Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 >> So, then, what would be the advantage of having the RNY? << I don't think there are any! -Sherry (Lake Marcel, WA) BPD/DS Feb. 2, 2001 self-pay 5'5 " / 304 pounds / 34 years old Lost 9 pounds in pre-op weight loss efforts Have lost 107 pounds since surgery! Total of 116 pounds gone forEVER! http://www.fluffynet.com/wls/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 >> So, then, what would be the advantage of having the RNY? << I don't think there are any! -Sherry (Lake Marcel, WA) BPD/DS Feb. 2, 2001 self-pay 5'5 " / 304 pounds / 34 years old Lost 9 pounds in pre-op weight loss efforts Have lost 107 pounds since surgery! Total of 116 pounds gone forEVER! http://www.fluffynet.com/wls/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 > regaining the weight are very small. So, then, what > would be the advantage of having the RnY? As far as I can tell, the advantages are: 1) relatively cheaper, 2) more likely to be covered by insurance, although usually not without a WLS fight to begin with, 3) more doctors doing it = more accessible, 4) negative reinforcement for eating " bad " foods...if you're into that kind of thing. -M Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 > regaining the weight are very small. So, then, what > would be the advantage of having the RnY? As far as I can tell, the advantages are: 1) relatively cheaper, 2) more likely to be covered by insurance, although usually not without a WLS fight to begin with, 3) more doctors doing it = more accessible, 4) negative reinforcement for eating " bad " foods...if you're into that kind of thing. -M Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 DS Switch vs. RnY > I swear I've been reading up on the various surgery > types but can someone explain in plain English the > pros and cons of these two? > > It sounds like the duo surgery is much better because > you can eat normal food eventually and the odds of > regaining the weight are very small. So, then, what > would be the advantage of having the RnY? 1. More surgeons perform this surgery. 2. More insurance companies cover it. 3. Some people want their bodies to punish them when they are 'bad' with their eating, so they like the " dumping " factor. That's all I could come up with... alyssa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 Wow Chris..you sure do give some great information. Thanks for all the time you take sharing with us. ~~* AJ *~~ Age 37 5'8'' Post op 7/24/01 Open BPD/DS self pay - Dr Baltasar -Alcoy Spain 07/24/01 BMI 64 - 415.1 08/06/01 BMI 59 - 390.2 -24.9 lbs!!!!!!!!!!~~~~ 08/16/01 BMI 58 - 387.0 -27.9 lbs!!!!!!!!!!~~~~ Check out the Bellingham Support Group and my personal page at WWW.WLSBellingham.homestead.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 Wow Chris..you sure do give some great information. Thanks for all the time you take sharing with us. ~~* AJ *~~ Age 37 5'8'' Post op 7/24/01 Open BPD/DS self pay - Dr Baltasar -Alcoy Spain 07/24/01 BMI 64 - 415.1 08/06/01 BMI 59 - 390.2 -24.9 lbs!!!!!!!!!!~~~~ 08/16/01 BMI 58 - 387.0 -27.9 lbs!!!!!!!!!!~~~~ Check out the Bellingham Support Group and my personal page at WWW.WLSBellingham.homestead.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 The big argument against the DS is the POTENTIAL for protien malnutriton, fat soluble vitiman defficiency (A,D,E,K), calcium defeciancy (potentially leading to boneloss and osteoperosis, and iron defficiency anemia. Some mistakingly claim that B12 defficiency is a disadvantage, but actually the DS is better in that regard then the RNY because of the preservation of a portion of the duodenum. Iron deficiency is only an issue in menstruating women, and in 90% of the cases oral supplimentation is sufficient. In about 10% of the cases women will have to have intramuscular iron boosters. Vitamans A,E, and K deficiencies are easily resolved with a simple multi-vitamin. Vitiman D and Calcium defficiency are potentialy serious, and additional supliments (beyond a multivitamin) are often required. Even so, elevated levels of parathyroide hormone indicate potential calcium deficiency exists. So far the evidence suggest that no signifcant reduction in bone ass occurs, but the full data is not in. Dr. Marceau will be publishing a study on this very soon, and he hints at good results. Protien deficiency is a potentialy serious problem with this procedure. Initally the original Scopinaro procedure had about 15% incidence of it. With the combination of the DS and adaptation of either intestinal lengths or stomach sizes, the incidence of malnutrition is only a few %. Still, this problem is the leading reason for restoration of intestinal continuity. A problem associated with protien deficiency is chronic diaharrhea. This problem seems to be correlated with the length of the coman channel. Marceau reports that by increasing the common channel from 50cm to 100cm the incidence of this problem is reduced significantly. Even so, 10% of patients will suffer this problem to one degree or another. About 3% of the patients need reversals. Major side effects include foul stool oder and frquent bowel movements. This side effects are well tolerated by most patients. The Roux-en-Y has plenty of side effects and complications as well. The intially high rate of complications with the original Scopinaro procedure have lead many surgeons (even to this day) to avoid the BPD/DS. In addition there has been an unjustified association of the BPD procedure with the jejernal-illial bypass (JIB). JIB was a procedure that non-selectively bypassed over 90% of the small intestine. The result was chronic malunitriton problems, liver problems and many others. Because BPD and JIB both fit into the category of " malabsorption " procedures, many simply damn BPD and BPD/DS by association with JIB. Sue W is infomous for this, but so to have