Duodenal Switch? What the heck is that? - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

Claire-in-Texas · 07-08-2007, 02:52 PM

Can someone tell me what a duodenal switch is, and how it differs from the plain ole Rouxy En Y Gastric Bypass procedure? Really curious about this.

Eseret · 07-08-2007, 03:35 PM

Got this from Google.....

The DS is similar to the RNY with respect to the intestinal bypass (malabsorptive) portion of the procedure. The lower part of this surgery is basically the same as a distal RNY. RNY's are done either proximal (with a shorter length of the intestines bypassed) or distal (with more of the intestines bypassed). Studies have shown that people who have distal bypasses have greater success at losing large amounts of weight and keeping it off.
The RNY and DS are very different with respect to what is done at the top end of the surgery -- the portion involving the stomach (the restrictive aspect of the surgery). The RNY doctors do a variety of things to make the stomach smaller -- most create “pouches” or transect (divide) the stomach. They then reroute the intestines by connecting them directly to the new stomach pouch, bypassing the duodenum. In the RNY/pouch procedures, the pyloric valve (which regulates the emptying of stomach contents into the duodenum) is bypassed and therefore doesn't function after surgery.
In the DS procedure, the surgeon creates a smaller stomach by removing about 75% of the stomach (which is called a partial gastrectomy). The top part of the gastric bypass is connected below the duodenum which keeps the upper part of the digestive process the same as before surgery (except that your stomach is smaller). Your pyloric valve continues to regulate the emptying of the stomach contents into the duodenum and all of the hormones and secretions that occur in the duodenum continue after surgery.
In RNY/pouch procedures, the duodenum and pyloric valve are bypassed and the intestines are connected to the newly created stomach pouch. Dumping happens when the stomach contents (unregulated by the pyloric valve which has been bypassed) dump directly from the new stomach pouch into the intestine. Eating sugars can cause dumping for many RNY/pouch patients. For this reason, they must be very careful of sugars. Some feel that this type of surgery with the dumping syndrome is the best option for people who eat a lot of sweets, since the dumping acts as a deterrent to eating sweets.
Since our pyloric valve and duodenum are left functioning as before, we DS patients don't have dumping syndrome, nor a risk of staple line problems, clogging of the anastamosis, ulcers at the stoma, etc. (remember, we don't have pouches or stomas). So, we don't have the problems with "stretching" the pouch or getting something stuck in the stoma -- because what we have is our real stomach, connected the same way it was before surgery to the duodenum.

Claire-in-Texas · 07-08-2007, 03:44 PM

How interesting!

I don't believe much is discussed about a duodenal switch, and my surgeons never mentioned it as an option. I wonder why.

I am very happy with my pouch, which is behaving well. Am I correct in assuming that the surgeon gave you this procedure as one of your options?

Eseret · 07-08-2007, 04:15 PM

Quote:

Originally Posted by Claire-in-Texas

How interesting!

I don't believe much is discussed about a duodenal switch, and my surgeons never mentioned it as an option. I wonder why.

I am very happy with my pouch, which is behaving well. Am I correct in assuming that the surgeon gave you this procedure as one of your options?

Nope, he never brought it up. I read about it awhile back when Keith had his. I think I'd rather have the GB as it looks like it's better in the long run and will cure my sugar addiction via dumping.

Teri

Claire-in-Texas · 07-08-2007, 04:55 PM

I definitely have had a sugar addiction for at least 65 of my 67 years, and now I am not interested in anything sweet. I never liked dark chocolate because it tasted bitter to me. Now I look for dark chocolate brownie protein bars because they aren't sweet.

Gastric Bypass definitely changed my sweet tooth. I hope that continues. I am determined not to go back to bad habits.

Have you decided on the DS, or are you considering GB as well?

Eseret · 07-08-2007, 05:14 PM

Quote:

Originally Posted by Claire-in-Texas

I definitely have had a sugar addiction for at least 65 of my 67 years, and now I am not interested in anything sweet. I never liked dark chocolate because it tasted bitter to me. Now I look for dark chocolate brownie protein bars because they aren't sweet.

Gastric Bypass definitely changed my sweet tooth. I hope that continues. I am determined not to go back to bad habits.

Have you decided on the DS, or are you considering GB as well?

Like you, I have a non-stop sweet tooth I hope will end after surgery. I'm really not into chocolate, but any other sweets I crave. Getting away from my sugar demon will not only allow me to lose weight, but save me tons of money I'd spend on food, snacks, etc.

I see my surgeon this coming Thursday, and I hope to talk to him about both types of surgeries, pros and cons of both, etc. As of today, I want GB.

How are you doing? I can't wait to get on the losers bench!

Teri

Claire-in-Texas · 07-08-2007, 05:41 PM

Teri, I am very happy with my progress. My entire life has changed.

My marriage is better, I am happier, I exercise and love it (this from the person who NEVER exercised), and most importantly, my back doesn't hurt.

What caused me to turn to WLS is my pain management doctor, who told me he couldn't help me anymore. My spinal stenosis had become so painful that surgery was required (or at least physical therapy), and I was too fat for both. My husband was with me, and asked more about WLS and physical therapy.

That was the end of February. On April 9 I had GBS, have dropped 56 lbs and my own daughter, who received a new picture of me today, said she wouldn't recognize me on the street!

When I had lost about 35 lbs, I started physical therapy (had it for 4 weeks, 3 times a week). That worked wonders, and I moved on now to more traditional exercises, but I continue to do all my physical therapy exercises at home, every day.

So I'm doing really well, and I'm so grateful that I was able to get to a point where I feel so much better, can walk endlessly without pain (I was tied to a walker before), and have had no complications (I go for my three month checkup - and get blood work done -- on Tuesday). My grandson called me his hot grandma! LOL I loved it! And so did he!

Vickie · 07-08-2007, 06:15 PM

Hi there.

I have noticed that the only time i have ever seen the switch offered is on a patient that has already had a weight loss surgery. I know they can hold more food and dont seem to dump. They absorb it better to. I have noticed this alot with people who had the old banding procedure done. Mine never offered it to me either. Perhaps its a last resort sort of thing....im not sure.

sweetchristiangal · 07-08-2007, 06:46 PM

Could it be that some surgeons only specialize in certain surgeries such as RNY or Lap Band. Very few do a variety of them. I for one would rather have a master of one trade than a jack of many who may not know all the deep intricacies.

I am more for RNY as it is a permenant procedure and you are expected to make permenant changes to your life and diet. i think if I would have had one of the others I would have viewed it differently. JMO

Christina

VanessaSFL · 07-08-2007, 06:50 PM

If I remember correctly...My Surgeon said that he only does DS with Super MO people.BMI 50+.I may be wrong but that is what I remember.Hmmm?