What do you believe the role of ileal transposition versus duodenal exclusion will be?
Dr. Cohen: So far, there are good data from both procedures. It is unquestionable that ileal transposition is a very complex procedure with a lot of potential surgical complications. The only group performing that operation in the world adds the duodenal exclusion in more severe cases. So I have no doubt that both operations will have their place in different diabetic populations. And I ask all of the interested surgeons in this field to compare the so-called diverted ileal transposition (sleeve gastrectomy plus duodenal exclusion plus ileal transposition) to a duodenal switch: they are very similar, but the latter is already well established and less technically demanding. Dr. Pories: The data regarding ileal transposition is promising but fragmentary. At this time, I see no role for the operations outside of prospective, controlled trials. Similarly, although we know quite a bit more about duodenal exclusion, and the data are indeed encouraging, it is still not ready for wide adoptio
