I had the Sleeve at the beginning of November, am losing nicely, feel fantastic, had no pain post op and still feel no hunger to this day. The beauty about the operation is that it preserves the function of the stomach but removes the part that signals hunger. What a bonus! And although i do take vitamin tablets - it's only because i eat so little that i supplement. I'm very happy with my Sleeve as I am sure others are equally happy with their choices. Good luck with your choice!
   — Sharzi

January 17, 2009
I had this surgery DS in 1988-so almost 21 years ago when this surgery was really in its infancy and they did it for other problems than weight loss. It works more effectively than some of the things they do now. I am now considering a revision but doing research is smart. I would talk to several surgeons and then make my decision. Good Luck and God Bless, vinnigirl, retired RN
   — vinnigirl