[John]

I have attached a comparison chart that includes the duodenal switch procedure. Please note that while the Lap Band and Gastric Bypass are certified procedures, the duodenal switch is still only in an experimental phase, and is not a certified weight loss procedure. Since there is not much data available yet, the duodenal switch information is subject to change in the near future.

[kellyMASS]

I can't wait to see the switch become more popular.I wish Dr.Callery did this procedure I would be on a plane!

[Grammy O]

Interesting information John, thanks for posting it.

But there is a question? What do the "+"'s mean?

[Corrine]

John,

Can you clarify - I was told that the RNY is malabsorptive and restrictive.

[John]

Both are valid questions.

There's a chance that I may have mixed that one up. I have to wait to ask my dad to confirm. Will also get clarification on the +'s, but I think + is mild, ++ medium, etc.

[John]

Okay, part one:

There are a few major variations of the RNY gastric bypass, all of which vary regarding the malabsorption aspect. These variations somewhat depend on how much and what parts of the intestine the surgeon bypasses.

The variation that Dr. Callery specializes in is primarily restrictive, while malabsorption is an effect of the procedure (rather than the surgical mechanism). In contrast, duodenal switch (and some of the other bypass variations) may use malabsorption as a primary mechanism.

For example, they make the stomach incredibly small (not much larger than a golf-ball or two) - and the restriction aspect of this prevents individuals from eating too much food (hence losing weight). This is the primary mechanism of the surgery, while the parts of the intestine that they bypass also cause some malabsorption.

I guess it's more along the lines of "there's more than one way to skin a cat", and it depends on the doctor/surgeon that describes it.

I'll try to have the doc get me a better description this week.

John

[BabyNicole]

Does anyone know why the duodenal switch is not a "certified" wls? I've also heard of the mini-gastric bypass. Anyone know much about that?

[John]

I'm going to see if I can find more specific data for you...

[kellyMASS]

Medicare has certified the switch for three years now.It takes time for these things to fall into line..

[John]

From what I've heard is that the duodenal switch will likely play a much larger role in the future... it's just one of those things that takes time to refine, certify, adopt by surgeons, etc.

A lot of these equipment companies play a big role in marketing procedures, such as bariatric edge, the allergan, etc... so it probably will take many years before it is a mainstream procedure.