Second Thoughts on Type of Surgery?

[TJnWA 19]

It is about 11 days until my scheduled sleeve surgery and I'm starting to wonder if I should have gone with the bypass surgery. Has anyone else had this dilemma or changed the type of surgery they had so close to the surgery date? Help!!

[James Marusek 5,244]

One of the reasons why I had RNY gastric bypass surgery rather than sleeve was because I had severe acid reflux (Gerd). The sleeve will only make this condition worse. So you might factor this into your decision.

[Introversion 1,876]

The type of surgery you select really depends on your starting weight, current metabolic issues (e.g. PCOS, diabetes, insulin resistance), whether or not you presently have acid reflux problems, and your preferences regarding supplementation.

Before I proceed further, both the bypass and the sleeve are wonderful bariatric procedures with proven track records.

I have been pleased with my sleeve. I've lost 100+ pounds and easily maintain my goal weight with the help of this amazing tool. I choose the sleeve because:

1. I wanted my pyloric valve to remain functioning and intact.
2. I wanted a brief surgery time (30 minutes on the operating table).
3. I didn't want to become metabolically challenged several years from now. When the intestines are bypassed, the non-bypassed section adapts by increasing surface area and villus size to absorb more calories. This phenomenon, called intestinal adaptation, primes many gastric bypass patients for rapid regain years down the line. I maintain on 2000+ calories per day whereas many bypass patients maintain a higher body weight on 1200 calories daily or less.

However, anyone can regain some or all of their lost weight, regardless of the surgery they had. People with lap bands, sleeves, and bypasses have regained due to backsliding into old habits. A reduced size stomach won't stop one from overeating.

Edited July 24, 2017 by Introversion

[nursejackie 24]

Me ! I am going through the pre- approval process for the gastric sleeve. Yesterday my friend told me that bypass surgery may be better. Introversion , I have PCOS. I saw that that could be a factor in what surgery you choose. Do you know which is better ? I feel more comfortable with the sleeve just because of less nutrition absorption issues and shorter surgery time. But I am second guessing my decision. I really want this to work.

[Introversion 1,876]

1 minute ago, The thinner mint said:

Me ! I am going through the pre- approval process for the gastric sleeve. Yesterday my friend told me that bypass surgery may be better. Introversion , I have PCOS. I saw that that could be a factor in what surgery you choose. Do you know which is better ? I feel more comfortable with the sleeve just because of less nutrition absorption issues and shorter surgery time. But I am second guessing my decision. I really want this to work.

Gastric bypass is the gold standard bariatric procedure for obese PCOS patients.

Nonetheless, I know a number of women with PCOS who have reached their goal weights and found amazing success with their sleeves.

Here's the catch: due to the severe insulin resistance that is the hallmark of PCOS, weight loss is usually much slower with a sleeve and faster with a bypass.

[nursejackie 24]

1 minute ago, Introversion said:

Gastric bypass is the gold standard bariatric procedure for obese PCOS patients.

Nonetheless, I know a number of women with PCOS who have reached their goal weights and found amazing success with their sleeves.

Here's the catch: due to the severe insulin resistance that is the hallmark of PCOS, weight loss is usually much slower with a sleeve and faster with a bypass.

What about the bypass effects insulin resistance ? Thank you so much for your input. Are there additional hormones effected because of how the intestines are re- routed or is it just because of the further limitations on how much food you can eat ? It is impossible for me to lose the amount of weight I want. I did Optifast and stuck to it for months and could not get under 175 and I was eating 800 calories a day ! I have tried every diet on Earth, I am serious. If I do this and it does not work I may lose it !

[Introversion 1,876]

46 minutes ago, The thinner mint said:

What about the bypass effects insulin resistance ? Thank you so much for your input. Are there additional hormones effected because of how the intestines are re- routed or is it just because of the further limitations on how much food you can eat ?

Both types of bariatric surgeries (bypass and sleeve) affect multiple gut hormones favorably in PCOS and insulin resistance. Click on the link below if you can digest scholarly articles on the subject.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334389/

[nursejackie 24]

I have read that article before lol. That was actually the article that made my mind up to have the surgery in the first place. It seemed to say that the sleeve and bypass were more effective than the lap band, but to me it looked like both the sleeve and bypass were effective with the sleeve having less complications. That was why I choose the sleeve. But I am still second guessing myself like the OP.

Sorry if I hijacked this thread OP. It is hard to find people who understand PCOS and weight loss and insulin resistance and I get really excited when I do because I really want to make the right choice.

[TJnWA 19]

Don't apologize I'm taking all this in and appreciate all the input! My main concern is the amount of weight I need to lose and will the sleeve get me to goal vs my fear of more time on the operating table and having everything rerouted. Maybe I'm just having preop jitters

[nursejackie 24]

I feel the same way ! I think I will be second guessing myself until the surgery is actually done because I am just like that. Can you just do the second part after getting the sleeve if you are not getting the results you want ? I always tell myself that if worse comes to worse I could always go back.

[TJnWA 19]

That is always possible, my preop with my surgeon is this week...I'm going to ask a lot of questions. Thanks again everyone for the great input!

[Airstream88 361]

I chose Bypass because in the end I wanted this surgery to be one and done. At first I was dead set on the sleeve but after reading hundreds of experiences on these and other boards, I decided to go with my surgeon's preference and have the bypass. He suggested it because he felt I would lose more weight than with the sleeve. I also didn't want to develop GERD after the sleeve and have to have a revision later. I don't feel the malabsortion is a big deal as long as I take my Vitamins and Iron as directed. My labs have been great so far.