Gastric bypass has not been changed for years. The only difference is that some gastric bypasses are dangerously radical, the pouch size is 5 cc (grape size) and now it is being performed laparoscopicly.
In this stage of knowledge we know that excess body weight loss after adjustable
laparoscopic banding is approximately 50 %. Failure rate is approximately
at 30 %. 25 % of diabetics are not cured. 20 % of patients with high cholesterol
and triglycerides are not cured. In comparison, the duodenal switch
procedure cures approximately 100 % diabetes and 98 % hypertension and 98 %
lipid disorders. Vomiting, esophageal dilatation and motility disorders are
possible if band is to tight. Remember, the longer the band is around the stomach,
the risk for complications increase.
Modifications of the duodenal switch procedure performed in our practice is designed
individually. The factors taken into consideration are weight, body mass index, age
and goals. This procedure, for the most part, is totally reversible from the absorption
point of view.
We know that a patients response and successful weight loss varies. The most
important factor is weight (body mass index), especially a BMI greater than
60. This is why we developed a new approach that allows us to achieve
excellent results in weight loss independent of patient's BMI.
This is contrary to gastric bypass or the banding procedures, which are performed
the same way regardless of the patients weight (BMI).
There are a few things that patients need to realize. Duodenal switch is for the
compliant patient that is willing to take vitamins and minerals daily, attend support
group meetings and post-operative follow up.