Of course you know you can choose a gastric sleeve or a newer procedure that is getting a lot of reviews, the duodenal switch.
If I were doing it today I would give serious consideration to the duodenal switch, although it's probably a lot more surgery than I needed, considering I didn't have any obesity-related disease to speak of. I was pre-diabetic and had high blood pressure but other than that, I was just sick of carrying all that weight and yeah, I had bad knees.
I think what makes the DS most exciting is its amazing results at curing diabetes. You can't use the word cure unless you you can truly eradicate all traces of a disease. But it scares me because they take so much intestine. Actually they don't take the intestine; they just block it off. Here's what Columbia University has to say about that:
"Duodenal switch results in the greatest, most reliable and longest lasting weight loss of all the weight loss procedures. Since this operation induces a state of decreased absorption, patients will likely experience more frequent and looser bowel movements, increased flatulence, and need to be very closely monitored for vitamin, mineral and protein levels."
DS is also recommended for sleeve patients who have had little success losing weight. The sleeve is already in place so the intestinal portion is done in addition. Like Columbia University says:
"It may also be used as a revision operation for sleeve patients who have not lost enough weight or who regain significant weight. In such cases the intestinal bypass is added beyond the sleeve rather than dividing the sleeve and converting it to a gastric bypass."
All that being said, I cannot complain about my roux-en-y surgery. It remains the gold standard of bariatric surgery. I would prefer it any day of the week to the sleeve and would probably be too scared to try the duodenal switch.
Also, it's important to note that not that many surgeons are conversant in performing the duodenal switch surgery yet. It's too new and too complicated. It has to be performed in two stages over a period of 9 to 12 months, unless the patient already has a gastric sleeve.
It does show promise though, and I am going to be alert for any new research that comes through about it.