Hi All,

Has anyone every considered gastric bypass over the sleeve, but ended up getting the sleeve? Can anyone who has done this give any suggestions why you chose the procedure you did? I am asking this question because at my original appointment I was told that the sleeve was covered under my insurance and was assured tha all will go well. Well what do you know, time for approval stage and insurance company does not cover the Sleeve. But they will cover bypass and band. Any suggestions? I am so confuse now because I spent so much time researching the sleeve and was mentally prepared for it. Now I'm being pressured to make a desicion that I am not sure about.

There are a lot of posts about the lapband vs the sleeve on the forum. I have not seen as many about the bypass but from my research one of the main reasons to go for the sleeve over the bypass is the malabsorption problems. With the sleeve you do not have the same problems because nothing is changed in regard to your natural progression for digestion. The stomach is just smaller. Make sure whatever your choose is the right thing for you. Do not let the insurance pressure you. There are some people that have gone self pay and went for the sleeve because of insurance lack of coverage. I hope this helps some. Take the time to research the best option for you.

I am currently working on an appeal for the very same reason, insurance denial. I chose the sleeve for several reasons,

1. malabsorption - I want t be able to absorb all the nutrients my body needs.

2. food choices - I want to be able to eat a variety of foods and eat foods recommended by the national guidelines for healthy eating. (relatively little chance of dumping syndrome)

3. I want to maintain my stomach's pyloric sphincter. In the RNY, the bottom of the pouch does not have a sphincter, instead it just has a small opening which can stretch out over time, resulting in food passing through the stomach quickly, and becoming hungry quicker. This often results in weight gain.

4. The fundus of the stomach (which produces ghrelin to make you hungry) is removed, often resulting in lessening hunger pains.

5. the part of the stomach that is left is not as stretchy, and less likely to stretch out of shape over time.

6. the amount of food that can be eaten is a little larger than the RNY and I think that amount is healthier and better for me.

These are the things that have made me stick to my decision despite ignorant insurance companies.

Also, this may not seem like a very big deal, but if you use NSAIDS and really need them - for reason of arthritis, you will never be able to use them again with the GB.

The sleeve will still allow you to use these products. For me that is a big deal. No way I'm going to take tylenol all day, besides it doesn't help at all with the inflammation.

Good luck!

I chose the sleeve because I have watched a family friend who had bypass. He lost his weight quickly and was a real success story, but even ten years later if he eats anything with a signifigant amount of carbohydrates of sugars he is sick the remainder of the day with vomiting and diarehha. We recently went to the lake with him and we both ate a bit of everything. I spent the day swimming and he kept having to run to the port a potty. I feel like not being able to have a piece (all be it a small one) of wedding cake when I get married, or having mashed potatoes on Thanksgiving would have made me unsuccessful long term. That was 99% of my reasoning, a fully functioning stomach.

In my opinion, and that is all it is, if the sleeve would not have been a possiblity for me I was willing to go without WLS because I wanted a higher quality of life than the other surgeries could offer. Keep doing lots of research and find what makes you the most comfortable. You can go on any message board and hear rave reviews about one surgery and horror stories about the others.

Good luck!

Anna

I was in the opposite boat as you. My insurance originally did not cover VSG, even though that is the surgery I really wanted. That was about 2 years ago. Well, since RNY was my only option at that point, (in my mind lapband was not an option for me), I started studying up on it, even though it felt like I was starting over. I got used to the idea and felt really mentally prepared for the RNY journey. Low and behold I just found out my insurance now covers VSG, and this surgery was no longer something I thought about. I chose to go back to VSG anyhow simply because I was concerned about the aftercare becoming too extensive for me to be able to afford, should anything come up in the future regarding vitamin deficiencies and such. With that being said, what I kept seeing over and over throughout this process, was that if your insurance says they don't cover VSG and that is what you really want, APPEAL APPEAL APPEAL! People have had very good luck getting approved after initially getting denied because their insurance "didn't cover it". On another note if you are not able to get approved for anything but RNY (and that is the only other surgery you would choose), you most likely will be able to prepare yourself for that too. Mentally and emotionally it takes some time getting used to the idea of having another surgery, but don't let it discourage you from getting the help that you need. If my insurance denies me for the sleeve for any reason, I would still get RNY. There are pluses and minuses to both surgeries. You will do what is right for you! I hope this helps a little. Good luck with whatever you decide. If you need anything, feel free to message me.

