Laparoscopic BPD Complications & Side Effects

Because BPD with DS is major surgery, it poses possible complications and side effects, which should be considered before making the decision to have surgery. Complications can occur both early after surgery and later during the recovery period. Although no surgery is risk-free, AtlantiCare's program takes steps to minimize the chance of complications with:

  • Proper treatment
  • Monitoring
  • Support
  • Management

Potential Early Complications Following Duodenal Switch Surgery:

  • Deep vein thrombosis (blood clot)
  • Pulmonary embolism
  • Respiratory complications (such as pneumonia)
  • Gastrointestinal leak
  • Bowel obstruction
  • Infection
  • Bleeding that may require a blood transfusion or possibly a return to the operating room
  • Death.

Potential Later Recovery Period Problems:

  • Hair loss (not permanent for most women)
  • Vitamin deficiencies that may lead to anemia, metabolic bone loss or other problems.
  • Regaining of weight
  • Diarrhea and foul smelling gas, with an average of 3-4 loose bowel movements a day
  • Protein-calorie malnutrition, which might require a second operation to lengthen the common channel
  • Bowel obstruction

Sources:

  1. http://asmbs.org/story-of-obesity-surgery-biliopancreatic-diversion-and-duodenal-switch/
  2. The New England Journal of Medicine: Bariatric Surgery vs. Conventional Medical Therapy for Type 2 Diabetes
  3. http://www.ajronline.org/content/193/6/1576.long
  4. http://bariatrictimes.com/2009/06/18/the-duodenal-switch-revisited/
  5. http://www.duodenalswitch.com/procedure/1998hess/1998hess.html

Laparoscopic BPD with Duodenal Switch

Laparoscopic Biliopancreatic Diversion (BPD) with Duodenal Switch (DS) surgery is one of four surgical weight loss options we offer at AtlantiCare. The BPD with DS was first reported by Dr. Doug Hess in 1986 and is considered the most effective surgical weight loss approach available today.  It is also the most effective treatment for metabolic diseases, such as Type 2 Diabetes and hyperlipidemia associated with morbid obesity. The procedure has both restrictive and malabsorptive components. Very few centers in the world offer this procedure, especially with a laparoscopic approach.

Patients who choose to have laparoscopic BPD with duodenal switch surgery will typically experience these benefits:

  • Increased amount of food intake compared to the bypass and band and yet with the greatest weight loss
  • Less food intolerance
  • Possibly greater long-term weight loss
  • More rapid weight loss compared with gastric banding procedures
  • 70 to 80% loss of their excess body weight within the first 2 years  after surgery;
  • Decreased or complete remission of health disorders resulting from extreme overweight*, such as:
    • Diabetes (95% of patients with Type 2 diabetes experienced complete remission)
    • High blood pressure
    • Gastric reflux
    • Hyperlipidemia
    • Sleep apnea and other conditions
  • Increased mobility
  • Improved psychological wellness
  • Improved social interactions
  • And, most important, overall improvement in quality of life

*Improvement or complete resolution of medical problems is not guaranteed and they may recur if weight is regained.

What the Procedure Involves

  • Removal of 85% of the stomach including the portion that is responsible for producing an appetite stimulating hormone (Ghrelin).  Since this portion is removed, patients tend to feel less hungry than before surgery and yet the functional part of the stomach remains. Formation of the new stomach “sleeve”, which is shaped like a very slim banana which measures from 1-5 ounces.  By reducing the size of usable stomach the patient feels full with lesser amounts of food.
  • The small intestine is reconfigured and then reconnected to the remainder of the stomach so that not all of the calories that are consumed will be absorbed, producing the greatest amount of weight loss of all bariatric  surgical options

Laparoscopic-BPD

Long-term follow up and daily vitamin and protein supplements are crucial to the success of this operation. Life-long monitoring is necessary to prevent nutritional and mineral deficiencies – just as with the RYGBP.

The gallbladder, if still present, is removed as a part of the procedure.

