Help I went in for my initial consultation and wanted the Gastric Sleeve the doctor suggested the Duodenal switch surgery. I'm 6ft2 450lbs and it took me a lot to take this first step and I was confused and disappointed. My bmi was like 60 and I was wondering what your thoughts are. I read the pros and cons and I know the DS has more risk but he seemed to push it. I have mild diabetes and sleep apnea and major knee problems and blood pressure otherwise healthy. Age is 58.

I'm a newbie just joined tonight and read lots of encouraging stories.

Thanks in advance for any input.

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Edited October 21, 20169 yr by BigJohn58

statistically the DS results in the best weight loss and it's supposedly easier to maintain that loss. I know it's sometimes recommended for people with really high BMI's (which was me pre-surgery). If it was available to me, I would have gone that route as I had over 200 lbs to lose. But my insurance didn't cover it, and my surgeon doesn't do it. So I went with the second most effective - the RNY - and through a lot of hard work I was able to lose all my excess weight. There are sleevers who have done it too, though - it's just going to take a lot of hard work and dedication.

Great comments thanks so much..

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Okay I'm not going to read all 53 replies but I wanted to give you insight into what my surgeon told my father. 5'11 420lbs age 63 type 2 diabetic for 30 years on insulin pump extremely insulin resistant. Cardiac history.

He wants the sleeve because he is afraid of the issues with absorbing nutritions. When we saw the surgeon (my surgeon as well and I just had rny 9/26) he told us about a 2 part switch.

Basically he wants my dad to do the sleeve then in 18 months have the option for the DS. Some surgeons do it as 1 procedure but he does not. He wants the patient to have 18 months to lose about 100 pounds with the sleeve or more than look at having the 2nd part.

This is how my Dad looks at it. By the time he has the sleeve he will be 64. He isn't sure at 66 he will want to have another major surgery but is willing to do the work for the sleeve in those 2 years and decide then.

Hope that helps.

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Yes that helps tremendously thanks

What a bunch of awesome people this forum is great.

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Edited October 24, 20169 yr by BigJohn58

Hi mb11, I'll be a RnY in November, Lord willing and the creek don't rise, at 70+ I don't have wiggle time either. Just want it so my life will be better and more on a health track, been plump too long and my joints are getting spring. One knee already replaced, other knee and hips giving me complaints. Help!

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Rosey after that surgery your going to become a cougar lol What state do you live in.

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The duodontal switch was recommended bc of ur weight and the diabetes mixed that is why they recommended it bc u will loose the weight faster and take the diabetes away to help ur health that is why they recommended that for you there is always a reason behind they're recommendations and they always do what they feel is best for you if that's what they are recommending I would listen to what they think is best for your health.

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Point well taken but I been reading so many success stories of people with as much or more weight to lose with similar things wrong with them and they are all successful with the Gastric sleeve. If for some reason things don't work out I can always do the switch at a later time.

I'm going to do this.

Thanks for your comments

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Best of luck hope it works wonders for you. You will do great!!!

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Thanks so much Genn right back..

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Bigjohn58, here is what my doctor told me. Keep in mind i have not had surgery yet nor have i been approved through insurance yet still waiting. My BMI is 56 i am 391 pounds. He showed me all the surgeries that he performs and he explained each one. Pros and Cons. He gave me percentages of the amount of weight expected to lose in a year (of course every person is different). He also said he was not going to choose for me he let me choose. I went with the biliopancreatic diversion with the duodenal switch. He said perfect that is the one i was going to recommend. I asked him why he explained that this surgery was more invasive than the others, however it has a higher rate of weight loss.Plus it helps you more with keeping your weight maintained because of the malabsorption, It does take the diabetes away. He told me that it may or may not help with gerd but giving my other health issues gerd is not what he was worried about. I must admit i"m a little concerned about it. I am not promoting this surgery what so ever all i am giving you is what i was told. He also said that it is not the old DS its a newer one that does not have the same issues as the old one with the constant going to restroom, with this one they are sparing the pyloric valve which helps rid the diabetes and helps with the dumping. Now from reading articles and other information i did hear that your stool were going to be more smelly, and you will need to take a lot more Vitamins that with a sleeve. I have never had surgery before and was at one time completely against surgery but my life went wonky this last year that i had to make a change hopefully for the best. I am scared to death but from doing some reading even when things do not go as planned most of the folks are repeating the same thing, that they would do it all over again. The way i see things i am either going to lose my life on that table or in a couple of years if i continue down this path. My one true fear is being left mangled but that will be the risk i am willing to take in order to take control of this life of mine. One of the ladies that has inspired me a great deal is Princess Monster Truck on you tube she had the same procedure i hope to be having (because i may be denied) she was also the one that told me about this site. Please check it out and make up your own mind and of course get as many opinions as you need to put your mind at ease and be okay with your surgery. Also there is a ds forum on this site you could ask about it or just read the many experiences that people have had with it too. Good Luck to ya

Doxaholic I can't thank you enough for for all the good information. I can relate to a few things you said and I hope and pray things work out for you. I have never heard of the biliopancreatic diversion. I feel in my case I have to also get my mind right because all the surgeries in the world and I will eventually gain weight if I don't retrain my mind..

