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What's the diff between RNY & DS?



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With all the debating over gastric bypass vs. the Band, I still don't understand the difference between roux en y (sp?) vs Duodenal switch.

Which one of these causes some people to battle severe odor? Why does one have a pouch but the other doesn't, and which is which? I'm suddenly facisnated with the gastric bypass and must have info!

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Hi, Lisa. This compares the two in detail. It may be biased because it came from a DS site.

http://www.duodenalswitch.com/procedure/ds_vs__rny/ds_vs__rny.html

Lets see if this works: (Not the same as above link)

DSdrawing4.jpgThe BPD/DS combines restrictive and malabsorptive elements to achieve and maintain the best reported long-term percentage of excess weight loss among modern weight-loss surgery procedures. The Restrictive Component

The BPD/DS procedure includes a partial gastrectomy, which reduces the stomach along the greater curvature, effectively restricting its capacity while maintaining its normal functionality.

Unlike the unmodified BPD and RNY, which both employ a gastric “pouch” and bypass the pyloric valve, the DS procedure keeps the pyloric valve intact. This eliminates the possibility of dumping syndrome, marginal ulcers, stoma closures and blockages, all of which can occur after other gastric bypass procedures.

In addition, unlike the unmodified BPD and RNY procedures, the DS procedure keeps a portion of the duodenum in the food stream. The preservation of the pylorus/duodenum pathway means that food is digested normally (to an optimally absorbable consistency) in the stomach before being excreted by the pylorus into the small intestine. As a result, the DS procedure enables more-normal absorption of many nutrients (including Protein, Calcium, Iron and Vitamin B12) than is seen after other gastric bypass procedures.

The Malabsorptive Component

The malabsorptive component of the BPD/DS procedure rearranges the small intestine to separate the flow of food from the flow of bile and pancreatic juices. This inhibits the absorption of calories and some nutrients. Further down the digestive tract, these divided intestinal paths are rejoined; food and digestive juices begin to mix, and limited fat absorption occurs in the common tract as the food continues on its path toward the large intestine.

Here is RNY anatomy:

Surgery-Step-3a.jpg In the Sapala-Wood Micropouch® operation the very top of the stomach is completely divided. It is not stapled. This division results in the creation of a small “micropouch” completely separate from the lower part of the stomach. This Sapala-Wood Micropouch® is about the size of a grape (1-2 cc).

The small intestine is divided into two ends. One end travels upward to be connected to the Sapala-Wood Micropouch®.The other end is attached downward to the side of the distal small intestine to complete the circuit. Food travels down the esophagus, through the Sapala-Wood Micropouch®, to the intestine It bypasses the stomach. The bottom of the stomach no longer receives any food or liquids. But the stomach will still function because its nerve and blood supply are intact.

This is the best link, as it has info on all of the surgerys, not just RNY, DS and the AGB:

http://www.obesityhelp.com/morbidobesity/information/wlsjourney/surgery+types.php

That should help you out!

Rachele

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Oh, I forgot. The DS is the one that is rumored to have "stinky Gas!"

The only time I have had it was when I had indulged in too much fat, which you shouldn't do anyway, no matter what surgery you have, or I ate something that typically gives you gas, like broccoli, Beans, cukes, you know...But when you get it, you can for sure clear a room! :)

It helps if you have a dog, because you can always blame them!:)

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This thread got lost till now. Thanks for all the great info, especially the pictures.

As for the odor, I've heard and read about severe anal odor. Dr. Billy does bypass surgeries, so I've talked to some of his patients and his staff. The odor is associated with one version of the bypass, and it's so severe that Billy's staff can tell when a bypass patient walks in the door. Some are so severe that they wear carbon filters in their underwear to mask the smell.

However, I think the one that causes the odor is an old procedure, which is why I'm asking about the different types of bypass. Seems there's more than just 2 kinds, right? Since losing my band, I'm obsessed with bypass surgery just in case I start to gain my weight back. I'll have to post updated before & after pics to show you how scary I used to be.

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The vertical gastrectomy sounds really interesting...but I'm sure it's not available in my area and I don't want to wait for ages until it is. But I am saving the info.

Emily

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I read an article the other day that said the DS was the most risky one!

It is! But it offers the highest success rate, if you make it, that is!:confused:

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This thread got lost till now. Thanks for all the great info, especially the pictures.

As for the odor, I've heard and read about severe anal odor. Dr. Billy does bypass surgeries, so I've talked to some of his patients and his staff. The odor is associated with one version of the bypass, and it's so severe that Billy's staff can tell when a bypass patient walks in the door. Some are so severe that they wear carbon filters in their underwear to mask the smell.

However, I think the one that causes the odor is an old procedure, which is why I'm asking about the different types of bypass. Seems there's more than just 2 kinds, right? Since losing my band, I'm obsessed with bypass surgery just in case I start to gain my weight back. I'll have to post updated before & after pics to show you how scary I used to be.

Oh my gosh. No then, this is NOT the DS. EW. Carbon Filters? Yuck.

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The DS surgery makes ppl stink:huytsao , but this can happen with RNY also and may have to do with severely reduced caloric intake--there are even some pills (brand name Devrom) that are sold as an "internal deodorant"

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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