Obesity Surgery WP Blog

One Response to “Please explain difference in procedures”

1. bennett200 Says:
   November 27th, 2004 at 11:11 am

   There are basically two ways in which wls procedures work. They use
   restriction (how much or what you can eat) and malabsorbtion (your body
   doesn’t absorb the food you intake).
   The VBG and Lap Band are both entirely restrictive. They work entirely by
   limiting how much you can eat.
   The Proximal RNY has a weee bit of malabsorbtion but relies primarily on
   restriction for weight loss and maintenance. The Proximal RNY may also
   result in “dumping syndrome” which some consider a plus for helping keep the
   wls patient “in line” as to the types of food they are eating. You can do a
   search on dumping syndrome and get many definition on what it is. Often it
   is a Hypoglycemic type reaction to eating sugary food. Be aware, as many
   doctors don’t tell their patients this, that 25% of RNY patients never dump
   (which is good or bad depending on your perspective) and a small percentage
   have dumping so severe that things like ketsup or teriyaki sauce with send
   them into a dumping episode.
   
   The distal RNY and BPD/DS rely more on malabsorbtion for weight loss and
   maintainence. The distal RNY has more restriction than the BPD/DS. With the
   BPD/DS you can eat a fairly normal meal by 12 to 18 months out.
   Studies show the more malabsorbtion the better long term results of the
   procedure. Although restrictive procedure may do as well or better in the
   short run, 5 years or more out show the malabsorbtion procedures to be more
   effective. However, with this comes the possibility of nutritional problems.
   Compliance with vitamins, follow up appointment and bloodwork are more
   crucial with the follow up procedures.
   The BPD/DS does have less problems with B12 and iron than the other ones with
   malabsorbtion probably because there is a small portion of the duodenum that
   comes in contact with food still after the BPD/DS.
   The VBG does not have a good success rate. The AGB require routine follow
   ups (more so than I have had to have with my BPD/DS) with the surgeon to
   adjust the band. The RNY is done so many different ways that you really need
   to know how the surgeon does it and then research if that is how you want it
   done. Also surgeons often don’t tell patients about the possibility of stoma
   stretches with the RNY. In a proximal procedure this can render the effects
   of the surgery useless. With the BPD/DS you may have to travel to get the
   procedure and there are more frequent BMs.
   I could go on and on as I think I would be capable of giving a 2 day seminar
   on wls procedure and their differences.
   Basically you need to decide how aggressive of procedure you want. I wanted
   a very, very agressive procedure and therefore chose the BPD/Ds. I just had
   my 2.5 year bloodwork and have great levels on everything including iron,
   protein, etc., etc. In fact my iron is up from 6 months ago. I am very
   good about taking my vitamins. The only eating rule I go by is to “think
   protein” and eat a couple of good servings of protein a day. After that I
   eat whatever I want.
   You can read about the BPD/DS at www.duodenalswitch.com.
   Dawn–far south suburban Chicago, IL area
   Dr. Hess, Bowling Green, OH
   BPD/DS
   4/27/00
   www.duodenalswitch.com
   267 to 160 5′ 4″
   size 22 to size 10
   have made size goal
   no more high blood pressure, sore feet, or dieting

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