I'm going to keep going to a therapist to help with the brain lol

I seen people that lost 300lbs with the band and keep it off. I guess it's what you put into it. I never had surgery and it bothers me that I couldn't do it myself.

I need this tool so I can get a jump start.. Thanks again brother stay in touch. Where do you live?

I'm in New Joisey

Take care

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Edited October 28, 20169 yr by BigJohn58

I think it would add value to get a 2nd opinion for sure. That being said, did he say why he felt that was the better surgery for you? Usually there is a reason.

I had a similar experience. For whatever reason I thought the sleeve was the way i wanted to go and had done a ton of research. When I went in for my meeting with the surgeon they immediately recommended Bypass but that was because I had severe Gerd. initially I was devastated because I had only researched the sleeve thinking of course that I knew best.

When i left that appointment i made an appointment with my gastroenterologist who confirmed that the way to go for me was absolutely bypass. then i began researching the heck out of it and became very very comfortable with that plan.

It has been two years now and I lost all of my weight and currently am a normal BMI. I lost 152lbs and I fluctuate between 157 & 162 which is below my goal weight. I have been in maintenance since March 2016 and I got rid of all my comorbitities including that severe gerd thank goodness.

I personally would get a second opinion but for me, I would absolutely take the advice of my doctors. Mine was expert in his field and I trusted him after performing research.

I have no Gerd he just thought I would lose more weight with the DS I'm at 60bmi.. Tonight I read on the 400 plus forum plenty people lost 200 and 300lbs with the sleeve. I read with the bypass there is more maintenance and post op doctor visits than the sleeve.

I'm petrified of having my stomach rerouted. Thank goddess for this forum and all you great people.

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I am glad I was sleeved! I went in June 15th 2015 for my consult and wanted bypass. But my surgeon said sleeve would be best for me. I'm glad because my mom had bypass when they first started doing them and she has had nothing but problems with needing more surgeries. Plus I didn't really want my intestines re routed. So, anyways I had tests to do and I got surgery set for June 14th 2016 almost one yr to the day I had my first consult. I better get off this is getting lengthy. Take care! Oh and definitely get a second opinion. Out of those weight loss surgeries I feel the sleeve is the best option.

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I think it would add value to get a 2nd opinion for sure. That being said, did he say why he felt that was the better surgery for you? Usually there is a reason.

I had a similar experience. For whatever reason I thought the sleeve was the way i wanted to go and had done a ton of research. When I went in for my meeting with the surgeon they immediately recommended Bypass but that was because I had severe Gerd. initially I was devastated because I had only researched the sleeve thinking of course that I knew best.

When i left that appointment i made an appointment with my gastroenterologist who confirmed that the way to go for me was absolutely bypass. then i began researching the heck out of it and became very very comfortable with that plan.

It has been two years now and I lost all of my weight and currently am a normal BMI. I lost 152lbs and I fluctuate between 157 & 162 which is below my goal weight. I have been in maintenance since March 2016 and I got rid of all my comorbitities including that severe gerd thank goodness.

I personally would get a second opinion but for me, I would absolutely take the advice of my doctors. Mine was expert in his field and I trusted him after performing research.

I have no Gerd he just thought I would lose more weight with the DS I'm at 60bmi.. Tonight I read on the 400 plus forum plenty people lost 200 and 300lbs with the sleeve. I read with the bypass there is more maintenance and post op doctor visits than the sleeve.

I'm petrified of having my stomach rerouted. Thank goddess for this forum and all you great people.

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I am glad I was sleeved! I went in June 15th 2015 for my consult and wanted bypass. But my surgeon said sleeve would be best for me. I'm glad because my mom had bypass when they first started doing them and she has had nothing but problems with needing more surgeries. Plus I didn't really want my intestines re routed. So, anyways I had tests to do and I got surgery set for June 14th 2016 almost one yr to the day I had my first consult. I better get off this is getting lengthy. Take care! Oh and definitely get a second opinion. Out of those weight loss surgeries I feel the sleeve is the best option.

