Do You Ever Wish

[DLCoggin 1,788]

Everything I've read leads me to believe that the two surgeries (RNY and Sleeve) are roughly comparable with their own advantages and disadvantages. Sleeve is strictly restrictive. RNY uses restriction and malabsorption. Most studies seem to give RNY the nod for the most weight lost in the shortest time, and for the best long-term success rates, but not by huge margins. Although seldom done, RNY is theoretically reversible. The sleeve is not reversible since 75% to 85% of the stomach is removed. But the sleeve is relatively easily converted to RNY if the expected/desired weight loss is not achieved. The sleeve is often used as a "first stage" surgery for patients who are morbidly obese with the expectation that it will be revised to RNY with a second surgery at some point in the future. RNY changes the path that the food takes, bypassing a portion of the small intestine which results in some malabsorption and makes nutritional supplements absolutely imperative - for life. The sleeve does not alter the path of the food and does not bypass any part of the intestine and as a result, has a lower risk of malnutrition. Both surgeries appear to be equally safe but as noted, the sleeve is less invasive and can be completed more quickly than RNY. Also as noted, the sleeve is relatively new so there is much less data available regarding long-term effectiveness. RNY was first performed in Europe and was done there for many years prior to FDA approval in the U.S. RNY continues to be the most popular bariatric surgery worldwide - about 80% of all bariatric surgeries are RNY.

There is an excellent article on WebMD that you can find at http://www.webmd.com/diet/weight-loss-surgery/your-options-in-weight-loss-surgery-making-the-choice for more information. When all is said and done, perhaps the best advice is talk to your doctor and the two of you make the decision based on your particular situation.

[law8486 40]

my doctor would deff disagree with that. no offense. ive been seeing him for 4 yrs and he does not advise the sleeve as a first option. why wouldnt he just do the rny to start with? it seems ridiculous for a person to get the sleeve KNOWING theyre going to just switch later. thats one unnecessary surgery. rny is most successful. and im sick of hearing people stress the malnutrition. taking a Vitamin a day doesnt kill you. and i in no way look malnourished. sorry if i sound brash but this is a very sensitive subject and being italian i have strong opinions lol.

rny 4/6/12 <br />hw 255/cw 214/ gw 140

[Made4More 1]

gosh, I didn't mean to offend- I'm just trying to get all the info I need. I'm just going by what I read/hear at this point, you know? my sister is a nurse and she told me last night "the rny should be outlawed," and here I am still researching it. it's not her body.

I am a little scared of that painful hernia thing that can happen later, but that's operable and doesnt' kill anyone, right?

I really want fast weightloss, and I really think dumping can be wonderful for me because I am a slave to sugar. I HATE HATE HATE it. I see a lot of peopel ont eh sleeve boards that talk about how they are eating a lot of carbs and they just can't stop. I dont want that at all! Iw ant to be successful for life.

my bmi is only (only?) 41, and I dont have any co-morbidities. when do i meet with my surgeon? :/ I'm starting the 6 month diet w/ my dr, and I need to get him to sign the referral paper and then i can make my appt w/ missouri bariatrics. will i see the surgeon then? I didn't go to a seminar because they had an online seminar. which i think was handy.

gosh- it's a huge decision, isn't it?

[DLCoggin 1,788]

my doctor would deff disagree with that. no offense. ive been seeing him for 4 yrs and he does not advise the sleeve as a first option. why wouldnt he just do the rny to start with? it seems ridiculous for a person to get the sleeve KNOWING theyre going to just switch later. thats one unnecessary surgery. rny is most successful. and im sick of hearing people stress the malnutrition. taking a Vitamin a day doesnt kill you. and i in no way look malnourished. sorry if i sound brash but this is a very sensitive subject and being italian i have strong opinions lol.

rny 4/6/12 <br />hw 255/cw 214/ gw 140

No offense taken law and I am sorry if I hit a nerve. I can see where it might seem ridiculous but there are many who would disagree. Quoting from the WebMD site that I linked in my previous post...

