Why did you choose VGS instead of Bypass and any regrets.

[klock 12]

I'm scheduled for VGS Dec 19, I selected this method after much research to maintain my digestive tract. My concern is my surgical group is primarily bypass oriented but also does VGS ( 80% bypass and 20% sleeve ). It seems every person I speak to that has had WLS is a bypass, with impressive results.

I'm a relatively low BMI ( 38 ), surgery for severe hip and knee degeneration, but still need to loose 100 pounds for normal BMI. My overall health is good.

My surgeon is non committal, he simply states either option will work for me, but states he does far more bypass procedures. His group is well respected in our area and they work out of a hospital labelled as center of bariatric excellence.

I'm driving myself nuts second guessing the TYPE of procedure ( I'm mentally prepared for WLS and feel it is my best recourse ). Any help or insight would be appreciated !!! ( and yes I have searched this forum ).

[scstxrn 213]

Why I chose VSG:

1. Decreased risk of dumping syndrome. Three years from now, if I want a bite of donut, I can have a bite of donut - enjoy a bite of donut, and odds are, not feel like I'm going to fall out.

2. Increased ability to eat 'healthy' food.. Lean and green are the mainstays of this lifestyle.

3. I read a study that indicated that families where the mom has had VSG lose weight and the children are less likely to be obese. I think that has to do with #2.. I want that; I want my kids to see me eating healthy, not to see me able to eat 'whatever' and still lose weight.

4. I work with ALOT of people who have had both surgeries. It has been my observation that post bypass, while the weightloss is faster, the skin is MUCH looser, the overall appearance is less healthy (dry, ashen, etc..), and to quote my husband they look like 'a pillowcase with the s*t slung out of it'.

5. I'm not the best at taking supplements long term. I stuck with prenatals for a year of planning + pregnancy and then another year of nursing.. and then Vitamins became hit or miss for me. I don't want to lose bone mass, blood cells, etc because of massive supplement needs secondary to malabsorption.

6. Research indicates that the part of the stomach left after gb can restretch; not so much with vsg due to the fact that the fundus is removed.

7. The intestines increase their ability to absorb, it's a survival thing. What if I get used to being able to eat crap and lose weight, stretch my stomach out, and my intestines start absorbing enough calories that I put it back on?

8. I want a normal colonoscopy, where all my insides can be visualized without having to have a special procedure.

For me - bypass was a very brief fleeting thought. I believe the VSG will be effective. If it's not, I can always have a revision to the DS. If it is, I've avoided all the stuff that steered me away from gastric bypass for the last decade.

[klock 12]

Scstxrn

Wow, I'm guessing your in the healthcare field, thank you, it is reassuring seeing the positives outlined. I love your husbands comment !

I'm familiar with your statements. A major influence for me was still being able to have a standard endoscopy ( history of stomach cancer in family ). I'm not sure I understand how a colonoscopy would be influenced by RNY.

[MichiganChic 3,262]

I had my surgery two years ago on December 19. Most definitely an anniversary I Celebrate each year - more so than birthdays or holidays - because it changed my life.

I also struggled with a sleeve vs RNY. In the end, I chose the sleeve because there is less incidence of ulcers post sleeve, and you can take NSAIDS with a sleeve. I know that as I age, needing those types of medications (as well as steroids), will increase. I do take ibuprofen every day without issue. I also didn't want the malapsorption issues, or the possibility of dumping. I can eat anything, and I've had great success with the sleeve, so for me, it was a good choice.

On the flip side, because I can eat anything, it requires a lot of self restraint on my part not to. (I'm sure it's similar with RNY, though). I am a grazer, and honestly, RNY would have been a better choice in that respect. Because I don't have dumping syndrome, there is not physical aversion to sugar. That's both a blessing a curse, but I'm still not sad about it.

While the RNY is reversible, the sleeve is not. However, I've never wished for my stomach back. I also know that I could convert to a RNY if needed. Some people get reflux really bad. I had it before surgery, and for a while afterwards, but now I don't have it and I don't have to take anything for reflux.

So, I did a list of pros and cons, and that NSAID thing was the deciding factor in my case. Only you know what your issues and concerns are, but knowing the benefits and risks of each surgery can help you make your decision.

[LipstickLady 25,682]

I chose the sleeve over bypass because I wanted my life to be as close to "normal" as possible.

While the chance of dumping is still there, it's decreased vs. bypass. I wanted to be able to have a piece of b-day cake or ice cream occasionally without getting sick. As luck would have it, I can't eat ice cream -- I dump. HA! I've also noticed if I eat candy/cookies/brownies one day, the next morning I will have the poops and it's not pretty. So...

I am horrible at taking pills. HORRIBLE. With bypass, supplements are a must. With sleeve they are a must, too, but my surgeon said as long as I keep my blood work looking good, he's OK with my propensity to "forget". Aside from Vitamin D, my levels are awesome and even my D is better now than it was pre-op.

It's my OPINION that the bypass is easier to "eat around" than the sleeve. I may be totally incorrect, I am an expert on no one but myself, but with my sleeve, once I'm full, I'm full. Sleeves don't stretch, pouches can according to my doctor.

Most importantly, I didn't have any co-morbidities that would make bypass a better option. My doctor was on the same page as me when I told him I was more interested in the sleeve. He said he would have felt differently if I was diabetic or had other health issues.

Good luck with your decision. Trust your gut and the people you are paying to help you along with this decision!

[klock 12]

MichiganLady and Lipstickchic

Thank you for your insight for choosing VGS, being able to tolerate NSAID's and avoiding long term malabsorption are at the top of my list.

