Sleeve vs. Bypass

[RSM 69]

I am seriously thinking about switching from sleeve (which is scheduled for Sept. 18th) to a bypass. Any reasons why I should or should not. I KNOW it is an individual decision, I would just like some experienced feedback.

-Thanks-

Edited August 25, 2017 by RSM

[LifeChangesLori 79]

If you have issues with GERD I would go with the Bypass as the Sleeve will make it worse. I am having the Bypass because of this on 9/12.

Sent from my SM-G955U using BariatricPal mobile app

[RSM 69]

8 minutes ago, LifeChangesLori said:

If you have issues with GERD I would go with the Bypass as the Sleeve will make it worse. I am having the Bypass because of this on 9/12.

Sent from my SM-G955U using BariatricPal mobile app

I have 0 issues with Gerd. I had to look it up on Google to even find out what Gerd was. Stupid me.

[LifeChangesLori 79]

Lol! You are too funny!
Also Bypass patients tend to lose more weight quicker then sleeve patients from what I have heard. I'm sure you will make the best decision for yourself, good luck!

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[JohnnyCakes 593]

On 8/25/2017 at 0:57 PM, RSM said:

I am seriously thinking about switching from sleeve (which is scheduled for Sept. 18th) to a bypass. Any reasons why I should or should not. I KNOW it is an individual decision, I would just like some experienced feedback.

-Thanks-

well... you'll lose more weight on average and run no risk of developing GERD. your ghrelin (hunger) levels will be lower and you'll experience more positive changes in gut bacteria. and you'll enjoy a much longer track record of success and treatment. and RNY is reversible, the sleeve is not.

to be honest, i can't think of one reason why anyone would get the sleeve instead, but i don't wanna open that can o' worms again.

Edited August 26, 2017 by JohnnyCakes

[RSM 69]

38 minutes ago, JohnnyCakes said:

well... you'll lose more weight on average and run no risk of developing GERD. your ghrelin (hunger) levels will be lower and you'll experience more positive changes in gut bacteria. and you'll enjoy a much longer track record of success and treatment. and RNY is reversible, the sleeve is not.

to be honest, i can't think of one reason why anyone would get the sleeve instead, but i don't wanna open that can o' worms again.

Did you have bypass?

[Joann454 1,329]

well... you'll lose more weight on average and run no risk of developing GERD. your ghrelin (hunger) levels will be lower and you'll experience more positive changes in gut bacteria. and you'll enjoy a much longer track record of success and treatment. and RNY is reversible, the sleeve is not.
to be honest, i can't think of one reason why anyone would get the sleeve instead, but i don't wanna open that can o' worms again. <_>

RNY is reversible?

[RSM 69]

Bypass surgery results in bypassing of the intestines which produces a malabsorptive aspect (less time for your body to absorb calories since your intestinal tract is shorter) that effectively reduces calorie consumption. Does the malabsorptive aspect also affect medications being absorbed?

Edited August 26, 2017 by RSM

[JohnnyCakes 593]

2 hours ago, RSM said:

Did you have bypass?

yes.

2 hours ago, Joann454 said:

RNY is reversible?

yes.

[DaniO 14]

I am seriously thinking about switching from sleeve (which is scheduled for Sept. 18th) to a bypass. Any reasons why I should or should not. I KNOW it is an individual decision, I would just like some experienced feedback.
-Thanks-

Six years ago I had a sleeve. On 9/13, I am having a conversion to bypass. My GERD became worse after the sleeve, I have a hiatal hernia that needs to be repaired, and I did not experience the amount or permanency of weight loss that I had hoped for. I wish I had started with bypass.

[Mhy12784 423]

On 8/26/2017 at 1:02 PM, JohnnyCakes said:

well... you'll lose more weight on average and run no risk of developing GERD. your ghrelin (hunger) levels will be lower and you'll experience more positive changes in gut bacteria. and you'll enjoy a much longer track record of success and treatment. and RNY is reversible, the sleeve is not.

to be honest, i can't think of one reason why anyone would get the sleeve instead, but i don't wanna open that can o' worms again.

Ill preface this by saying im getting a bypass (because I have serious GERD) but the sleeve is the better option for many if not most people. Its safer, less side effects/long term complications, less long term risks, its a much simpler operation, it doesnt change the anatomy, and it allows you to still consume alcohol and NSAIDS (yes one of these two is much more important than the other)

And im an operating room nurse in a facility that does a ton of bariatric cases and unfortunately ive seen a few cases first hand of what can go wrong with a bypass years down the road, so I know how much more dangerous it is than a sleeve. I have NEVER seen a patient come back to the operating room with long term complications from a sleeve. But ive seen many patients come back with Petersens hernias, perforated ulcers, bowel obstructions from Gastric Bypasses. Some of these are life threatening and altering.

