Why sleeve and not bypass?

[Sophie74656 1,572]

after talking to me at length and learning about me my surgeon suggested the sleeve for me and I trusted her judgement. I am beyond happy with my decision

[BLERDgirl 6,417]

And the opposite. How did you decide?

Different surgeries, different procedure. I knew how much of a tool I needed. I didn't want to be rewired & I disliked the idea of malabsorption & dumping.

[cindyw41 761]

My bmi was never 40 or above during my 7 month managed diet. My highest bmi was 39.4. My insurance approved me quickly because of my lengthy list of conditions.

[HeatherB911 6]

I have IBS so sleeve was suggested to me to not disturb the already "disturbed" bowels. I think bypass is great for diabetics though!

[Lexigurl82 160]

I decided to get the sleeve because I read that many people suffer with nutrient absorption and Vitamin deficiencies from the bypass. I'm 2 weeks out, 16 pounds down. So far so good.

[WalkOnWaking 139]

I think bypass is great for diabetics though!

I had the sleeve, and am no longer diabetic. I was insulin dependent for over 10 years.

[Alex Brecher 10,515]

seaniepoohbear,

A good question…and I think you’ve gotten some great answers! Definitely talk to your surgeon – or several surgeons if you haven’t yet made up your mind. Ask their opinions, but don’t let them make the final decision for you.

Also, as the others have said, do your research. The bypass has a higher risk of deficiencies, but it has a longer history as a WLS procedure, so it has a lot of documented success. The sleeve is pretty new, relative to the bypass, but it’s the most common now. Some patients like that it doesn’t rearrange your digestive tract and intestines too much compared to the bypass – it just shrinks your stomach.

The bypass gives a higher risk of dumping syndrome. That’s not pleasant, but for some who want to quit eating sweets, it can be a good choice because it forces you to avoid sugary foods.

There’s no single right answer, as I’m sure you’ve noticed. Good luck!

[drmeow 323]

I chose the bypass b/c I was a huge sweets eater and wanted the extra accountability of potential dumping to help me with that. I also already had high blood pressure, sleep apnea and pre-diabetes with an insulin-dependent brother. I went into surgery fully confident of my decision, and woke up to find the surgeon had been unable to perform it. Despite a relatively low BMI (40 at initial consult) and no fatty liver, my intestinal omentum was so fatty that it prevented him from bringing the intestine close enough to my stomach. Since I had been adamantly against the sleeve (didn't like the idea of permanently losing a part of my stomach), I was closed up with no surgery. My surgeon put me on a fully liquid diet for 4 weeks and said that would remove enough abdominal fat to let the intestines stretch up normally. I was supposed to lose 20 lbs that way but only ended up losing 16, even though I was fully compliant. For the second surgery I signed permission to do the sleeve if he could not do the bypass, and I did end up with the sleeve. He said it had improved drastically and was very close to being able to reach but he was afraid it would leave tension on the anastomosis, so he went with the sleeve. I was very disappointed at first but it seems to be working well for me so far. I'm 6 weeks out and down 30 lbs since surgery.

Annoyingly, I do seem to feel hunger if I go too long between meals, and that makes me eat too fast, so I have to watch myself and have a snack available (cheese stick, Jerky, etc) if I can't stop work to eat right away.

I can also eat anything I want, including sweets. Luckily, they don't taste quite as good (usually) as I remembered, and I can't eat much before feeling full/nauseous but there is no dumping. It's making the holidays a bit challenging, as there are many goodies out at work, etc. but I just have to make sure I eat Protein frequently enough so I don't want the others.

[JamieLogical 8,727]

@@drmeow I hope your sleeve ultimately works out for you. It must have been very disappointing to go through all that and still not end up with the procedure you wanted. I suppose if it doesn't work out, a revision to bypass is always possible, though you obviously can never get that 80% of your stomach back. I think that if you are diligent and focus on making the most of your sleeve, it can work for you. All the best!

[drmeow 323]

@@JamieLogical,

Thanks - that's what i figured too. I've already lost enough that if for some reason it had to be revised, it should work now. But there are certainly some positives with the sleeve for me too so after I got over the initial disappointment I'm determined to make it work. There are definitely pros and cons to both procedures and ultimately it's what works best for each person. So far I haven't had any reflux which was my biggest worry with sleeve, as I'd had some bad GERD many years ago (but my scope just before surgery showed none)