Posted by softheprairie on November 6, 2012, at 14:01:40
In reply to Re: Considering gastric bypass - med questions, posted by prettygoodpatient on November 6, 2012, at 8:56:40
Definitely read lots about your choices before making such a major decision.
The chance of a morbidly obese person losing the weight on their own through diet & excercise and keeping it off more than 5 years is in the 2-5% range. Surgery offers much better weight loss chances (they vary by surgery type). If you had cancer, would you go with the treatment with 2-5% chance of success, or the treatment with a higher rate?
It sounds to me like Vincent had the Scopinaro procedure, aka the biliopancreatic diversion withOUT duodenal switch. That procedure has, for the most part, been abandoned, and rightfully so.
All of it's advantages can be had with the duodenal switch (aka biliopancreatic diversion WITH duodenal switch), while getting rid of or reducing some of the risks and side effects of the Scopinaro procedure, especially those related to loss of the pyloric valve, and to the Scopinaro procedure's pouch.Whatever you do, I would especially avoid the adjustable gastric bands (such as name brands Lap-Band or Realize Band). They are only "less-invasive" on the day of surgery. They have a low rate of patient satisfaction, and lower rate of weight loss. They have a high rate of needing to be re-operated on down the road. Many of their patients come to call them "crapbands." If you want only a little bit of surgical help (restriction only), I would recommend the vertical sleeve gastrectomy. You would still absorb practically all the calories you consume, but would not face the bowel and gas changes that come with having the DS, nor need to consume as much protein, nor as many mineral and vitamin supplements, nor watch labs as closely. For myself, I am all about the malabsorption though. That, and keeping the pyloric valve functioning normally. In other words, the DS. Surgeons who push the sleeve over-hype the supposed big impact of removing most of the grehlin-producing part of the stomach, saying your hunger will be way down. I have not found that to be the case for myself, so I am very grateful to not absorb all the calories I am still hungry to eat. (The DS includes the vertical sleeve gastrectomy, plus rerouting the intestines.) It is not politically correct to say, but I'll go ahead anyway: with the DS, you can get away with eating the most (compared to the other surgeries or non-surgical dieting), and still have the best weight loss; that's my kind of surgery.
Generally speaking, I would only potentially go with a RNY gastric bypass if your worst problem were GERD.
poster:softheprairie
thread:1030679
URL: http://www.dr-bob.org/babble/20121029/msgs/1030829.html