Vsg Vs. Rny

[newbeginnings2012 4]

I went to my pre-op appt. with my surgeon this week and found out that my upper GI showed a hiatal hernia. My surgeon suggested that I consider changing to the RNY because of this. I have never had problems from reflux that I know of so this surprised me to find out about the hernia. My surgeon is concerned that I may develop reflux problems with the VSG procedure and that is why he thinks I may do better with the RNY. Now I am 1 1/2 weeks from my surgery day and have this major decision to make! I would have had the RNY 8 years ago if my insurance would have covered it. And I know several co-workers who have had the RNY and are doing well. (Except some have major gas issues that I was hoping to avoid due to my job as a nurse.) Once I found out about the VSG procedure and found out my new insurance covers these procedures, I have been working on getting the sleeve since last January. I really thought this was the answer for me.... now I am not so sure. Any words of wisdom out there for me??

[chad2rad 491]

If you get reflux problems could u not convert to an rny later?

While I think rny procedures are also greatly improved, I would still pick the sleeve. Re malnutrition and dumping are not fun either.

[UTGal99 327]

I have a hiatal hernia and I am getting a VSG. My surgeon states he repairs them ALL the time. It is a routine repair while in performing the sleeve gastrectomy.

I would only go with the procedure you are most comfortable with. Have you asked your surgeon why he won't perform the VSG in conjunction with a hiatal hernia repair?

There are lots of people on this site that have had a very successful VSG and hiatal hernia repair done at the same time.

I would either find another surgeon or challenge that. Just my 2 cents...

[NuStyle 28]

I am 7 weeks out from VSG surgery and I had a hernia repair during surgery that I did not know anything about either. No problems at all thus far. There are meds to take for reflux. RNY is too invasive IMO. Good luck to you.

[Sleeved&Hopeful 182]

Yes, I hear about people getting hernia repaired during VSG all the time. Some of them even chimed in here. I'm surprised he said that. I think it should be up to you and weighing the pros and cons. My sister did really well with the gastric bypass but for some reason the potential side effects scared me too much so I chose the VSG. However, I have developed reflux since surgery and never really had it before. My case must not be that severe because if I take a Prilosec first thing in the morning, I don't experience any reflux symptoms.

[Wolfgirl1978 256]

I had a surprise hiatal hernia my surgeon removed during surgery. I didn't have any test prior to surgery, because I was self pay. Anyway, I'm doing fine. I take 1 Prilosec every morning

[MrsG 329]

My dr submitted to my insurance for a duodenal switch which means if the sleeve doesn't work I can go back and get the rny and its all covered. Can they do that for you? I would try the sleeve first and if you have problems you could go back, if thats an option you have. If I was in your shoes and had to choose rny or nothing I would chose rny but that's me. I'm sorry about your hernia, good luck with whatever you decide!

[RickM 1,753]

As others have noted, this is a fairly common occurance, so I would read the OP's docs response as indicating that he may not be very comfortable with the sleeve procedure yet, so it would be worth getting a second opinion on this issue. This may not be very convenient at this late stage before your scheduled surgery, but the cost of the alternative - living with an RNY and all that goes with it for the rest of your life - is just too high to rush into it. Or, to keep the schedule, and if you really like your surgeon, perhaps he can have a more experienced sleeve doc assist so that he can better learn to handle this relatively common problem.

My dr submitted to my insurance for a duodenal switch which means if the sleeve doesn't work I can go back and get the rny and its all covered.

Hopefully, if the sleeve doesn't work for you, then you would go ahead and have the DS completed rather than changing it to an RNY which would not likely work any better than the sleeve. Also, more than likely, once the sleeve is done, any future revisions would involve another round of insurance approvals unless the doc specifically had a two-stage DS approved.

[Raven21 121]

I was afraid of the RNY because of the malabsorption issues (Tylenol does not work for me, I need Motrin) and just the whole abnormal rerouting of your body. The sleeve seems much more simple to me. Having said that, at this point I'd consider pretty much anything that will get me out of this hellhole I've been living in. I hate hating myself.

[KS Fort Worth 86]

Count me in those who had a hiatal hernia repaired during surgery. They are apparently very common in both obese and older people. No reflux before or after. Only effect from the repair was swelling at the site which made me straighten my abdomen to drink and eat comfortably, otherwise things seemed to 'hang.' Still does to some extent. In other words, no slouching in an easy chair to eat, which I probably should not do anyway. Given the increased risks all around with RNY over the sleeve, and if you are sure the sleeve is right for you, I would seek a second opinion. Insurance companies are happy with second opinions. Good luck, whichever path you choose.

I have never heard that RNY has a lower risk of reflux. Is that really true?

[Robyn Owens-Miille 132]

I had a hiatal hernia repair by a general surgeon first and then my bariatric surgeon scrubbed in and did the sleeve. Apparently it is a pretty common thing in their practice to do things this way.

Not quite 3 months out but I am doing awesome. And I LOVE NOT HAVING REFLUX!!!!!!

[thewellkeptwoman 15]

Do what is right for you.

I just found that half of my co-workers have had some sort of bariatric procedure done. The one closest to me told me that I should go ahead and get a RNY becuase everyone else tried the VSG and Lap-Band and ended up having to get a revision. That is probably why his wife got one right off the bat (although I think she would have done just fine with a VSG because her BMI was a couple of points higher than mine). I just don't want any of the issues that come with RNY such as the very rapid weight loss and nutritional deficiencies.

I see VSG as more of a tool and not a cure-all. My main problem is not being satsified when I have a meal; after researching which surgery was right for me, I decided that VSG, as opposed to Lap-Band was the way to go. I'm pretty sure that I could have gotten a Lap-Band, but I don't like having any kind of devices in my body.

[KS Fort Worth 86]

We see things the same way, thewellkeptwoman. I think some people view ANY weight loss surgery as a cure-all, and thus end up with problems or weigh regain. I know several people who never quite made it to goal with RNY, and are heading back the other direction, because they refused to change their habits. ANY of these surgeries can be beat if we continue to act stupidly. Like you, I wanted a TOOL, and that's exactly what I got.

[newbeginnings2012 4]

Thanks everyone for all of the great advice~ I really appreciate all of the replies.