The Most Effective Surgery
I am frequently asked which is the best surgery for morbid obesity? Of course, this is a complicated question to answer in view of the multiple procedures available today.
For me, the best surgery has to be safe, has a fast recovery, gives the patient the best chance to achieve his/her ideal weight, and helps control medical problems associated with morbid obesity. The best surgery also has to control 3 aspects of weight loss: intake, absorption, and metabolism.
The Bileopancreatic Diversion with Duodenal Switch (BP-DS) fulfills these requirements. To perform this operation, part of the stomach is removed, which decreases food intake and removes chemicals in the stomach that promote hunger. Then, the very beginning of the small intestine, the duodenum, is connected to the new stomach. This is the metabolic component of the surgery, because it stimulates and inhibits certain hormones that control insulin. The lower intestines are rerouted, and food bypasses the initial part of the intestine, which significantly reduces the absorption of fats.
The BP-DS has been performed in the United States for 10 years, and it has been performed around the world on thousands of patients. With new minimally invasive techniques, this surgery can be performed laparoscopically, which increases safety and minimizes mortality.
The one disadvantage is that it is a very complicated procedure and very few surgeons have the experience or commitment to do it. However, it has the greatest weight loss percentages (80% estimated weight loss at 5 years). So the answer to the initial question is “The BP-DS is the best surgery for weight loss.”