VSG vs RNY

[Froukje 0]

My surgeon is insisting on doing the RNY- I do not feel this is the surgery for me. I want to do the VSG. I take a lot of pain medications & already have a food tolerance issue due to a liver disease. I am looking for help with what to take to my surgeon to convince him that the VSG IS right for me. Can anyone offer me some tips & pointers please.

[Tiffykins 673]

Why does your surgeon feel this is the best option considering your medical history? What are his reasons?

Personally, I would find another surgeon that would support my decision on what parts of my body he gets to cut on. I can give you my standard reply for why I chose VSG over RNY.

This is my standard reply when this question pops up every couple of days. I won't try to sway anyone one way or another, but I'll give you my reasons for choosing VSG over RNY for my revision from the band. You can also check out the revision, failure, and food issue forums on here to get an idea of some long term RNY patients. For me, it was never an option. The cons outweighed the pros.

The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.

1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.

2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.

3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.

4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me

5) I have too many friends in real life that struggle with Vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.

6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,

7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.

8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.

9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of Cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of Cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.

I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!

Best wishes in your research!

[MINI-Me 196]

I definitely agree with Tiff. Why does he think bypass is right for you?

Is it because he isn't comfortable with performing the sleeve? If so - find another surgeon!

If it is a medical reason, be sure to listen. I would not want the bypass, but I would definitely listen to an experienced surgeon's opinion.

[Froukje 0]

Thank you for your quick response- that was very helpful. I emailed the surgeon with my concerns and have arranged to speak with him over the phone next week as the surgeon is 200mil away. I will keep you posted- I am not willing to do the RNY and will seek a second opinion if this surgeon will not do the surgery of my choice.

In Canada the surgery of choice is the RNY because they feel it has more success stories. It is going to be a battle to get the surgery of MY choice but I am willing to fight for what I believe is right for me.

Why does your surgeon feel this is the best option considering your medical history? What are his reasons?

Personally, I would find another surgeon that would support my decision on what parts of my body he gets to cut on. I can give you my standard reply for why I chose VSG over RNY.

[KellyL 173]

Also something to consider, is he insisting on the RNY because he feels it's best for you, or is it because it's what he is trained and more skilled in? I personally would want a surgeon that is skilled and experienced with the procedure I felt the most comfortable with.

I called a dr in my state to inquire about the sleeve. The person that answered the phone said that he did not do the sleeve. I said, well that is really the one I felt most comfortable with. She then proceeded to tell me "Oh, it's not up to the patient which procedure you have, it's the dr's decision". I said that I completely disagreed since it's my body, my health, and my life we're talking about. I have researched this for 7 yrs. And I know my health issues. Of course this dr would recommend the RNY if it's the only one he does. Also they get to bill anywhere from $20,000-$60,000 to our Ins Co for the RNY.

I am not a dr myself but I do recommend researching the complications and regrets boards on OH. To me, the whole gold standard thing is outdated.

Good luck in your journey!