many estemeed suregons including the incoming president of the ASBS (Dr. Poires). Today the BPD/DS is well beyond its investigational phase. There are still a few technical issues to work out. What is the optimum stomach volume, common channel lentgth, and alimentary limb length? But the comlication rate is now comparable to the RNY procedure. Hull Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2001 Report Share Posted August 19, 2001 The big argument against the DS is the POTENTIAL for protien malnutriton, fat soluble vitiman defficiency (A,D,E,K), calcium defeciancy (potentially leading to boneloss and osteoperosis, and iron defficiency anemia. Some mistakingly claim that B12 defficiency is a disadvantage, but actually the DS is better in that regard then the RNY because of the preservation of a portion of the duodenum. Iron deficiency is only an issue in menstruating women, and in 90% of the cases oral supplimentation is sufficient. In about 10% of the cases women will have to have intramuscular iron boosters. Vitamans A,E, and K deficiencies are easily resolved with a simple multi-vitamin. Vitiman D and Calcium defficiency are potentialy serious, and additional supliments (beyond a multivitamin) are often required. Even so, elevated levels of parathyroide hormone indicate potential calcium deficiency exists. So far the evidence suggest that no signifcant reduction in bone ass occurs, but the full data is not in. Dr. Marceau will be publishing a study on this very soon, and he hints at good results. Protien deficiency is a potentialy serious problem with this procedure. Initally the original Scopinaro procedure had about 15% incidence of it. With the combination of the DS and adaptation of either intestinal lengths or stomach sizes, the incidence of malnutrition is only a few %. Still, this problem is the leading reason for restoration of intestinal continuity. A problem associated with protien deficiency is chronic diaharrhea. This problem seems to be correlated with the length of the coman channel. Marceau reports that by increasing the common channel from 50cm to 100cm the incidence of this problem is reduced significantly. Even so, 10% of patients will suffer this problem to one degree or another. About 3% of the patients need reversals. Major side effects include foul stool oder and frquent bowel movements. This side effects are well tolerated by most patients. The Roux-en-Y has plenty of side effects and complications as well. The intially high rate of complications with the original Scopinaro procedure have lead many surgeons (even to this day) to avoid the BPD/DS. In addition there has been an unjustified association of the BPD procedure with the jejernal-illial bypass (JIB). JIB was a procedure that non-selectively bypassed over 90% of the small intestine. The result was chronic malunitriton problems, liver problems and many others. Because BPD and JIB both fit into the category of " malabsorption " procedures, many simply damn BPD and BPD/DS by association with JIB. Sue W is infomous for this, but so to have many estemeed suregons including the incoming president of the ASBS (Dr. Poires). Today the BPD/DS is well beyond its investigational phase. There are still a few technical issues to work out. What is the optimum stomach volume, common channel lentgth, and alimentary limb length? But the comlication rate is now comparable to the RNY procedure. Hull Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2001 Report Share Posted August 20, 2001 Hummmmmm I'm trying to think of the advantages of the RNY over the DS. Give me a year or two and I just *know* I'll think of one.. well maybe...... in Seattle DS 12/5/01 Dr Welker 295/198 So, then, what > would be the advantage of having the RnY? > Dee .com/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2001 Report Share Posted August 20, 2001 Ahem.. about those malnutrition issues... you are comparing proximal RNTs to the DS. You need to add in all the risk of regaining the weight with that version of the RNY. A huge disadvantage. With the distal RNY there are all the same malabsorption issues and risks. However complicating this is the tiny pouch preventing eating enough food to meet the body needs without major supplements. The comparison needs to be between distal RNYs and tbe DS. in Seattle > The big argument against the DS is the POTENTIAL for protien > malnutriton, fat soluble vitiman defficiency (A,D,E,K), calcium > defeciancy (potentially leading to boneloss and osteoperosis, and > iron defficiency anemia. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2001 Report Share Posted August 20, 2001 At 1:07 PM +0000 8/20/01, marym@... wrote: >Hummmmmm I'm trying to think of the advantages of the RNY over the >DS. Give me a year or two and I just *know* I'll think of one.. well >maybe...... I know! I know, teacher! Call on me! Call on me! If you get an RnY, you--yes, you, you lowly worm--can correspond with Carnie in her very own chat room. --Steve -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2001 Report Share Posted August 20, 2001 > If you get an RnY, you--yes, you, you lowly worm--can correspond with > Carnie in her very own chat room. DAMN, now you tell me. And here I am, stuck with this horrible DS! Guess it's time to go running off for a revision, isn't it. OH WAIT....if I do that, will I have to take the 148 pounds back? Let's just forget it, okay? Michele B., Cols, Ohio Failed VBG 1986 Revision - Open BPD/DS 7/14/00 Wt 320/172 BMI 50.2/26.9 -148 pounds in 13 months Dr. P. Maguire, Kettering OH Self-pay http://hometown.aol.com/chezmich/index.html " Men never do evil so completely and cheerfully as when they do it from religious conviction. " -- Blaise Pascal, philosopher and mathematician (1623-1662) Quote Link to comment Share on other sites More sharing options...
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