Question:
What are complications and success rates comparing the RNY and Duodenal Switch ?
I have researched several WLS procedures and have chosen the BPD/DS. My insurance co. says I don't have the out of network option and that the DS is too risky. What are the comparisons of the complications and success rates of the RNY and the BPD/DS? Which one has the greater possiblity of late weight gain? How do I argue my case with the insurance co? — Angel C. (posted on April 7, 2001)
April 7, 2001
If you have done any research... why would you buck medical findings and go
with a procedure that the top surgeons won't perform anymore because of
complications? The RNY, especially when done laparascopically has the
highest success rate with the least complications both short and long term.
I cant imagine anyone 'choosing' any other form of this surgery. Go with
the choice of the country's top surgeons...they do more of these type
procedures and have the smallest number of problems. If the DS procedure
produced better results and low incidence of problems they would be doing
30-50 of the DS a month instead of Lap RNY.
— [Anonymous]
April 7, 2001
I find it pretty disturbing that instead of voicing an OPINION, and perhaps
quoting a few studies with references so people can check for themselves,
you would present a personal opinion as indisputable fact. The truth is,
the NEW BPD/DS is different from the plain BPD, and the old jejunal
bypass, and is nothing like the mini-bypass. There are some studies
showing it to be have fewer (yes--fewer) nutritional complications, better
long-term weight loss, and a higher quality of life. As with any new
procedure, acceptance will be a gradual thing, and doctors like anyone else
aren't thrilled to learn new ways of doing things. In short, there is good
evidence it's a SUPERIOR procedure to the standard RNY, and the jury's
still out for the REALLY long-term issues. It's best to see a surgeon who
does both (such as Dr. Elariny of Arlington, VA, or Dr. Gagner of NY) and
ask his/her opinion, as well as the har questions abot safety...or spend a
few months reading for yourself--or both. Then make your decision based on
safety AND lifestyle factors. (A person who is attracted to fats and has
never liked sweets may do better with the DS for weight loss, whereas the
sweets lover may appreciate the built-in control of the RNY. And so on.)
Good luck to the poster who asked the question.---Jesse
— [Anonymous]
April 7, 2001
This is where I believe some of you are incorrect. No matter how much any
of us read about the different procedures we will NEVER be as qualified as
the surgeons who hands are inside people doing this procedure every
day(bariatric surgeons in the group excepted). In my opinion, find a doc
who does 5 to 10 of any of these procedures a week (not a month) and ask
them to explain the differences and what they recommend based on their vast
experience. They are the ones qualified for making the decisions as to
method. If the surgeons who are doing big numbers of these surgeries and
already have the patients lined up knew of NEW DS that would improve their
patients stats they would be quick to investigate and implement. I agree
with you in regards to the bulk of the doctors who are doing a few of these
procedures a month due to popular demand...but they arent the movers and
shakers of WLS.
— [Anonymous]
April 7, 2001
I have read alot of good things about the new BPD/DS and have heard things
like LESS calcium malabsorbtion and LESS b12 malabsorbtion. But it's all a
question of choice, and to the anon poster at the very bottom, I think you
are very high up on yourself. I CHOSE my VBG because I did not WANT to my
intestines rerouted and face the complications that can come with the RNY.
Granted, I have my OWN complications and risks with the VBG, but I chose it
none the less! I am getting sick and tired of the attitudes in this list
and the surgery bashing that goes on. I WANT YOU TO KNOW THAT IT'S NOT
RIGHT TO DO THAT! HUGS to the poster of this question and I hope you find
the one YOU want!
— Jo C.
April 7, 2001
I dont think the poster at the bottom of the list is bashing anyone. People
shouldnt be afraid to be controversial as we all learn more? She/He is
making a valid point, if the DS (new) is so great why arent there any
surgeons doing big numbers of these a month? If they worked and could be
done with better results and more quickly,it would be truly groundbreaking
news for everyone. It is just an easier surgery for those doctors who arent
qualified to do the lapRNY. This is my opinion.
— [Anonymous]
April 7, 2001
No one can tell you which surgery is better for YOU. We can only tell our
personal experiences and preferences. You must do the research. A good
place to begin studying about the BPD/DS is at: duodenalswitch.com Both
surgeries can have complications and there are a variety of opinions about
long-term success rates. Read the studies, ask people for their
experiences (and they will be totally varied, even among those who have had
the same surgery). Some insurance companies are still not educated about
the BPD/DS and consider it a 'riskier' surgery. The BPD/DS is NOT the
older bypass that was laden with severe possibility for nutritional
deficiencies, etc. It IS a more complicated surgery as a matter of fact;
It isn't an easier surgery and takes longer (many surgeons will not even
attempt it laparoscopically --- although there are a handful who do and
some of those are very experienced and top of their field). I chose the
lap BPD/DS after much research. If you do decide on the BPD/DS, you can
learn from those who have also experienced problems with insurance
approval/etc and get support at: [email protected]. Even if
you are undecided, it is an excellent starting point to get to know others
who have had this surgery and any problems encountered, experiences, etc.
All the best ([email protected]),
— Teresa N.
April 7, 2001
I'll try to just give you my own experience and not cross any lines here.
