Sleeve or Bypass? Confused

[I♡BypassedMyPhatAss♡ 806]

12 hours ago, SleevedK said:

While it is indeed standard practice to repair hiatal hernias with a gastric sleeve operation, I don't think any doctor can guarantee you that your hiatal hernia will never come back. The things I've read indicate that the gastric sleeve seems to make your stomach MORE likely to herniate (since a sleeved stomach is narrower and therefore can slide up through the diaphragm hiatus more easily than a normal stomach). I know for a fact that there are some gastric sleeve patients who have had multiple hiatal hernia repairs after the surgery (and others who were told to convert to a bypass because of their hernias).

As far as the acid reflux issue, worse acid reflux is a known risk of the gastric sleeve. Some people are lucky and have no issues, but others do develop acid reflux for the first time after the sleeve or have much worse acid reflux after the sleeve. I would definitely ask him about why he thinks that this is not a concern in your situation and what his plan would be for how to deal with it if your acid reflux does get worse after the surgery. (If he tells you that you would just take a PPI for the acid if it gets worse after surgery, keep in mind that PPIs are not enough to control the acid for some people who have really bad acid reflux after the sleeve).

You are smart to be thinking about these issues before your surgery. Personally, I deal with both acid reflux and a hiatal hernia after the sleeve (and no I didn't have a hiatal hernia before the sleeve - they looked for it when they did the sleeve). Knowing what I know now, I never would have gotten the sleeve. I think the bypass has stood the test of time better than the sleeve has - after decades of experience with the bypass, surgeons know the risks of the bypass and are better at managing them, whereas problems with the sleeve are often handled by just converting over to the bypass anyway. Just look at all the stories on the revision forum about people converting from sleeve to bypass because of sleeve problems:
https://www.bariatricpal.com/forum/1302-revision-weight-loss-surgery-forums-new/

Well said.