Why the sleeve and not gastric bypass?

[Ree 215]

Hi, I'm new to this forum but so far i've found it very informative. Today I went to the seminar and before going I already had my mind made up that I wanted the vertical sleeve, but now after going to the seminar I'm not sure if the vertical sleeve is the right surgery for me or not, or if I should get the gastric bypass.

I am 5ft tall (well, 4' 11 and three quarters) and I weigh 270. So to get to my ideal weight (normal weight for my height) I would need to lose close to 150 pounds. Thats a lot of weight to have to lose and I'm just not sure the sleeve will be best or not. The surgeon at the seminar said people lose more weight with the gastric bypass surgery over the sleeve or the band.

So what has been your experience with the sleeve? do you wish you had gotten the gastric bypass instead? and what ultimately made you decide to go with the sleeve over any of the other weight loss surgery options?

Thanks!

[tigerbelle 328]

after doing research, I decided on the sleeve because I didn't like the idea of re-routing my colon nor the nutritional disadvantages of malabsorption...I have heard that some people who have a very high BMI do the sleeve first and then later do a something similar to a gastric bypass as a second step...that is what a cousin of mine did...I am hoping that the sleeve alone will work for me (my surgery is scheduled for May 6)...I have heard some people say they went with gastric bypass because they didn't want to have to go through two possible surgeries and wanted to do a single procedure...I recommend to keep doing research before making a final decision (like you seem to be doing)...and also talk more specifically with your surgeon about your particular circumstances...the best for you...I know how difficult the decision can be

[southernsoul 773]

The surgery I think tigerbelle is talking about is called the duodenal switch. The 2 procedures are sometimes done separately, but also sometimes together. I have some good friends (a married couple) who both had DS, both done in one procedure. The wife says she would have rather had just the sleeve, but her insurance didn't cover it back then (about 6 years ago). I'm still preop, but I chose the sleeve because of the malabsorption issues & because I think the less stuff that gets altered, the better. I may not lose as much or as fast as with bypass or DS, but I'm OK with that.

[sleevehopefull27 29]

I am still pre op, May 13th is my day....I have been researching WLS for the past 3 years and I have been on VST for over a year now and from what I've seen is if you work hard and follow the directions you are given you can losse very close to the same as a person with gastric bipass. I chose the sleeve bc I have 4 kids and want to be able to be a "normal" mom. I feel like a prisoner in my fat body and don't want to be a prisoner in my skinny body! For example, I want to eat a small peice of my kids b-day cake and not get sick bc of dumping syndrome! I am always on the side line and I want to fully participate in life!

[sleevehopefull27 29]

*bypass

[marfar7 1,533]

I'm awaiting a sleeve revision soon (been lapbanded for 3 1/2 yrs). The reason I chose the sleeve was that my BMI is only 27 and I thought GB was too extreme to lose 30 lbs. My band slipped so it's of no use anymore and I need a tool to keep off the 100 I've already lost.

While I'm terrified of a leak happening with the sleeve and kinda freaked out that I'm losing 85% of my stomach, I can't see rerouting my organs, not being able to absorb most nutrients, not be able o eat sweets without regret, and having the possibility of gaining it back (the sleeve take out the stretchy part of the stomach making it nearly impossible to gain back any but a small amount) like my sister in law. She ha the RNY about 7 yrs ago at 320 lbs. She got down to 180. Today she weighs about 290-300. Your stomach can slowly stretch out if you're not eating correctly. And if we all ate correctly all the time, none of us would even need wls!

Those are my personal reasons for choosing the sleeve. I chose the band 3 1/2 yrs ago because, well the sleeve wasn't even offered to me. Had it been, I probably would've been inclined to still choose the band. It's reversable, there's not cutting of anything, you can't really gain weight because it's always adjustable. But now, after having it for over 3 yrs, I'm realizing what a pain it is. All the trips 6 hrs round trip to the dr for adjustments. All the vomiting if I eat the wrong thing or eat too fast. The reflux. So, so glad my band slipped so Medicare will pay for a revision!

Good luck!

[Chelenka 827]

This is a personal decision that you should make after you've done as much research as possible. I would get more than one medical opinion. Try to choose a hospital that has a bariatric center of excellence rating for your surgery. The bypass is still considered the "gold standard" as my surgeon put it, because it had been around longer, been studied and has statistics to back up the success of the procedure. I first considered the band, then was set on the bypass, but after learning all of the potential complications I opted for the sleeve and I am happy with my decision. I didn't want to deal with the dumping syndrome that happens to people who've had the bypass. Not just cuz it can be embarrassing but often people experience heart palpitations and I already have an irregular heart beat so, didn't want to go there. The sleeve is still a major surgery and there is a huge adjustment that has to happen both physically and mentally. Regardless, one must be ready and committed to making it work. Best of luck to you whatever you decide.

pre-surgery weight 325; surgery date 2/28/2013; surgery weight 307; 8 weeks past-op weight 281.4

[MichiganChic 3,262]

I also have a high BMI, and needed to lose around 150 pounds. My doc said I could do either, but thought I would lose more with RNY. I just couldn't get comfortable with the malabsorption, dumping, and inability to ever take NSAIDS again. I decided that even if I lost less, it would still put me at less than 200, and I could live with that. If I had wanted RNY, I could have done that years ago, and believe me, I considered it.

