hello - this is my first post. I did some research on Lap Sleeve Gastrectomy and discovered many patients need a second surgery. I am 5'4 and 373 pounds (eek). Am I correct that the VSG is the same as the Lap Sleeve? Is it normal for a patient to need 2 surgeries? My BMI is 64.

"The VSG is a reasonable solution to this problem. It can usually be done laparoscopically even in patients weighing over 500 pounds. The stomach restriction that occurs allows these patients to lose more than 100 pounds. This dramatic weight loss allows significant improvement in health and resolution of associated medical problems such as diabetes and sleep apnea, and therefore effectively ?downstages? a patient to a lower risk group. Once the patients BMI is lower (35-40) they can return to the operating room for the ?second stage? of the procedure, which can either be the Duodenal Switch, Roux?en-Y gastric bypass or even a Lap-Band?. Current, but limited, data for this ?two stage? approach indicate adequate weight loss and fewer complications"

I definiteky do not want to have 2 surgeries. Thus, what are some other alternatives? Is a second surgery always needed with the lap VSG?

The VSG is a stand alone procedure that is performed in one surgery. If you do not achieve your desired weight loss a second part of the surgery can be done (duodenal switch) to allow further weight loss.

That's old info. Originally, extremely obese patients were giving the sleeve part of the DS so they could lose enough weight to have the DS laparoscopically. Once they lost about 100 pounds, they'd have the switch done.

Except a lot never came back for the second part and that made doctors go "aha!" and start thinking that you could just do sleeves for a lot of patients. So now it's considered a standalone procedure.

Since your BMI is quite high, I would recommend you at least take a look at the DS as a WLS option. I love my sleeve & wouldn't want DS due to the malabsorption, but my BMI was 34 when I had surgery. Had it been >45, I would have looked at other options as well. Not saying that I would have chosen something different, but I would have at least considered it.

Now, if you are okay with getting the sleeve & then re-evaluating your WL later, the two step DS could work for you....and you could possibly not even need the second step. Just research all options & chose what's best for you.

My bmi was 48 (5'2" and weighed in 263lbs) when I had the sleeve, and would never consider DS before at least giving a the sleeve a chance. I knew a restrictive procedure would work for me because I was successful with my band when I had restriction.

There is plenty of research out there, and I hope you are able to choose the best option for your lifestyle.