Hailey

Bypass was never an option for me. I'd choose DS over RNY if I was forced to make that decision. Luckily, VSG was an option for my revision, I had to fight for it, but I got it.

I was never interested in a malabsorptive procedure especially RNY. I figured the 2 years of malabsorption of calories and fat was not a fair trade off for a lifetime of malabsorption of nutrients and vitamins. Considering RNY patients only malabsorb for 18-24 months, I figured what the heck am I going to do for the rest of my life if I rely on malabsorption to get me to goal?

Plus, I had a pouch with the band. My body hated the pouch. It's not natural, it didn't work for my body, and I knew RNY would give me the same pouch/stoma combo.

Add in that only 30% of RNY patients dump with sugar, it just wasn't appealing. I've watched friend after friend have multiple long term complications with RNY. I can't count how many of them are deficient on some vitamin, one friend is going in for her 4th surgery related to her 7 yr old RNY pouch. This time, her intestines are twisted, and obstructed, and she's malnourished to the point of her teeth falling out because she malabsorbs so much of the nutrients she eats. For me, I just didn't want to deal with the long term complications that I've witnessed with friends in real life. I love having a normal, full functioning stomach.

If VSG would not have been an option for my revision, I would have had my band removed, and stayed fat.

Many patients win appeals for VSG. Work with your surgeon, and if your surgeon won't work with you, find a surgeon that will give you the surgery you want. You have to live with the surgery type for the rest of your life, not the surgeon.

Best wishes, and don't give up or give in on getting the sleeve if you truly believe it is the best option for your long term health, and life goals.

I originally was hoping to have an RNY when I first started researching bariatric surgery 4 years ago, but my insurance didn't cover it and after spending months, daily, on an RNY board and seeing just how many people had major complications afterward, I couldn't justify taking the chance on going self-pay, and then not having insurance coverage for any complications afterward. The sleeve was new then, and I just didn't look much into it at the time.

Fast forward to this past December, when I started looking into WLS again, hoping that our new insurance that kicked in January 1st might cover it. Well, of course it didn't, because the creature who owns our company continues to specifically exclude it from our policy to save a few dollars (he's a multi-millionaire and a horrible excuse for a human being, truly, and I don't say that lightly). But I digress.... so now, suddenly there's all this new info and data about the sleeve, and so many more people sharing their experiences and successes, and much more in the way of complication stats--well, compared to the RNY, they were practically zilch. BINGO! For those reasons, in addition to all the facts and comparisons made by the posters above me, I knew immediately that the sleeve was for me. I saw my family doctor for blood work, EKG, and clearance, saw the surgeon a week after that, and had my Sleeve 12 days later and it's been WONDERFUL!!!

I don't remember if anyone noted this above, but so far studies show weight-loss stats from VSG as equal to the RNY, with less chance of rebound weight-gain since our sleeves really don't stretch, but the RNY pouch does. My surgeon expects the VSG to become the go-to, preferred WLS sometime soon, and I've seen other people say that their surgeons say the same thing. In the end it was really a no-brainer for me, and I couldn't be more thrilled with it.

I can only give you my experience with the Lap Band as I know that is one of your choices. I had the Lap Band put in Aug. 2005. I originally lost 140lbs. All was well for about the first 2 years. Like so many people who can quote my story, I began having problems with the band and ultimately had to have all the fluid removed. I was okay for a while and went through a pregnancy. I gained ZERO weight during my pregnancy which really freaked out my doctor as I had almost weekly ultrasounds to check her growth and delivered an almost 8lb butterball .

After her birth I began having even more severe problems with my Lap Band. I got to the point where I was on primarily liquids for 6 months prior to having my band removed and sleeve done at the same time last Thursday. I figured the only difference is clear liquids rather than other liquid foods at this point.

My band was placed wrong by a doctor who at the time had an awesome reputation. It was dangerously close to my heart and major blood vessells. Thankfully my new surgeon, Dr. Castro had the skills and experience necessary to get the band out without any complications and sleeved.

So that's about 5 years worth of Lap Band experience. I did gain about 60lbs back, so I am 70lbs under my start weight, therefore even with all the complications, I am a Lap Band success story!! Imagine that!