Sleeve or RnY?

[daniotra 298]

I know this topic has come up a gazillion times, but here we go again.

I met with my surgeon last week, and he gave me the option of doing either surgery. I had assumed RnY because I occasionally have mild reflux and I'm quite large (BMI > 50). The doctor said my reflux is so mild, that it doesn't preclude sleeve surgery. I don't have diabetes, or any of the standard comorbidities that would typically push someone towards RnY.

For me, advantages of sleeve are being able to use NSAIDs if needed, maintaining my pyloric valve, no surgery on my intestines, lower complication rate, less malabsorption. Advantages of RnY: greater average weight loss in first year (though it seems to even out by year 3 according to my reading), potential negative reinforcement of eating sweets (dumping syndrome).

The Vitamin protocols for both are the same with my program, and our bariatrics specialist says that the risk of malnutrition is very low if you are compliant with Vitamins (<3% for compliant folks, while they typically see closer to 15% of patients with issues). Take your Vitamins, folks!

For me, it comes down to am I willing to take a higher risk of complications for the possibility of greater weight loss? I'm in this to be healthy and active, not skinny or attractive. It's a tough call to make. Especially when the end result, what happens 3, 5, 15 years down the line, all comes down to how I use the tool that I am given.

What were the key things that you thought about when making your choice?

[Christinamo7 4,042]

I take salmon oil to treat ADD and I did not have reflux, so the sleeve was the natural choice for me.

[KristenLe 5,979]

Gastric Sleeve has the possibility of greater weight loss...just not as fast as RNY. I have a BMI of 54 and my Team recommended the Sleeve.

[KristenLe 5,979]

@@daniotra I should also mention they considered my eating habits before making this decision. Because I'm not a grazer or a sweet eater - they thought that the restriction was all I would need.

[shriner37 249]

There are a couple of studies out there indicating that over a long period of time the RnY may be more effective than the sleeve. I don't know whether to believe them or not, since research studies can often be developed to achieve a specific result. Plus, the sleeve just hasn't been around long enough for lots of long term studies, where the RnY has been the staple of weight loss surgery for over a decade.

That being said, I went for the sleeve and have been happy with it.

One question though - my surgeon told me no NSAIDs with the sleeve. I had not heard that restriction was only applicable to the bypass. Did I understand that correctly?

[daniotra 298]

Re: NSAIDs, that is what my surgeon said. I thought it was with both surgeries as well.

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[sbg224 318]

No nsaids with the sleeve either per my surgeon, and I had a total knee replacement, would have loved nsaids. I will be hones, I never even considered the RNY, just because I did not want my intestines rerouted and I was terrified of dumping. I am 8 months post sleeve, and love it. Good luck with your decision. Diabetics i do know ar better off with RNY, from what I have heard and seen.

[lat72 38]

My surgeon won't even do a RNY. God did not intend for someone to reroute our insides. Long term complications. Good luck

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[dunnadunna 26]

I have a bmi of 44 right now. I'm getting the sleeve done, mainly because I have reactive hypoglycemia... I suffer dumping syndrome frequently if I'm not minding what I eat, anyway, and the doc worried that it would be too hard on me to get RnY. Sleeve it is.

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