Guest guest Posted June 18, 2001 Report Share Posted June 18, 2001 hi guys. just got back from my consult ...had a couple of questions 1 in the rny is the stomach actually separated from your pouch? if yes does this eliminate the ulcer issue? 2. has anyone heard of liver failure with the ds? 3. how do most doctors calculate the amount bipassed? this dr sd he doubles you bmi..so mine would be 80 cm. is that enough? thanks cheryl Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2001 Report Share Posted June 18, 2001 i think you are right..i told this dr who preforms only rny's lap that i was considering the ds. he told me that he spoke to an asst. of someone making lots of money off this proceedure that there are many complication with the ds. He mentioned the liver failure. he sd with the rny the liver enzymes go up but only till the weight starts to stablize. he told me the rny was the gold standard. i just listened. i am concerned about excess vomitting. the rnyers seem to have a lot. i hope ds'ers don't. dr ren emailed me back and sd in literature (whatever that means) ds is a more complex proceedure. does that mean riskier? well thanks for the help. i am really sorting things out now. cheryl Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2001 Report Share Posted June 18, 2001 > hi guys. > just got back from my consult ...had a couple of questions > 1 in the rny is the stomach actually separated from your pouch? if yes does > this eliminate the ulcer issue? NOPE. The ulcers are from the acidic secretions in the stomach coming into contact with the alkaline tissues of the intestine.. the only way to prevent marginal ulcers is to NOT get an RnY. They may cut the stomach away from the pouch, but that's to prevent staple line disruption & the pouch stretching. > 2. has anyone heard of liver failure with the ds? That's something that RnY docs like to tell you to scare you away from the DS.. the liver is stressed when ANY method is used to lose weight.. this improves as you get farther postop.. has NOTHING to do with the surgery you choose. > 3. how do most doctors calculate the amount bipassed? this dr sd he doubles > you bmi..so mine would be 80 cm. is that enough? With the RnY, it might be, but I'll freely admit I don't know a lot about them.. I just know that literature on the 2 procedures shows fewer postop problems from the DS, & better weight loss from the DS, so that is what I chose to have. In the DS people are more concerned with their common channel length.. seems I recall one example where the biliary limb was 240cm, the food limb 180cm, then the common channel around 100cm.. but I was scanning that post & I could be incorrect. > thanks > cheryl Welcome, hun.. Hugs, Liane Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2001 Report Share Posted June 19, 2001 mary this was the rny dr. i had this consult scheduled before i looked into the ds. my ds dr is dr ren in nyc. i was not real impressed with this dr..dr schmidt in hackensack. he sd there is liver failure alot with the ds. i really want to ck into this. also those other things i had never heard before. he also told me to stay off the internet. no way!!!! that's where all the information is. thanks for the info cheryl Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2001 Report Share Posted June 19, 2001 1. with the DS there is no "pouch" only a stomach that was made smaller. If your doc makes a "pouch" you are in deep doo doo 2. never heard of liver failure with the DS 3. doubling the BMI makes no sense to me at all. Wonder where the doc got that idea? This would mean that the people who least need the DS get the shortest one and the largest people get the longer ones. 80 cms is great though. Who is this surgeon again? in Settle ----- Original Message ----- From: star00066@... hi guys. just got back from my consult ...had a couple of questions 1 in the rny is the stomach actually separated from your pouch? if yes does this eliminate the ulcer issue? 2. has anyone heard of liver failure with the ds? 3. how do most doctors calculate the amount bipassed? this dr sd he doubles you bmi..so mine would be 80 cm. is that enough? thanks cheryl Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2001 Report Share Posted June 19, 2001 Stay off the internet??? As in " don't inform yourself because anyone who knows more than I do is a threat? " LOL Maybe he needs a few DS websites to upgrade his lousy information. Glad this was the RNY doc giving you rotten info.. hate it when bad info comes from the DS surgeons. They're good, but perfection is yet to be attained. in Seattle >mary >this was the rny dr. i had this consult scheduled before i looked into the >ds. my ds dr is dr ren in nyc. i was not real impressed with this dr..dr >schmidt in hackensack. he sd there is liver failure alot with the ds. i >really want to ck into this. also those other things i had never heard >before. he also told me to stay off the internet. no way!!!! that's where all >the information is. thanks for the info >cheryl > Web Mail services provided by http://www.aa.net Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2001 Report Share Posted June 19, 2001 At 10:48 AM -0400 6/19/01, star00066@... wrote: mary this was the rny dr. i had this consult scheduled before i looked into the ds. my ds dr is dr ren in nyc. i was not real impressed with this dr..dr schmidt in hackensack. he sd there is liver failure alot with the ds. i really want