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COMPARE BARIATRIC SURGICAL PROCEDURES
Gastric Reduction Duodenal Switch (GRDS) (LGRDS -DS)

This surgical procedure was originated by Douglas Hess, M.D. of Bowling Green, Ohio. In the restrictive component of the LGRDS, 65 % of the stomach is resected (removed). The size of the stomach after resection has the volume for approximately 4-6 oz. The small bowel (intestine) and duodenum (first segment of small intestine) is divided and new connections are made. This procedure bypasses approximately 60-65 % of the small bowel. The part of the intestine where the digestion and absorption of fat and proteins is taking place after surgery is called the common channel. A calculation regarding the length of the common channel is very important in this procedure. It determines how much malabsorption should be created. The length of the small intestine varies for each individual. There are other factors that are also taken into consideration within this calculation. These factors include patient's age, weight, BMI and goals. Each patient has a different length of common channel and alimentary loop designed in order to achieve the best results. Routinely the gallbladder and appendix are removed. There is a 80 % chance of gallstones forming following weight loss. The gallbladder is removed to eliminate this possibility. The appendix is removed to avoid future confusion of questionable abdominal symptoms of appendicitis or necessity for an appendectomy in the first months following surgery. This type of surgery (LGRDS) is the most successful Bariatric procedure at this time. It is designed to be the most physiological and have the best long term results.

PLEASE NOTE

  • NO PART OF THE BOWEL (INTESTINE) IS REMOVED IN SURGERY.
  • ALTHOUGH THE STOMACH IS RESTRICTED, IT WILL STRETCH IN TIME. APPROXIMATELY 12 MONTHS FOLLOWING SURGERY PATIENTS ARE ABLE TO EAT 60 % THE AMOUNT OF FOOD EATEN PRIOR TO SURGERY.
  • THE LENGTH OF THE SURGICAL PROCEDURE IS 2.5 TO 5 HOURS.
  • AVERAGE HOSPITAL LENGTH OF STAY IS 3 DAYS.
  • WEIGHT LOSS WILL LEVEL OUT IN APPROXIMATELY 12 TO 24 MONTHS.

    RESULTS

    Patients are losing 85 % to 95 % of the excess body weight within one to two years following surgery. A patient's weight and BMI prior to surgery does have an effect on the weight loss as well as the compliance of a patient to follow post operative instructions.

    Studies have shown that the long term success in this surgical procedure for morbid obesity is approximately 85 % of the excess body weight loss. This weight loss has proven to be the most successful for the treatment and alleviation of hypertension, Type II diabetes, sleep apnea, hypercholesterolemia, pain associated with arthritic changes in joints, asthma and urinary stress incontinence as well as improving psycho-social activities.

    POSSIBLE SURGICAL COMPLICATIONS

    INTRA-OPERATIVE

  • BLEEDING
  • BLOOD TRANSFUSION
  • INJURY TO LIVER, SPLEEN, ESOPHAGUS, LARGE BOWEL

    IMMEDIATE POST-OPERATIVE COMPLICATIONS

  • PERFORATION INVOLVING SMALL BOWEL, DUODENUM, STOMACH
  • BLEEDING
  • OBSTRUCTION
  • PANCREATITIS
  • EVISCERATION
  • PULMONARY EMBOLI
  • DEEP VEIN THROMBOSIS
  • ABSCESS
  • PNEUMONIA
  • PERIOPERATIVE MORTALITY RATE (approximatey 0.5 %)

    SUBSEQUENT POST-OPERATIVE LONG TERM COMPLICATIONS

  • HERNIA
  • EXCESSIVE WEIGHT LOSS
  • OSTEOPENIA / OSTEOPOROSIS
  • ANEMIA
  • OBSTRUCTION

    SYMPTOMS TO RECOGNIZE

    Side effects following this surgery are very rare, however, patients sometimes do experience various symptoms. The most typical symptoms are distorted taste and smell, dry mouth, diminished appetite, occasional nausea, dizziness and hot flashes. Most patients discover these symptoms are gone within 2 - 4 weeks after surgery.

    The symptoms patients need to be aware of that are of most concern are frequent nausea with vomiting, diarrhea, temperature above 100 degrees, drainage from incision, unexpected abdominal pain, shortness of breath, chest pain or swelling of the legs.

    Gastric Bypass - (open or laparoscopic)
    Adjustable Laparoscopic Band

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