Question:
Why is the Distal Gastric Bypass/Duodenal Switch not being talked about?
I came across a couple of DGB/DS websites and they basically say it is an advancement on the Distal RNY with less complications and similar results. I was wondering if this is hype or that the surgery is just too new to have critcal mass? — Micheal B. (posted on August 1, 2002)
August 1, 2002
There are only a few surgeons in the country who regularly perform the
"DS" as we call it. For a wealth of info on this surgery, go to
www.duodenalswitch.com. I had a DS 10/01, and have lost 101 lbs to date. I
feel great! However, the DS has a greater chance of long term nutritional
problems than the RNY. One must take the prescribed vitamins religiously as
well as consuming about 100 gms of protein daily. I've had no problem with
either of these requirments. There's also a Yahoo discussion group
dedicated to the DS.
— dantevolta
August 1, 2002
I had a DS in October, 2001. I have lost 125 pounds so far and feel great.
I chose this surgery because it was less restrictive on my lifestyle (more
food choices, etc) and because I felt the malabsorbtive component would
give me a better long term weight loss. Although I have to watch what I
eat to avoid long stays in the bathroom, I believe this was a good choce
for me and wouldn't change it for anything. If you are interested, you
will probably have to have your surgery at a major medical center, since
many fewer surgeons do this one than the RNY. Good luck to you.
— Spunkwoman S.
August 1, 2002
The DS really isn't as popular as rny. I am convinced its the best way to
go and am persuing having that done. My friend had it and just had her l
year check up. She looks wonder full and got to goal in 8 months. She can
eat anything. She now eats a childs portion. There are only about six
doctors in Calif . who do it . The surgeon I want has been doing this
procedure for 14 years. Wish I had done it 14 years ago. There aren't many
doctors trained in it as its a newer procedure than the rny. Sheri Carson
— Sheri C.
August 1, 2002
Susan: One doesn't have to take 100 gms of protein a day -- I've taken
75=80 and my labwork has all been fine (including protein/albumin levels).
So, I think the protein consumption grams are really individual. Some
surgeons may err on the side of caution and recommend higher amounts. My
daily intake of 75-80 gms was at my surgeon's/nutritionist's orders. It
is true that we could face higher nutritional deficiencies IF we are not
compliant with supplementation. It is also important to note that we must
be compliant with follow up visits (not only to our surgeon within the
first year post-op but also our PCP. I have my PCP do the bloodwork, etc.
now). The key is to catch an deficiency (mainly the fat soluable A, D, E
or K, iron, protein and/or calcium) BEFORE it gets very advanced. Problem
is, all of these deficiencies take time to develop. So, it can be pretty
easy for someone who doesn't get proper, regular labwork and medical
aftercare to think they are absolutely fine when they are developing a
serious nutritional deficiency! Of course, there are deficiencies that a
post-op RNY can deal with and these are not pleasant (calcium, iron, vit
B-12 and even protein). The DGB/DS is not an improvement over the distal
RNY - it is a totally different surgery all together. But, I agree that it
is an advancement over the distal RNY in the fact that it allows someone to
get more nutrition in but the high malapsorption still prevents late
regain. I chose the laparoscopic DS and am extremely pleased with my
results. I've lost a total of 144 lbs so far (I'm still losing at 19
months post=op!!!). I have not had any significant problems with smelly or
frequent BMS and gas but I do get this on occasion. I have 1-2 bms a day
on most days in the morning upon waking up. But, sometimes I may have 1-2
more in the afternoon or evening. I have been religiously taking my
supplements: Two chromagen forte iron pills (in the pm before sleeping and
am upon waking up), 2 multis (Theragram M), 3 ADEKs (a special vitamin with
ADE and K) and 6 calcium citrate pills (I eat these with meals - so it's 1
ADEK, 1 multi and 2 citrates/breakfast and lunch and then 1 ADEK and 2
citrates at dinner). I really don't have any problems with taking these
pills daily since most of them are taken with meals! :) My labwork has
all been 'totally normal' (I get blood drawn every 3 months - but now will
have it done twice annually). I feel WONDERFUL! I personally wanted the
high malapsorption to keep the weight off for good. All the best, (lap ds
with gallbladder removal, January 25, 2001, Dr. Gagner/Mt. Sinai/NYC,
preop: 307 lbs/bmi 45 now: 166 lbs/bmi 24).
— Teresa N.
August 2, 2002
The reason it's not been talked about much is because far fewer surgeons
perform the DS than those who do the RNY, but it is quickly catching on and
has become very popular in the last year or two. Someone stated in an
earlier answer that this is a new surgery, but that is incorrect. It is
older than the RNY (and there are long-term studies to prove it which can
be found at www.mywls.com) and has been a very successful surgery in Europe
where it is very popular. But it is only just now catching on in the
United States. It is unfortunate it has taken so long for surgeons here to
accept this surgery, but it is gaining ground rapidly, and that is very
good for the M.O. population. <p>BTW, I had the surgery 11 months ago
and have lost 120 pounds to date--I'm within 17 pounds of my own personal
goal (my surgeon said I don't need to lose any more weight). No
complications--no excessive gas/bathroom issues, etc. I am very happy I
made this choice even though my surgeon originally tried to talk me out of
it in the beginning--he wasn't as well read on the long-term benefits/risks
of the DS as he is now. He has since come around and is very excited about
the DS and the long-term success it offers. He calls me the "poster
child for the DS" (LOL).
— artistmama
August 2, 2002
I had laparascopic DS in June. The idea of a 1 oz pouch, high percentage
of patients with dumping, vomiting and ulcers (as compared to DS patients)
made the RNY less attractive to me.
I set a deadline of June 2002--either Blue Shield HMO would come through or
I'd be flying to Spain for self-pay with Dr. Baltasar.
Of course, I ended up in Spain! ;) I'm still working up to getting all
those pills in (vitamins, calcium, etc) but it's getting easier.
Check out the Yahoo!Groups by doing a search for "duodenal" or
"DS" from the Yahoo Groups homepage. Other sites include:
www.duodenalswitch.com, www.gr-ds.com, www.pacificsurgery.com,
www.lap-sf.com.
Good luck!
— Pamela B.
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