Sure theyre both great operations which have their benefits and drawbacks, with situations where one is clearly superior to the other. But if one of them was the "winner" I would certainly say it was the sleeve.

Edited August 28, 2017 by Mhy12784

[JohnnyCakes 593]

23 minutes ago, Mhy12784 said:

Ill preface this by saying im getting a bypass (because I have serious GERD) but the sleeve is the better option for many if not most people. Its safer, less side effects/long term complications, less long term risks, its a much simpler operation, it doesnt change the anatomy, and it allows you to still consume alcohol and NSAIDS (yes one of these two is much more important than the other)

And im an operating room nurse in a facility that does a ton of bariatric cases and unfortunately ive seen a few cases first hand of what can go wrong with a bypass years down the road, so I know how much more dangerous it is than a sleeve. I have NEVER seen a patient come back to the operating room with long term complications from a sleeve. But ive seen many patients come back with Petersens hernias, perforated ulcers, bowel obstructions from Gastric Bypasses. Some of these are life threatening and altering.

Sure theyre both great operations which have their benefits and drawbacks, with situations where one is clearly superior to the other. But if one of them was the "winner" I would certainly say it was the sleeve.

i respectfully disagree.

the risk of dying during surgery is the same at around 0.5%. making both very safe, "routine" procedures. so your "simpler operation" rings irrelevant to me. i guess it's relevant if your surgeon sucks or if you're doing it on the cheap in a Mexican alleyway, but that's another issue.

risk of short-term complications? slightly higher with RNY, yes, but you have to consider relative risk. no complication goes over 5% (leak, stricture, etc). there's risk of leak with VSG too, it's a bit lower at 3%. now, if that 2% is enough for you to choose a less effective bariatric surgery? that's your choice. i guess i have a different calculus when it comes to those things.

the long-term risks you cite are rare and the patient has to purposely disobey basic rules of common sense to trigger. like going back to eating way way too much. don't want ulcers? don't take NSAIDS. it's quite simple, if you reach for Tylenol instead of Advil, your risk of ulcers is negligible. but the average American is stupid as hell, so even simple directions like that are routinely ignored. Petersen hernia? most studies have this occurrence as low as 1%, and is virtually not an issue with an experienced surgeon who knows where to connect the roux anastomosis.

now, you want to talk about life-altering long term risk? let's talk GERD. which i've seen studies range from 20-40% of VSG patients!!!!! this can range from merely annoying to life-crushing and needing revision to, yes, RNY. this message board is FILLED with these patients and my surgeon says about 20% of his operations are revisions from sleeve to RNY. now THAT is risk.

and perhaps the biggest risk not talked about is that of permanence. to me, it's very RISKY to do the sleeve because your stomach is thrown in the trash bin and it is completely irreversible. the RNY is reversible. ergo, much much less risk.

again, you mention the sleeve "doesn't alter the anatomy". first of all i don't understand this argument. what's wrong with altering anatomy if it makes your body perform better? by that logic, getting glasses to help you see is "altering your anatomy". getting a heart bypass if you have heart disease is "altering your anatomy". is this a God, intelligent design thing? i'm not going there. all i know is that cutting your stomach out (VSG) is very much altering your anatomy. much more than RNY which leaves it there to be a perfectly healthy functioning body part capable of getting back on the playing field if need be.

another risk of the VSG? not reaching your goal weight. and isn't that why we're doing this? the fact is RNY results in 70-75% excess weight loss on average. and that average is brought down a lot by a huge sample population of people who are too dumb to behave after surgery. VSG is, with a smaller and more motivated sample set of patients, at best 60-65%. i guarantee you that as time goes on and more and more VSG patients are tracked, that number will go down even further.

[JohnnyCakes 593]

let's just be honest and talk about the REAL reason most people get sleeve over RNY....

they are scared of not being able to eat as much as they want after RNY. and with the sleeve, they think they can get *most* of the benefit of RNY and also be able to eat more.

they want to have their cake and eat it too. (and that might be the most appropriate use of that phrase in history)

[FlyFatA$$Fly 155]

let's just be honest and talk about the REAL reason most people get sleeve over RNY....
they are scared of not being able to eat as much as they want after RNY. and with the sleeve, they think they can get *most* of the benefit of RNY and also be able to eat more.
they want to have their cake and eat it too. (and that might be the most appropriate use of that phrase in history)

Completely disagree.

[RSM 69]

Thanks for your inputs, I am taking some of your points of interest to my surgeon on this Friday and we will discuss in detail. Your posts have given me information I need so I have some valid points before me. I realize she is one surgeon out of MANY, but I will post on here your points with her responses.