My husband & I both had distal RNY, very distal. We are some of the
lucky ones who were fairly well supplemented, so we have suffered very few
nutritional consequences. My husband had a post-op leak, could happen with
any surgery. But long term, we have both lost and maintained 100% of our
excess weight and tend toward the low end of our weight range, which is our
preference. I'm 6+ yrs out, he's a year behind me. For many of us, our
first choice may be our first surgery, followed by revision. Mine was
revised last year, from non-transcted to transected, same surgery,
better/newer style. Back in 1993, when I made my choice, there were not as
many options available. Had I chosen the other option, I'd also have been
revised, probably sooner. STILL. We are where we are today, we stay here
with ease, we do not diet. We avoid milk & sugar, we take a very
specific set of supplements. We get fequent labs, which we should do at our
advanced age, anyway. We are healthier than we have ever been in our lives
because we are more closely monitored than we were. We both would choose
our distal RNY again.
— vitalady
April 7, 2001
Ok, I agree with everyone that says to DO YOUR OWN RESEARCH! Whichever
procedure you feel is right for you, you will know it. Just trust
yourself. As far as some of these posters saying that the top surgeons are
only doing the RNY's etc etc because it's proven most safe and effective,
yada yada yada.. . All I have to say to that is: Doctors are just people
and we all know that OLD HABITS (AND IDEAS AND OPINIONS) DIE HARD!! I think
they're giving Docs way too much credit here. They're gonna keep doing
what they're doing becuz they know the procedure backwards and forwards
(they're doing oodles of them a month, right?) they trust themselves with
it and it is paying the bills just fine for them! What Dr (or any
person,for that matter) would want to openly admit to a prospective client
that they aren't doing the latest procedure? The patient might get the
idea they're not "with it" on current research in their
specialty, so instead they put the procedure down. Maybe they've been so
busy doing 50 surgeries a month that they haven't had the time or desire to
read up on what's new and exciting in their field of specialty!! They
have already been telling their patients it's "the best" and why
lose face and say that maybe another procedure is showing promise as well -
especially if they are NOT performing it?? Your best bet is to talk to a
Dr who is well versed in BOTH procedures. . .you notice there are not too
many of them. . .now why is that?? Another thing to keep in mind is that
the RNY may be the "standard" here in the US, but it is not in
other First world, developed countries. Why is that? It's all a matter of
opinion. I would rather have a Dr well versed in all aspects of his
specialty (which is the only fair way to label him a specialist!) instead
of running a WLS mill and being blind to new developments because he was
too busy "doing what he does!" I guess even the horse and buggy
was the "standard" once too. . . Where would America be without
those visioneers and those of us willing to ask, "Why NOT?!" :-)
— ChristiMNB
April 7, 2001
I think the most important part about researching which surgery is for you
is research and keep an open mind. I was originally having an RNY until a
week later my surgeon(due to medical reasons)recommended BPD/DS. I
researched this and I am very comfortable with my decisiion.(surgery 4/11)
One reason the insurance companies don't approve as often is the cost. It
is more cost effective to do the RNY than the BPD/Ds. The DS is a longer
surgery,slightly longer recovery and costs more. Of course they want to go
with the cheaper! My advice is to go to many different sources. Ask people
who've had all different types why. Have they had complications? If so
what. What do they like about their surgery,what has been the best and
hardest part about the surgery. The duodonalswitch.com is good along with
www.surgicallyslim.com. I'm only recommending this site as reference as it
lists both the RNY and BPD/DS.(this site is Mount Sinai's) Don't make a
quick decision. There is no need to. Write down the pros & cons of each
and compare side by side. Then, I think you will make the most informed and
best choice for YOU. That's what counts. I would also speak with my
surgeon. Ask their opinion and why. Maybe there's a reason they would feel
one would work best for you over another. Best of luck on this journey of
discovery!
— Linda M.
April 7, 2001
I have done research on both and I have chosen the DS procedure. This
doesn't mean that the other ones are not any good, this one was just the
right choice for me. I would suggest lots of research. All of the
procedures have worked, and they all have risks involved. I would not say
one is better than the other, it's up to what each individual wants. A lot
of people think their procedure is the best, and I'm sure it was the best
for them. As for the first poster and their opinion about RNY being the
better procedure because it's the most popular? That is totally obsurd.
There are always new and updated procedures on the horizon. I'm sure we
will see plenty more in the future years. There are plenty of surgeons that
perform several procedures a week, weather they are DS, RNY, Lap, and so
forth. I personally would prefer a doc that took his time and took care of
me rather than measuring their surgical ability on how many surgeries they
perform per week. I do not understand where all of this negativity and
arrogance comes from. I come here for support, and to speak with people
with the same problem that I have on a nice and friendly level. Just
remember each person is an individual and what is right for you may not be
right for everyone else. And I do not understand why the people with the
most strong opinions always post anonymous!!
Good luck to you and your decision. I'm sure you will choose the one that's
right for you.
— Kim B.
April 8, 2001
Here's some good information on RNY vs. DS:
http://www.duodenalswitch.com/Procedure/DS_vs__RNY/ds_vs__rny.html. Good
luck in your research! ---->>>
— [Deactivated Member]
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