Now that I'm 4 months post op, I'm happy with my decision. I don't know if I'll get to goal, but I plan to, and my doc says it is possible. His personal stats are similar between RNY and VSG patients. I think with both, it comes down to hard work on our part. The sleeve just makes it easier for me becuase while I still get hungry, I don't have that continuous drive to eat like I did pre-op. Also, it forces me to eat less, and because I committed to changing my habits, I'm learning a new normal way of eating. I've got a long way to go, and some days are harder than others, but it's a million times easier than it was preop. Now that I'm starting to see results, my motivation is high, which fuels a positive cycle of change for me. Good luck, whatever you decide.

[lizv123 389]

I went the sleeve because I didn't want dietary restrictions as much as Portion Control. So many with bypass have lifelong dumping. In the seminar the bypass lost my vote when the surgeon said "if you attend a wedding, just don't eat the cake." um....no....I want to be able to eat a piece of my wedding cake. I want to taste my future children's birthday cakes. There are some sleevers that dump, but the stats are much lower compared to bypass. My surgeon's office nurse had a bypass 7 (I think) years ago and her eyes and nose will start to run if anything has too much sugar in it. Like chicken with a sauce. I couldn't do that to myself.

The bypass has been done much longer and for the most part you'll lose more weight faster. Which is great for a scale, not so much for the droppy hound dog appearance. I'm not saying sleevers don't get saggy. My arms are like sails. But if I lost at a faster weight I'm pretty sure they'd be worse.

As for "cutting out the hunger hormone"......ehhh....I still get hungry. Not head hunger, real hunger. But unlike before surgery my stomach doesn't growl, I tend to get nauseas. Some sleevers don't get hungry at all. But there's a good number of us that still do.

The biggest perk of starting with a sleeve is this: you can add a DS to it which is essentially a bypass with a different shaped stomach. If you have a very large amount of weight to lose and after a period of time, the sleeve isn't cutting it, you can take another step.

I have to lose about as much as you and went with the sleeve. There are people on here who have lost hundreds of pounds. The sleeve results are what you make them

[Ree 215]

Thanks so much everyone for sharing your reasons for doing the gastric sleeve instead of the gastric bypass. Now that i've read up on dumping and food restrictions I'm pretty sure I want to still go with the sleeve. I know this might all depend on what the surgeon has to say too but I still want to be able to eat whatever I want, even if it's just a small bite and thats it. I don't want to worry about the dumping. That sounds painful! I'm also concerned about malabsorption with gastric bypass so the sleeve sounds more of the right fit for me.

[lizv123 389]

I was also just informed that if you have a roux en y, you can't have a liver transplant if ever needed in the future. I don't know the specifics but that alone would be reason for me. You never about accidents or anything. More surgeons need to inform us of this!

[mistysj 1,940]

As part of yiur research, please ask the same question in reverse on the RNYtalk board, to get the other side of the opinion. Most people on VST will have a pretty obvious bias.

For myself I am getting the sleeve because it is medically less complicated. I was prepared to get the RNY if the doctor recommended it because I have GERD, but he was not concerned about GERD and the sleeve. I have about 115 lbs to lose.

[RAAinNH 113]

I recommend Alex Brecher's "The BIG Book on the Gastric Sleeve" Everything You Need To Know To Lose Weight and Live Well with the Vertical Sleeve Gastrectomy. I'm reading it now, the book is packed with researched information. I bought the Kindle version through Amazon.com.< /span>

[gsleeved 5]

When I went to my info seminar the doctor there was clearly biased towards the bypass. I chose the VSG to avoid the food restrictions and malabsorption. It also just seemed more physiological - it's not rerouting the plumbing but rather resizes and reshapes the stomach. One reason I have heard that people opt for the bypass is reportedly people lose more weight - percentage wise - than the sleeve. I have trouble with this statistic - it's far to generalized and of course also include people who regain their weight back. I haven't seen any really useful data broken down by age, gender, weightloss level etc. Also, much about what you hear about the sleeve data incorporates results from early surgeries. When the sleeve was used as a first step before getting the bypass the sleeves were bigger. Today's sleeve bouge sizes are typically 32-40 fr. Most early sleeve bougies were over 60 fr in size since they were expected to precede a gastric bypass.

Another reason why people opt for the bypass is it theoretically reversible. You can theoretically reconnect the stomach. This reversal is extremely rare - it is a far more invasive surgery and far riskier (and far more expensive) than the original bypass.

Ultimately, as everyone else said - you need to determine the best option for you. Most importantly - fine a surgeon you trust and are confident with.

G

[Threetimesacharm 1,400]

In my opinion go for the bypass. This surgery is very helpful if you are a sugar addict. This is a food product that we don't need to eat so for some, not being able to without getting sick is a selling factor. One of my doctors had this surgery for this reason and is extremely happy and has lost alot of weight. With either surgery you can gain weight back; it is all about choices.