Information on laparoscopic Roux-en-Y gastric bypass surgery »

Information on laparoscopic adjustable band surgery »

Information on laparoscopic sleeve gastrectomy surgery »

Next: What are the complications and risk factors of Duodenal Switch? »

Alexander Onopchenko, MD, FACS

Medical Director and Bariatrician
Center for Surgical Weight Loss & Wellness
AtlantiCare Physician Group
2500 English Creek Ave
Building 800
Egg Harbor Twp, NJ  08234
(609) 407-2332

Alexander Onopchenko, MD, FACSAlexander Onopchenko, MD, FACS

Dr. Onopchenko graduated from Ursinus College with a B.S. in Biology in 1979 on the Dean’s Academic Honors list. He obtained his doctorate in medicine from the Medical College of Pennsylvania in 1984 with honors, completed a residency in general surgery at the University of Medicine and Dentistry of New Jersey in 1989, and has been a practicing general surgeon in Atlantic County since July of 1989.

Dr. Onopchenko is board-certified in general surgery, and is a fellow of the American College of Surgeons. He is also an active member of the American Society of Bariatric Surgery and presented a paper on identification of internal hernia after gastric bypass at the 2005 national ASBS meeting.

Dr. Onopchenko is a member of the Society of Laparoendoscopic Surgeons, the Society of Abdominal and Gastrointestinal Endoscopic Surgeons (SAGES), past president of the Medical Society of New Jersey, Atlantic County, and past president and member of the AtlantiCare Regional Medical Center Medical Staff. Since 1990, Dr. Onopchenko’s special interest has been in minimally invasive surgery. He was one of the first surgeons to perform a laparoscopic cholecystectomy in Atlantic County, as well as performing other advanced minimally invasive laparoscopic procedures including appendectomy, inguinal, abdominal and paraesophageal hernia repairs, anti-reflux gastric surgery, gastric and colon surgery, and adrenal surgeries.

In March of 2002, Dr. Onopchenko founded the Center for Surgical Weight Loss & Wellness at AtlantiCare and has extensive experience in performing Laparoscopic Bypass and LAP-BAND® surgeries. Dr. Onopchenko is also a member of the American Society of Bariatric Physicians and has passed both the written and oral exams leading to certification by the American Board of Bariatric Medicine, the only surgeon in Southeastern New Jersey to achieve this.

Dr. Onopchenko performs Roux-en-Y Gastric Bypass, Adjustable Gastric Banding (LAP-BAND®) and Laparoscopic Sleeve Gastrectomy Surgery.

More About Dr. Onopchenko:

Important information about scheduled appointments

If you would like to schedule a consultation with Dr. Onopchenko:

  • First, view our webinar and complete a short online test (20 true/false questions) indicating that you have participated in the seminar and understand the information. Or attend our Pre-surgery Educational Seminar (register by calling 1-888-569-1000).
  • You may then register with Dr. Onopchenko online.
  • Those who have viewed the online webinar and passed the online test may contact Dr. Onopchenko’s office at (609) 407-2332 to make an appointment.
  • Have questions? Call us at 1-888-569-1000.

Important information about scheduled appointments.

In order to see patients in a more efficient manner, all paperwork mailed to our patients or given out at the seminar must be filed out completely prior to your visit or your visit will be rescheduled.

If you are more than 20 minutes late for your appointment, your appointment will be rescheduled.

It is the patient's responsibility to know if a referral is needed. If your insurance requires a referral, please make sure you have one for your office visit. If you do not have one, your office visit will be rescheduled.

Gastric Bands

Your insurance company may not cover your adjustments. If it is a non-covered procedure with your insurance company, any adjustment done will be the responsibility of the patient at the time of service. The cost of the adjustment is $200.00

Samir Patel, MD, FACS

Samir Patel, MDSamir Patel, MD, FACS

Dr. Patel was born and raised in New York City. He completed undergraduate work at Cornell University, earning a degree in biochemistry. At Albert Einstein College of Medicine in New York City, he received his doctorate in medicine, graduating with honors.

Dr. Patel completed a residency in general surgery at State University of New York at Brooklyn and a fellowship in Advanced Laparoscopy and Bariatric Surgery at the Staten Island University Hospital, under the training of George Ferzli, MD, a world-renowned laparoscopic surgeon.

Dr. Patel is a member of the Society of American Gastrointestinal Endoscopic Surgeons, American Society for Bariatric Surgery, Society of Laparoendoscopic Surgeons, American College of Surgeons and the American Medical Association.

