Question:
How do you chose which surgery is righ for you???

I've been reading a lot about the different types of surgeries. I've seen my PCP and he referred me to Dr. Maguire, of New Life Surgery Center. He does both open and Lap RNY, and also DS. I think I want one then I want the other. How do you know which surgery is right for you?    — Robin W. (posted on July 5, 2003)

July 5, 2003
The LAP RNY or open RNY are the same surgeries the only difference is access. The end results are the same. The DS has a lot more malabsorbtion and frequently insurance doesnt cover it because of the long term risk of vitamin and other deficencies. You might get barb thompsons book she is a member here and wrote a excellent book, see the very bottom of my profile. Theres also the adjustable band. Its good we have choices.
   — bob-haller

July 5, 2003
First, take a look at this site:<P> http://www.gr-ds.com/forpatients/Comparison_Html.html <P> Then, check out www.duodenalswitch.com <P> I am prejudiced, as I am a recently approved pre-op for the DS with Dr. Rabkin, and I fought with Aetna for 5 months to get approved for the DS, although Aetna approved me for the RNY immediately. The RNY is called the gold standard, because it's been done for a longer time, and is better known. The newer DS is called the platinum standard, and I would not accept the RNY under just about any circumstances after reading about both. If the RNY is the ONLY procedure you can get, or if there are specific issues that make the RNY better for you in particular (and there could be -- carb and sugar addicts in particular often say they think the RNY will be better for them due to the immediate negative feedback -- called the dumping syndrome -- that eating these bad foods gives them). I am not a sugar addict or even a carboholoic -- though I do like my carbs -- and I see no reason to have to live the rest of my life with a tiny pouch that will rule my food choices for the rest of my life. Yes, there is more malabsorption with the DS -- that's why the longterm weightloss statistics are better with the DS. Yes you have to take supplements for the rest of your life -- but that's true for the RNY as well, if not more so. Yes, overeating carbs and fats will cause diarrhea and/or gas with the DS -- but not immediately, and if you WANT to indulge, you can prepare to be prepared the next day for the effects (or to take OTC medications like Imodium and Gas-X to prevent them) and YOU WON'T GAIN WEIGHT. No marginal ulcers, no stoma strictures, much reduced nausea and vomiting (a very important consideration for this emotophobe), being able to eat NORMALLY after the first several months as the stomach returns to almost-normal size and retains all it's moving parts (keeping an intact pylorus was very important to me), being able to eat ANYTHING after I've lost the weight, not having to chew my food to mush for the rest of my life, being able to drink with my meals in the future, being able to take NSAIDS if I need them -- the list goes on. The big downsides right now to the DS are (1) that it is a more difficult procedure, and there are very few doctors who are competent to perform it, and (2) that many of the insurance companies are very technologically backward, and still consider the procedure (performed for 18 years now) to be "experimental" or "unsafe or inadequately studied." Two weeks ago at the ASBS annual meeting, the bariatric surgeons passed a resolution pronouncing the DS to be no longer considered experimental and will be urging the insurance companies to change their policies accordingly.<P> As I said, I am biased, because I have spent months and months researching this, and even more time than that because of having to fight Aetna for the right to have the surgery my surgeon recommended for me, and which I determined to be the best one for me as well (I have a PhD in biological chemistry and molecular biology from UCLA Medical School, so I'm pretty confident of my ability to not only read reviews of scientific literature, but the original papers themselves, and to understand the metabolic consequences of the various procedures). This is not to say the RNY doesn't work, or doesn't work well for some, but that I believe the DS is better, in particular better for me. But that might not be true for all. YMMV. Diana
   — [Deactivated Member]

July 5, 2003
I'm glad you're thinking about DS. It's hard to get good information about it as it's not well known and a lot of RNY surgeons give incorrect information to potential patients; one told me I'd have diahhrea the rest of my life. That is NOT true! It's good that your surgeon does both. He won't use scare tactics. DS has normal eating patterns (no dumping, vomiting, pureeing food, etc), normal stomach (no pouch). I can eat whatever I want including meat and fat and limited sugar, and there is no risk of regaining the weight later, my biggest fear and the reason I finally decided to pay for DS rather than have insurance cover the RNY or VBG. [The ASBS has just *finally* formally recognized DS, so insurance coverage should improve soon.] You might want to read posts at some Yahoo groups to compare post-op life. Try http://groups.yahoo.com/group/DS_Results/ http://groups.yahoo.com/group/DS_PostOp_Problems/ http://groups.yahoo.com/group/ossg-hungry/ http://groups.yahoo.com/group/ossg-Main-List/ And lots of others. Congratulations for researching carefully before deciding. This is for the rest of our lives! So many people just do what a friend did without knowing what they're getting into, which is understandable given the desperation and hopelessness we all feel. I don't want to see anyone fall into that trap. Good luck! Chris...DS 6/11/02, 378-230 lbs, BMI 57-35, size 38-18. No more sleep apnea, hypertension, arthritis, depression, insulin resistance, meds, diets, fear, shame, or fat-lady stores. Life is great!!
   — Chris T.