"A sleeve gastrectomy is a simpler operation that allows them a lower-risk way to start losing weight. Afterwards, once they've lost weight and their health has improved -- usually after 12-18 months -- they can go on to have a second surgery, such as gastric bypass. In people with high BMIs, sleeve gastrectomies result in an average weight loss of 40% to 50% of excess weight after three years."

From the National Institute of Health - http://win.niddk.nih.gov/publications/gastric.htm#whataresurg

"VSG has been performed in the past mainly as the first stage of BPD-DS (discussed earlier) in patients who may be at high risk for problems from more extensive types of surgery. These patients' high risk levels are due to body weight or medical issues. However, more recent research indicates that some patients who have VSG can lose a lot of weight with VSG alone and avoid a second procedure. Researchers do not yet know how many patients who have VSG alone will need a second stage procedure."

One more from the University of Maryland - http://www.umm.edu/weightloss/lap_sleeve_gastrectomy.htm

"The laparoscopic sleeve gastrectomy is a bariatric procedure in which the surgeon removes approximately 85% of the stomach, shaping the remaining stomach into a tube or “sleeve”. It can be used as a first stage operation prior to a gastric bypass or as a definite procedure."

The same idea is stated repeatedly, there are situations where the "staged" approach involves less risk to the patient. Certainly a valid concern and one that I'm sure your doctor would take into account for patients who fall into the high risk category.

[law8486 40]

i dont need all those articles. my mom is a nurse and fully supported me. i didnt have a hernia after. that doesnt always happen. my doc is amazing and has a 100% success rate. im not gunna go back and forth on this board. i know what i believe and rny has been extremely successful for me.

rny 4/6/12 <br />hw 255/cw 214/ gw 140

[law8486 40]

i dont need all those articles. my mom is a nurse and fully supported me. i didnt have a hernia after. that doesnt always happen. my doc is amazing and has a 100% success rate. im not gunna go back and forth on this board. i know what i believe and rny has been extremely successful for me.

rny 4/6/12 <br />hw 255/cw 214/ gw 140

[law8486 40]

i dont need all those articles. my mom is a nurse and fully supported me. i didnt have a hernia after. that doesnt always happen. my doc is amazing and has a 100% success rate. im not gunna go back and forth on this board. i know what i believe and rny has been extremely successful for me.

rny 4/6/12 <br />hw 255/cw 214/ gw 140

[law8486 40]

and fyi my doctor always suggests rny as the first option for all his patients. and All his patients are successful.

rny 4/6/12 <br />hw 255/cw 214/ gw 140

[john 181]

Law ignore this person.

[Panda 354]

I think I saw on discovery health channel where there have been people that have weighed 600 lbs where they did a 3 step weight loss surgery process due to them being what they called super morbidly obese. These patients had to be moved out of their homes by the fire dept and walls taken down to get them out of their homes. So there is some validity to what is being said about the sleeve sometimes being done as a precursor to the bypass. I just praise the Lord that I didn't have to go that route

Sent from my Nexus S 4G using RNYTalk

[Panda 354]

I think I saw on discovery health channel where there have been people that have weighed 600 lbs where they did a 3 step weight loss surgery process due to them being what they called super morbidly obese. These patients had to be moved out of their homes by the fire dept and walls taken down to get them out of their homes. So there is some validity to what is being said about the sleeve sometimes being done as a precursor to the bypass. I just praise the Lord that I didn't have to go that route.

Also the program said that there are only a limited amount of bariatric surgeons that will do surgery on the super morbidly obese...food for thought.

Sent from my Nexus S 4G using RNYTalk

[law8486 40]

thx john lol. and fyi my doc doesnt reject anyone. come to boston for a doc who understands his patients and takes the time to work with them. he called my house every day to check on me after surgery when i got pneumonia. god bless doctors like him

rny 4/6/12 <br />hw 255/cw 214/ gw 140

[Panda 354]

Lets give it up for Boston! That was very compassionate of him to call and check on you everyday...and lets thank the Lord that you are doing much better and recovering. Really nice to read you are doing so much better.

Sent from my Nexus S 4G using RNYTalk

[john 181]

Youre welcome

[law8486 40]

thanks panda! yea its been quite the journey but im almost myself again

rny 4/6/12 <br />hw 255/cw 214/ gw 140