BPD/DS Weight-Loss Surgery

icon-2-g Biliopancreatic Diversion

This procedure is more complex than the other bariatric surgeries and involves two separate surgeries. The first is similar to Gastric Sleeve Surgery. The stomach is separated in two, creating a smaller stomach pouch while the remainder is removed.
The second surgery then follows similarly to the Roux-en-Y Gastric Bypass. And roughly three-fourths of the small intestine is bypassed by the food stream.
The small intestine is divided in two, and the lower section is attached to the newly formed stomach. This redirects food to bypass most of the small intestine. The surgeon also reattaches the bypassed section to the last part of the small intestine, allowing digestive juices to mix with food.
This type of surgery allows you to lose more weight than the other options. However, this is also the most likely to cause surgery-related problems and a shortage of vitamins, minerals, and protein in your body. For these reasons, only an experienced surgeons will perform this surgery.

The Biliopancreatic Diversion with Duodenal Switch is considered to be the most effective surgery for the treatment of diabetes, and results in a significant decrease in the absorption of calories and nutrients (particularly protein and fat) as well as nutrients and vitamins dependent on fat for absorption (fat soluble vitamins and nutrients).
Compliance with follow-up visits and strict adherence to dietary and vitamin supplementation guidelines are critical to avoiding serious complications from protein and certain vitamin deficiencies.

Of the individuals that are overweight by 50 pounds or more, 90% fail to control weight through exercise and diet. This is not due to laziness or a lack of willpower, but to an increased metabolism that processes nutrients and minerals at a faster rate. These individuals will gain more calories than before when eating the same meals. When a change in lifestyle is insufficient, weight loss surgery becomes the most viable solution. However, a successful operation often requires an additional surgery to finalize improvements to health and weight.

Post-bariatric surgery is a very important part of rehabilitation and success. Follow up surgeries are typically performed about 12 to 18 months after surgery, when the patient has adapted to lifestyle changes, and weight loss has slowed down or even begin to reverse. By then, the body has likely compensated for the shift in diet by increasing the absorption of calories consumed. Often times, this happens prior to the patient achieving their desired results, and independent of anything the patient may have done wrong. This is why revisional surgery is often necessary to fine tune and solidify a patient’s overall progress. Failure to get a revisional surgery can lead to; difficulty maintaining dietary guidelines, minimized results, or even weeks of dieting undone. Some possible indications that it’s time for a revision include; incapacity to attain desired body mass, unexpected changes despite maintaining the same diet, slowed weight loss prior to achieving satisfactory IBM, greatly increased appetite, greater capacity to eat than expected, and more.

Furthermore, a revision may be necessary if there is cause for concern as described below.

When you come into our office, we will evaluate any developments since your previous weight loss surgery. We will take diagnostics, conduct X-rays, and run tests to determine the current state of your anatomy. Our surgeons will also consider other conditions that may affect your bariatric revision and will take into account your progress and goals. Your success is important to us.

A surgical revision is generally recommended to maintain improvements, but may even be necessary if symptoms or incidents become reason for concern. Here are a few possible revisions to help you get back on track:

  • Correction or Reversal of a Biliopancreatic Diversion:
    Intestines can continue to grow following surgery and the composition of bacteria, hormones and nerves can change over time. If you experience metabolic changes that cause your intestines to absorb more calories, promoting weight gain, our surgeons can conduct a revision to your Biliopancreatic Diversion, including further adaptations to the stomach or intestines. Additionally, a more serious condition such as internal leakage or erosion could require surgery. Although difficult, all or part of this procedure can be reversed if necessary.
  • Usage of an Adjustable Gastric Band, a Vertical Banded Gastroplasty, or a Vertical Sleeve Gastrectomy:
    If you still experience trouble losing weight and our doctors notice an enlarged pouch, it may be possible to use a band or a sleeve gastrectomy to enhance results.
  • Conversion to a Roux-en-Y Gastric Bypass:
    If the stomach pouch has expanded enough, it may be possible to pursue a form of the Roux-en-Y by rerouting a different section of the intestines, although this may impose more risks and complications.

Generally, our surgeons can perform revision surgery laparoscopically. This is a minimally invasive surgery that uses small incisions with the aid of a camera to operate. This technology helps avoid large incisitions in your body that would make day-to-day life activities more difficult and take longer to heal. Our physicians use only the best technology to revise your bariatric surgery.

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