I'm feeling better about selecting the road less travelled in our area for WLS. Although, it scares the hell out of me that my group does so few VSG's but then again it is a less complicated surgery. I guess I would be more concerned if VSG was considered a more complicated surgery than RNY.

[Vickybli 64]

I chose the sleeve to avoid all the complications of the bypass. I was extremely obeese and my doctor said the bypass is a much more traumatising procedure for the body and too dangerous to do in my case. Even with the sleeve I spent 4 days in ICU (as a precaution - luckily there were no complications) He did tell me that I might not lose all the weight with the sleeve and we may need to do a bypass later. I have been stuck now for over 5 months and he tells me that I probably reached the limit of what I can hope to lose with the sleeve as i've lost more than the average sleever but I have no regrets. I feel fine and my bloodwork is perfect with no supplements. I;m still overweight but since I;m no longer hungry and i can work out now im confident i can work on losing some more.

Since your BMI is not very high and your doctor says the procedure will work for you I wouldn't worry too much about it if I were you - I would definitely choose the less invasive solution.

[klock 12]

Vickybli

Congrats !!! on your success and great attitude, Im sure you will reach your goal.

[Mayaresearchmom 104]

Why I chose RNY over VSG

1. Reflux, reflux reflux. Historically, if you gave GERD before getting the sleeve, it will be worse after surgery. It improves or even goes away with RNY. I already had bad GERD, and even had multiple small cystic polyps in my stomach caused by long term use of PPI's. With RNY, I only need to take PPI's for the first six months, then can go to as needed use instead of every day use.

2. You lose at least 10% more weight with RNY.

3. While the sleeve has been around for years for treatment of ulcers etc., it has only been used as a form of WLS for the last 5 years. There is not a lot of historical WLS data available to show long term success. And according to my doctor, she is now seeing sleeved patients coming back for revision to RNY after failing to maintain weight loss

4. The sleeve is NON-REVERSIBLE. They cut out a huge chunk of your stomach. RNY is REVERSIBLE. (Not that my doctor has ever had anybody want it reversed)

[samuelsmom 670]

@@klock

WLS is, in my opinion, the "nuclear" option. Last year, after years of attempts, and a BMI around 50, I documented my efforts for 1 year and what I discovered was that I lost and regained the same 15 pounds. At that point I realized that I needed "nuclear!" I spent a few days researching and found that the sleeve was my preferred option for the following reasons:

1) No rerouting of digestion

2) Reduction in the hormone Ghrelin so you feel less hungry

3) Less operative risk

4) An easier operation and less time under anesthesia

5) No or minimal risk for dumping syndrome

6) I found studies with 5-10 years worth of data which supported the efficacy of the procedure.

At my practice the physicians do all 3, however, my surgeon said that more and more people are choosing the sleeve. I had mine done just last week so I can't speak long term yet for myself, so we'll see!

[klock 12]

Mayaresearchmom

And you have just hit on why I'm still considering RNY. While I do not currently suffer from GERD it concerns me, and my surgeon tells me literally word for word what you said about long term documentation. I was not familiar with VGS to RNY for long term weight loss.

[klock 12]

samuelsmom

I figure over the past 30 years of yo yo dieting I have lost well over 400 pounds, unfortunately I have but back 500 pounds. My surgeon asked when I first noticed I was heavy, I responded at about 9 months old.

I can see the benefits of both surgeries, difficult decision.

[livvsmum 2,369]

I initially was going to have gastric bypass. The reason I wanted it was that I read the statistics that you lose more weight with that than the sleeve. So that was my decision. About half way through the insurance requirements I got very uneasy with the re-routing of the intestines that goes on with the bypass, so I switched to the sleeve. I figured if I would lose, say, 80 pounds with bypass and only 65 with the sleeve, I would work my butt off and make up the difference on my own through discipline and hard work. Well, I ended up losing 140 pounds with the sleeve, and I couldn't be more thrilled. That concern of not losing as much with the sleeve - in retrospect - seems a total moot point for me. I haven't regretted my decision at all.

[IcanMakeit 1,318]

An interesting PowerPoint presentation which compared weight regain after different WLS's was posted by @MyBariatricLife yesterday:

I was already glad that I chose the sleeve because I have two sisters who have experienced significant weight regain with the bypass, but this presentation makes a good case for choosing the VSG or the DS over the bypass.

I see that the link did not work. The original post was titled "Does the patient fail the procedure or does the procedure fail the patient."

Edited November 24, 2014 by IcanMakeit

[missbrown30 148]

I'm scheduled for VGS Dec 19, I selected this method after much research to maintain my digestive tract. My concern is my surgical group is primarily bypass oriented but also does VGS ( 80% bypass and 20% sleeve ). It seems every person I speak to that has had WLS is a bypass, with impressive results.

I'm a relatively low BMI ( 38 ), surgery for severe hip and knee degeneration, but still need to loose 100 pounds for normal BMI. My overall health is good.

My surgeon is non committal, he simply states either option will work for me, but states he does far more bypass procedures. His group is well respected in our area and they work out of a hospital labelled as center of bariatric excellence.

I'm driving myself nuts second guessing the TYPE of procedure ( I'm mentally prepared for WLS and feel it is my best recourse ). Any help or insight would be appreciated !!! ( and yes I have searched this forum ).

I had VSG surgery on 4/8/14. The decision was made because:

1. I was extremely afraid of having my insides re-routed

2. I have a history of non-compliance with taking my meds, including my blood pressure meds so my surgeon felt VSG was best for me

3. I needed to loose less than 100 pounds

I am extremely happy with my decision. I haven't had any complications and I'm losing at a slow but steady rate. I'm 7 months out and have 16 more pounds to lose to reach my goal. Then maybe I will try for an additional 10 pounds.

I wish you the best on your journey.