I currently have a band that needs to be removed due to problems. I just found out my insurance has approved the removal and conversion to either the sleeve or bypass. I have to chose which one I want to have done. I've been leaning towards the sleeve, but now wonder if they bypass would be better.

I lost almost 100 lbs with the band. My BMI is currently 34.8. Is the sleeve better for lower BMI patients?

I chose the sleeve because of several reasons. One of which is that there is no malabsorption with the sleeve. I can still take pills, I still process my vitamins, little to no dumping syndrome. I think it's a wonderful "in between" the band and the bypass.

Personally, I think that it is not so much a matter of how much you have to lose. It seems to me that people with both high and low BMI's do well with the sleeve. Since it is a restrictive only surgery, then the main results will be from eating less. Also, many people (but it seems not all) have a lowered appetite after the surgery (although for some it seems to take a few weeks to kick in). My primary concern is that I eat too much. I am not a big sweets eater, and know how to eat healthy, but I just eat too much. Also, I am always hungry. Even after a big meal, I will be hungry two hours later. I also want to eat a varied diet that includes some carbs/veggies/fruits/fried foods etc. I just want to be satisfied with less. I also do not want to worry about malabsorption problems. Even if I lose and still remain 20-30 pounds overweight (by standards) I will be happy.

For me my reasons for not choosing the RNY nor ever even considering it.

1. They make a stomach pouch which often stretches out.

2. You have a blind stomach which is nearly impossible to scope should you have any problems.

3. I did not want my intestines rerouted. I was not interested in malabsorption. It might be fine now when we're younger and healthy, but about when we're elderly people and just by virtue of age and aging need additional supplements. I don't want to have to deal with being malnourished, malnutritioned, etc. because of malabsorption.

4. The revision rate is pretty high with RNY. I did a lot of research and on the Revision board and failed weight loss surgery boards over on OH there were just too many RNY's looking to revise to something else..some even desperate enough to go to BOB...band over bypass. To me that is the worst of all wls worlds.

5. My problem was overeating..not so much WHAT I was eating. I just had a really big appetite...although I did eat a lot of carbs...who doesn't like carbs? I quit carbs about six weeks before surgery and frankly I don't miss them.

My reasoning was having a fully functional stomach. I can eat a piece of birthday cake and not get sick. I feel like for MY needs this was the way to go. You have to find the surgery that works best for your personal needs. You can find horror and success stories online for each of the surgeries, but this was the choice for me.

Anna

I have to have the option of anti-inflamatories. (ie. ibuprofen, aleve, etc) for my TMJ and if I am like my mother...arthritis when I am older.

Here is my 2 cents and the reason I chose the VSG:

The RNY pouch stretches significantly, the VSG doesn't.

No malabsorption = no need for multiple Vitamins and supplements (plus, the malabsorption aspect only lasts for a few years before your body figures out how to absorb all of the calories, but you still miss the vites and other good stuff).

Everything functions normally, just smaller (I am fond of my pyloric value - it prevents "dumping syndrome").

The odd "blind stomach"

VSG = The removal of the part of the stomach that produces the hunger hormone.

The ability to take NSAIDs (I'm young now, but not naive to the fact that I may have to depend on these when I get older!)

How did you do with the band? Did you have it removed because you had problems with it, or are you revising because you have lost all that you can? You were luckly enough to already have a "restrictive - only" procedure and have lost 100lbs (congrats by-the-way!). This should help you decide whether restriction-only is good for you or not. How was it working for you? If you were doing fine with the band and restriction, but started having problems with the band itself, then I say go for the sleeve. If you have had good restriction with the band with no problems and just can't lose anymore of the weight, then maybe you need the malabsorption; however if this is the case, I think it is worth a look at the DS, I would do the DS over the RNY anyday...but that's just my opinion.

Good luck!!