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Thanks so much I appreciate your insight

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Doxaholic I can't thank you enough for for all the good information. I can relate to a few things you said and I hope and pray things work out for you. I have never heard of the biliopancreatic diversion. I feel in my case I have to also get my mind right because all the surgeries in the world and I will eventually gain weight if I don't retrain my mind..

I'm going to keep going to a therapist to help with the brain lol

I seen people that lost 300lbs with the band and keep it off. I guess it's what you put into it. I never had surgery and it bothers me that I couldn't do it myself.

I need this tool so I can get a jump start.. Thanks again brother stay in touch. Where do you live?

I'm in New Joisey

Take care

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In US vernacular, the biliopancreatic diversion with duodenal switch (BPD/DS) is the same thing as what is commonly called the DS. Back in the good ol' days there was a European procedure developed by Dr. Scopinaro that was called the BPD, which was a similar intestinal rerouting combined with a large pouch like stomach similar to the RNY gastric bypass, only larger. Typically the common channel was fairly short (50cm, IIRC) for a high degree of malabsorption, but low restriction, and typically the nutritional problems that went along with it. The BPD was never adopted in any numbers in the US, but was used as the basis of what is today the DS, which combines a sleeve gastrectomy with the switch type of intestinal bypass, typically with a common channel length of around 100cm, give or take, for a moderate level of malabsorption along with moderate restriction and milder nutritional impact (the DS typically uses a larger sleeve than the stand alone VSG.)

When seeking approval from the industry (ASBS, precursor to today's ASMBS), Dr. Scopinaro insisted that the DS be referred to as the "BPD with DS" as a link to his BPD, hence maintaining credit for his contribution. The early DS docs generally agreed to keep him quiet, but this caused no end of problems with patients trying to get approval for the BPD/DS after most of the US insurance industry had soundly rejected the BPD due to its nutritional problems.

In short, BPD/DS=DS, just two different names for the same thing, much like we have the VSG, sleeve, VS. and VG all referring the the stand alone sleeve gastrectomy. However, the BPD/DS or DS should not be confused with the new kid on the block, the SIPS/SADI/"loop DS" which has its own merits and de-merits and should be considered on its own as a distinct option to the VSG, DS and RNY.

Doxaholic I can't thank you enough for for all the good information. I can relate to a few things you said and I hope and pray things work out for you. I have never heard of the biliopancreatic diversion. I feel in my case I have to also get my mind right because all the surgeries in the world and I will eventually gain weight if I don't retrain my mind..

I'm going to keep going to a therapist to help with the brain lol

I seen people that lost 300lbs with the band and keep it off. I guess it's what you put into it. I never had surgery and it bothers me that I couldn't do it myself.

I need this tool so I can get a jump start.. Thanks again brother stay in touch. Where do you live?

I'm in New Joisey

Take care

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In US vernacular, the biliopancreatic diversion with duodenal switch (BPD/DS) is the same thing as what is commonly called the DS. Back in the good ol' days there was a European procedure developed by Dr. Scopinaro that was called the BPD, which was a similar intestinal rerouting combined with a large pouch like stomach similar to the RNY gastric bypass, only larger. Typically the common channel was fairly short (50cm, IIRC) for a high degree of malabsorption, but low restriction, and typically the nutritional problems that went along with it. The BPD was never adopted in any numbers in the US, but was used as the basis of what is today the DS, which combines a sleeve gastrectomy with the switch type of intestinal bypass, typically with a common channel length of around 100cm, give or take, for a moderate level of malabsorption along with moderate restriction and milder nutritional impact (the DS typically uses a larger sleeve than the stand alone VSG.)

When seeking approval from the industry (ASBS, precursor to today's ASMBS), Dr. Scopinaro insisted that the DS be referred to as the "BPD with DS" as a link to his BPD, hence maintaining credit for his contribution. The early DS docs generally agreed to keep him quiet, but this caused no end of problems with patients trying to get approval for the BPD/DS after most of the US insurance industry had soundly rejected the BPD due to its nutritional problems.

In short, BPD/DS=DS, just two different names for the same thing, much like we have the VSG, sleeve, VS. and VG all referring the the stand alone sleeve gastrectomy. However, the BPD/DS or DS should not be confused with the new kid on the block, the SIPS/SADI/"loop DS" which has its own merits and de-merits and should be considered on its own as a distinct option to the VSG, DS and RNY.

Hey Rick thanks for the edgeamaction lol All kidding aside thanks brother for the great information..

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If I were in your situation, I would talk with:

Mitchell Roslin, MD
E-mail: mroslin@lenoxhill.net
Phone: 212 434-3285
Lenox Hill Hospital
130 E 77 th St
New York , NY 10021