Question:
What are post-op differences between BPD/DS and Roux-en-Y ?

After many months of reviewing different procedures, talking to several doctors, and talking to those who have had weight loss surgery I am ready to have the surgery. I have advised that either the Roux-en-Y or the BPD/DS (Bilo-pancreatic Diversion with a Duodeno Switch) is the appropriate surgery for me. I have choosen a doctor and he is willing to do either procedure. I would like to hear the pros and cons and quality of life after having one of these procedures. Many thanks, Jim    — James S. (posted on April 7, 2003)

April 7, 2003
I believe most of the people at this website had RNY and can give their opinion on that surgery. I had DS and you can get more information on that at www.duodenalswitch.com, www.gr-ds.com and various Yahoo groups. I had DS because I had a history of ulcers (DS has a lower risk of ulceration because it uses the natural outlet for the stomach), headaches for which I frequently take NSAIDs (in general, it is strongly recommended that patients not take NSAIDs on a regular basis with RNY...due to risk of ulceration), didn't want to risk dumping syndrome (RNY has a much higher incidence of this...some choose to see this as a positive to help them manage their sugar intake), didn't want to be on a liquid diet for an extended period of time (of course...this is just a preference! But, in general, DSers are eating what they can tolerate within a couple of weeks...varies by doctor). Most importantly was that I was heading towards Type II diabetes and couldn't tolerate the medications which meant I'd be on insulin fairly quickly. The way I even found out about DS was doing a MedLine search, looking for alternative treatments for diabetes. The BPD part of DS has been used to treat intractible Type II diabetes, familial hypertriglyceridemia and a few other endocrine disorders associated with insulin-resistance. The effect (from studies and case reports) appears to be independent of the weight loss. So...I figured if I was one of the 10% or so who "fail" DS...at least I wouldn't be on insulin! ;) Unfortunately, insurance tends not to pay for DS if this is your main motivation! I was self-pay with Dr. Baltasar in Spain. Both surgeries can work...both surgeries can fail. If your insurance will cover either, join some Yahoo groups...check out the chatroom here; gather your information and make whatever choice seems best for YOU! People tend to be fairly passionate about whichever procedure they had...find out the negatives about each alternative...including lap versus open...so you know what to expect. Since both surgeries work, you may end up choosing based on the potential negatives instead of the positives. Good luck! Lap DS, 6/5/02 260/144 5'7" Size 24---now size 8 (single digits, even! ;) )
   — Pamela B.

April 7, 2003
My surgeon does the RNY for nearly all hois patients because the DS has much more malabsorbtion that puts ius at higher risk of anemia and vitamin deficency. I like my RNY and mild dumping reminds me to not do too many sweets. Besides the RNY does NOT remove any body parts. The DS removes and discards a large portion of the stomach. Someday that might be needed.
   — bob-haller

April 8, 2003
I was initially scheduled for an RNY, but the more I researched, the more concerned I became about the risk of late weight regain. It's quite significant with the proximal RNY (about 1 in 4 patients have substantial regain), but almost unheard of with the DS. I had spent my adult life yo-yo dieting, and I really wanted to give myself the best possible shot at making this a *permanent* solution to my obesity. So, I canceled my RNY date and went out-of-state to self-pay for the DS instead. It was a tough decision at the time (it would have been much easier to have my surgery locally and let my insurance cover most of the bill), but I'm so glad I made it. I'm now almost ten months post-op, feeling terrific, and just a few pounds away from my goal weight. I do have to be careful to eat enough protein (I'm a longtime vegetarian) and to take my vitamin-mineral supplements every day, but that's become second nature at this point. My blood work has been great, and I have no food intolerances or bad side effects. Life is good! :-) For me, the DS was definitely the best way to go. However, YMMV. A lot depends on finding a really skilled surgeon, because the DS is a more complicated procedure than the RNY. If you do choose the DS, please make sure your surgeon is very experienced with it and has a good follow-up program. Good luck with your decision!
   — Tally

April 9, 2003
Jim, I had an open BPD/DS 2 yrs ago tmo! I love my DS. I was origianlly scheduled for the RNY but my surgeon felt this was better for some other medical reasons. I can't imagine it any other way. I have an issue with people about the malabsorbtion thing. First off, either surgery you take vitamins for life. However, I can actually eat an 8 oz meal. So, I actually get more nutrients from food because I can eat more food. I mean i would have had 100 cm bypassed if I had the RNY too. So, if I can eat more because my "normal" stomach can hold more than why am I not getting more of the nutrients? I love that I'm not limited to eating anything. I've had ribs-seafood,desserts(altho I don't want as much anymore)everything. I love going to trainings for Scouting and I don't have to worry about what's being served!So, continue to do the research. Are you willing to do the work for the RNY? Chewing food alot, not drinking 1/2 hr before/after, no sugar etc....? If so, than RNY might be for you. If you like the convenience of eating what you like, not limited to quantities, and retaining most of the weight loss than DS might be what you're looking for.Please realize you still need to make behavior changes with both surgeries. Might be a little easier with the DS. Compare the pros & cons of both but only you can make the decision of what's right for you. For me, I can't imagine anything else. Best wishes and best of luck
   — Linda M.