to ck into this. Not so. See the msg to this list that I copy below. In 10 years, 400 patients, Dr. Hess had found only **one** case of liver involvement. excerpts: From Table 10 --One death involved " fatty liver, liver failure, renal failure, ARDS, multiple organ failure " " ADVANTAGES There are several advantages to the biliopancreatic bypass with a duodenal switch. There is no isolated stomach, no foreign body or band required. There is preservation of the pylorus, no dumping syndrome, no marginal ulcers, and good weight loss. This operation is both a restrictive and a malabsorption procedure. However, neither of these procedures are performed to an extreme degree. The restriction is related only to reducing the size of the stomach. There is no constricting band or narrowed stoma. We use a vertical gastrectomy which preserves the pylorus, a portion of the antrum, some of the mid and upper stomach, and removes most of the acid producing fundus. If in the future any revision needs to be performed on these patients it would be unusual to have to re-operate on the stomach. Surgery in this area becomes difficult due to adhesions between the stomach, liver, and the upper abdominal area on the second surgeries. The malabsorption portion of this operation consists of an alimentary canal of 250 to 350 cm, with a common channel portion measuring 50 to 100 cm. of the distal ileum, which practically always gives adequate absorption and nutrition. If there is some difficulty with malabsorption, the length of the alimentary canal and common channel can be extended without much difficulty and without disturbing the stomach or the duodenal anastomosis. Liver failure, renal failure, severe electrolyte imbalances etc. do not seem to be a problem with this operation, if the patients have adequate follow-up and proper supplementation. Since the pylorus is still intact a functional reversal of this operation can be performed quite satisfactorily. The volume of the stomach, 100 to 175 cc, will enlarge with time, and is always adequate in size. Shortening of the roux-en-y or anatomical reversal would work without the formation of an ulcer or the need of a vagotomy. It is known that the gastric bypass with both a short or long limb roux-en-y may be an ulcergenic operation. By the addition of the duodenal switch procedure the possibility of a marginal ulcer is remote9. We have never had a marginal ulcer since using the duodenal switch procedure in all of our cases, which including our redo surgeries, number more than 600 procedures. Since we do not remove the pylorus and do not have marginal ulcers there is little need for a vagotomy, and in turn, no dumping syndrome, We have never had a dumping syndrome in any of our cases. In our 20 years of experience, the biliopancreatic bypass with a duodenal switch has shown to be the most effective weight loss procedure, for both the morbidly obese and the super morbidly obese patient. For the super morbidly obese patient, restrictive procedures alone will probably not be successful. The biliopancreatic bypass with a duodenal switch, however, is a procedure that has shown to be a successful method of treatment for the super obese patient. " also those other things i had never heard before. he also told me to stay off the internet. no way!!!! Stay away from Dr. Schmidt! But, do be responsibly critical of what you read on the Internet. It's not all true. And, on this list, people try to be as objective as possible and do not intentionally mislead, but you are dealing a lot with individuals' opinions, and you have to filter them to arrive at the truth for yourself. Good luck, Steve At 7:56 PM +0000 5/11/01, tlarussa@... wrote: To: duodenalswitch X-Originating-IP: 63.202.180.172 From: tlarussa@... Mailing-List: list duodenalswitch ; contact duodenalswitch-owner Delivered-To: mailing list duodenalswitch List-Unsubscribe: <mailto:duodenalswitch-unsubscribe > Date: Fri, 11 May 2001 19:56:39 -0000 Reply-To: duodenalswitch Subject: Liver Problems -- 10 YEAR POST-OP STUDY Hi all: Steve and Nick referred to the fact that their primary doctors have hesitations about the DS, specifically in regard to liver damage down the road. Just want to let everybody know that Dr. Hess has done a 10-year study of more than 400 patients, and only one liver-problem is reported. The study is available at <http://www.duodenalswitch.com/Procedure/1998Hess/1998hess.html> You guys should print it out and stuff it down your doctors' throats ... er ... I mean, hand it to them at your next appointments. Tom Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2001 Report Share Posted June 20, 2001 steve: thank you so much for taking the time to show me all this great information. it's funny as i keep tell others about the ds it seems like i have made my decision. there are definitly so many more advantages over the rny. i guess my main idea is that even though i am fat bmi41, i am still healthy and have pretty much maintained this weight for many years. i am active can play sports and keep going all day. i don't want to trade a fat healthy body for a thin sick one. i need to make sure i can live with this decsion. i am about 90% there. it would be real nice to be thin!!! i never have been. well anyway. thanks again. i will let you know how my appt with dr ren goes. cheryl Quote Link to comment Share on other sites More sharing options...
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