Dr. Patel performs Adjustable Gastric Banding (LAP-BAND®), Gastric Bypass and Laparoscopic Sleeve Gastrectomy Surgery.

More About Dr. Patel:

Dr. Patel's web site

If you would like to schedule a consultation with Dr. Patel:

  • First, view our webinar and complete a short online test (20 true/false questions) indicating that you have participated in the seminar and understand the information. Or attend our Pre-surgery Educational Seminar (register by calling 1-888-569-1000).
  • Those who have attended Dr Patel's seminar or have viewed the online webinar and passed the online test may contact Dr. Patel’s office at (609) 407-2332 to make an appointment.

  • Have questions? Call us at 1-888-569-1000.

Dr. Patel's office hours and location:

Center for Surgical Weight Loss & Wellness
AtlantiCare Physician Group
2500 English Creek Ave
Building 800
Egg Harbor Twp, NJ  08234
(609) 407-2332

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A Dream Come True

Weight Loss Surgery at ARMC makes a “Dream Come True” for Ocean County couple

degutises_story

In 2007, Casandra and Derek DeGutis, of Lanoka Harbor, New Jersey, decided to change their lives by undergoing weight loss surgery at AtlantiCare Regional Medical Center (ARMC). Today the DeGutises are thankful for the decision and celebrating happier, healthier lives.

Casandra, age 32, an assistant bank branch manager, and Derek, age 35, a mortgage banker, had been happily married for two years and wanted to have children. After trying to conceive on their own and undergoing in vitro fertilization without success, their doctor explained that they each needed to lose 100 pounds and stop smoking.

The thing we want most is to have children,” said Cassandra. “So, when the doctor told us to lose weight, we took it to heart.

“The thing we want most is to have children,” said Casandra. “So, when the doctor told us to lose weight, we took it to heart.”

Derek and Cassandra took advantage of a free informational seminar at AtlantiCare’s Center for Surgical Weight Loss & Wellness about weight loss surgery. From there, they met with surgeons from four different organizations, including Wael Kouli, MD, a fellowship-trained bariatric surgeon at ARMC. “We hit it off immediately with Dr. Kouli,” said Derek about their first meeting. “He is so knowledgeable, but is also approachable and low-key. We were impressed.”

Kouli was similarly impressed with the DeGutises. “They were special,” he said. “They were engaged in the process and had researched the procedure. It was clear they were determined. They also were energetic and had a loving relationship. I knew they would be good candidates for surgery.”

Derek had his surgery first in November 2007. Casandra had hers in January 2008.

 
 

“The day I got home, Cassie and I walked about 150 yards to a stop sign close to our house, but that’s as far as I could go,” he said. “Every day we went a little bit farther.”

As Derek was incorporating regular exercise into his routine, Casandra was preparing for her own surgery, starting her liquid diet on New Year’s Day. Her surgery also went well, and just two weeks after the procedure she felt so good she decided to go snow tubing. She promptly broke her leg.

“It was mentally very hard,” she admitted. “Derek and I do everything together. But during this time, I had to sit in the living room while he was on the treadmill. Eventually I did physical therapy, and from there began exercising.”

Now Casandra and Derek exercise together regularly. According to the couple, while surgery at ARMC started them on the road toward better health, maintenance of their good habits is the key to life-long fitness.

Following surgery Casandra lost 126 pounds and competed in 5K races. Derek finished both the New York City marathon in November and the Lake Placid Ford Ironman® Triathlon in July. He has lost 185 pounds since his surgery.

After years of trying to conceive, the DeGutises welcomed their first child, Victoria Rose DeGutis, March 1, 2011. She weighed a healthy 6 pounds, 10 ounces and was 20 inches long.

DeGutis%2011%20victorious

When asked about her name, the proud parents explained, "We named her Victoria, because we feel victorious. It really is a dream come true for us."

“Dr. Kouli was one of the first people we called when we found out we were pregnant. It was the whole reason we decided to have weight loss surgery in the first place, so it was important to tell him. He told us he was very proud that we are his patients.”

Both Casandra and Derek agree that the journey has been a long, difficult one, but it has brought them to a much happier, healthier place in their lives. According to Casandra, “You have to be prepared and mentally ready if you undergo the surgery. But, if you are, it can change your life.”

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