Category: AGB
Slipped Band
November 02, 2012 10:40 pm
Revision or Reversal of the Duodenal Switch
September 08, 2012 7:00 pm
A significant portion of my practice involves the revision of the Gastric bypass and Adjustable Gastric Banding procedures to the Duodenal Switch operation. The re-operations are necessary to correct the complications that have been caused by these procedures. There are also instances of required revisions due to inadequate weight loss or weight regain. Our website contains detailed information regarding reasons for revision and the reversal of weight loss surgical procedures. I think it is important to mention that these complications are very common and almost never have anything to do with the patient’s behavior.
Duodenal switch operations may also require reversal or revision. The general reasons for a revision or reversal of the Duodenal Switch is the same as for all weight loss surgical procedures and include a variety of reasons. The reversal or revision of the Duodenal Switch operation is one of the simplest revision surgeries that I perform.
Let’s review a few facts about Duodenal switch.
The Duodenal Switch procedures has two components:
1.) The sleeve gastrectomy
2.) The separation of the biliopancreatic secretions from the food to limit its absorptions.
Clearly, the portion of the stomach that has been removed cannot be reintroduced to the abdominal cavity. The second part of the operation can, however, be easily “undone.
The assumption is that the bowel needs to be divided again and re-anastomosed to reconstitute its continuity. This revision or reversal of the Duodenal Switch operation is done by simply creating a new connection between a new anastomosis, located between the biliopancreatic limb, and the alimentary limb.
If a complete reversal is needed, then the connection is made just distal to the ligament of Treitz. Ligament of Treitz is the transition point between the duodenum and Jejunum. This single anastomosis is safe and simple to perform and does not involve removing the previous staple lines.
If a partial revision is needed, or the common channel needs to be lengthened, then the anastomosis is made further proximal to the junction of both the alimentary limb and the biliopancreatic limb, but distal to the ligament of Treitz to allow for increased absorption of the calories and nutrientsIn my opinion, the revision and reversal of the Duodenal Switch operation is, from a technical perspective, the simplest of all revisional weight loss surgical procedures.
In my opinion, the revision and reversal of the Duodenal Switch operation is, from a technical perspective, the simplest of all revisional weight loss surgical procedures.
Carbonated Drinks and Weight Loss Surgery
August 11, 2012 3:56 pm
The consumption of carbonated drinks is discouraged after weight loss surgery. In fact, there is a wealth of information that documents the detrimental health effects of carbonated drinks for each individual. These include osteoporosis, obesity, and premature dental decay, just to name a few. Indirectly, carbonated drinks have been found to increase risk of stroke and Cardiac events. There are studies that show a 48% increase in heart attack and stroke rates for individuals who drink diet sodas vs. those who drink it rarely or not at all.
There is also no health benefit to diet carbonated drinks. In fact, there are animal studies that show that rats who consume no-calorie sweeteners found in diet sodas experience an increased appetite (Susan Swithers, PhD- 2004).
There are also other factors to consider. The carbonation comes from a mixture of dissolved gasses that are released when the container is opened. The Carbon Dioxide gas dissolved in the drinks, amongst others, can distend the stomach. Potentially, stretching your stomach. There is also acidity that needs to be corrected by the body. This has been shown to result in changes in the bacterial population in the GI track, resulting in significant bloating and reduced absorption of nutrients.
Calcium loss is caused by the leaching of the calcium from the bones with carbonated drinks, which can cause osteoporosis.
Yearly lab and medication requests
October 17, 2011 5:28 pm
First, we now have preferred laboratories that have partnered with us. The laboratory results are expected to be sent to us electronically, which should cut down on the time between the blood draw and when the results are available to us. The information on the preferred labs is located at: https://www.dssurgery.com/lab. Needless to say, there are no financial incentives for us. You should also check with one of the labs, as well as with your insurance company, to make sure that they are a contracted facility and that the order is covered under your policy. It is your responsibility to make sure that your insurance company will pay for the labs ordered. We are in no way responsible for the verification of benefits for the laboratory services that we order.
Second, we have had to change the way we order our yearly lab work. As most of you are aware, it is critical that weight loss surgical patients have continuous yearly follow-up care and monitoring. It is critical that the patients continue to receive yearly follow-up care, not only by doing their scheduled laboratory studies, but also by a yearly follow up in office exam. We provide a comprehensive follow-up plan to the patients who have had the the Duodenal Switch or Revision from other failed weight loss surgical procedures. This includes ordering the laboratory studies, review and interpretation of the results, as well as office visits as frequently as required or deemed necessary.
Weight loss information
September 22, 2009 4:22 am