How do you decide?

I feel like they are STRONGLY encouraging me to to go rny because of my Diabetes (t2).

Thoughts?

I have read that the sleeve has actually been around for a very very long time ... it was the first step of a bypass when the patient SLOWED/stopped loosing weight with the sleeve then they would complete the bypass. Earlier someone mentioned first getting the sleeve and then.the.bypass... that's why I mentioned that.

Oh I'm not sure to tell you the truth. My dr. Said it hasn't been around that long. But you know how dr.'s can be.

I have read that the sleeve has actually been around for a very very long time ... it was the first step of a bypass when the patient SLOWED/stopped loosing weight with the sleeve then they would complete the bypass. Earlier someone mentioned first getting the sleeve and then.the.bypass... that's why I mentioned that.

I've heard of people going from banded to either the sleeve or rny.

The sleeve is the first part of a duoedenal switch procedure, DS. You can actually have the sleeve and get the D/S later if you do not lose to your desired weight. (At least my surgeon does that) If I had opted for the DS he would have left a larger stomach because you can eat more due to the malabsorption factor and still lose quickly. For now the sleeve is working well. I am a type 2 diabetic who moved to regular insulin at the beginning of the pre op diet, I am still on it but my a1c went from 7.5 to 6 quickly. Anxious to see where it will be after 3 more months.

Good luck in whatever you decide. I had dumping 'like' symptoms on one of the new injections...I never want to experience that again...

It's true the sleeve has not been around as long as the bypass surgery, but I had read that it's essentially the same surgery that they've been using for decades for stomach cancer and ulcers.

Anyone else read this?

My doctor said the sleeve has been around for at least 5 years, but it was in "test mode/experimental" up until this year. I can definitely see them using it for stomach cancer and such previously.

It's true the sleeve has not been around as long as the bypass surgery' date=' but I had read that it's essentially the same surgery that they've been using for decades for stomach cancer and ulcers.

Anyone else read this?[/quote']

I had actually read that somewhere.

FWIW - I’ve had “dumping” for 12 yrs - and you learn what you can or cannot have - the meds for diabetes have a syndrome which from all accounts is identical - it’s NOT pretty - it’s inconsistent - and in my PRE-surgery case - doesn’t do a thing for weight loss - if it did - I’d be THINNNNNNNN.

Thank you all for talking here - it’s therapeutic and like talking to friends - it’s thinking through the pros and cons and helps me -

I thought about the sleeve and how if it wasn’t the results I wished I could do the DS or the full bypass - I think that’s where the Nut and RN were coming from yesterday when they said you don’t wanna do that - and when I think about the LONG list of stuff I need to do - sleep test - pulmonary (2 visits possibly 3) - endoscope - endocrinologist and blood workup - psych eval - Nut (2) and all of this is after my 6 month mandatory PCP visits with monthly NUT visits - I can totally see how they are leaning toward the do it once right and you won’t have to be a surgical candidate twice -

I’m going to have WLS - that’s not a debate - it used to be - but I’m invested now - and it’s a matter of figuring out which surgery - and what is going to be best for me - for my family - for my future - keeping in mind that #1 on my list is to be an active person and #2 is mitigating diabetes and it’s hold on my life expectancy -

all of this is daunting ... and having someplace to talk to - so instantaneously - it’s like magic - my husband might crawl through his skin if i debate this stuff with him - he supports me - and is my rock (26 yrs of being my rock) and he just is afraid of the potentials - who isn’t - and afraid of regain - I TOTALLY GET IT - I am too...

with that - thank you - and you’ve ALL given me something to chew on

i had to go there - that was funny - hahaha - bairatric humor - haha

I was a revision from band to sleeve and just want to mention that beyond the hassle - your risk of serious complications is much higher for revision patients. From a risk point of view, doing the one surgery that works for you the first time is much better.

I thought about the sleeve and how if it wasn’t the results I wished I could do the DS or the full bypass - I think that’s where the Nut and RN were coming from yesterday when they said you don’t wanna do that - and when I think about the LONG list of stuff I need to do - sleep test - pulmonary (2 visits possibly 3) - endoscope - endocrinologist and blood workup - psych eval - Nut (2) and all of this is after my 6 month mandatory PCP visits with monthly NUT visits - I can totally see how they are leaning toward the do it once right and you won’t have to be a surgical candidate twice -

I’m going to have WLS - that’s not a debate - it used to be - but I’m invested now - and it’s a matter of figuring out which surgery - and what is going to be best for me - for my family - for my future - keeping in mind that #1 on my list is to be an active person and #2 is mitigating diabetes and it’s hold on my life expectancy -

It's true the sleeve has not been around as long as the bypass surgery' date=' but I had read that it's essentially the same surgery that they've been using for decades for stomach cancer and ulcers.

Anyone else read this?[/quote']

This is the case and it goes back over a decade. One of the side effects of those who lost most of their stomach (left with only a sleeve) was weight loss. So then it became a part of the doudal (I can't spell that) WLS as step one. What they found was that with step one, many patients lost most of their weight during that phase and didn't move on to step two. But as a stand alone surgery it is relatively new.

I have read that the sleeve has actually been around for a very very long time ... it was the first step of a bypass when the patient SLOWED/stopped loosing weight with the sleeve then they would complete the bypass. Earlier someone mentioned first getting the sleeve and then.the.bypass... that's why I mentioned that.

a sleeve CAN be converted to bypass, but it's not really "the first step" of a bypass. With a bypass, your stomach is still in your body, but it is separated into two parts, with you intestines connected to the smaller sac. You can recreate this with a sleeve, but a normal, first bariatric surgery RNY patient will not be missing most of their stomach like sleevers are. The "second step" of converting a sleeve to a bypass is by rerouting the small intestines.

The "bypass" part refers to bypassing the first section of your intestines, which is where your body absorbs fat, calories and most nutrients from the food your stomach has digested. Because of this, you only absorb a small amount of nutrients from the foods you eat. This, combined with the much smaller stomach pouch, is why RNY patients have a much harder time maintaining the right levels of Vitamins and minerals vs. sleeve patients. But it is also why they can tend to lose weight more quickly than a sleeve (tho some sites/surgeons swear the weight loss is comparable between RNY and sleeve).

This difference with resectioning the intestines is also why RNY patients come off their diabetes meds faster. They aren't able to absorb sugar as easily AND because of the small sac, if a large amount hits your intestines too quickly, it will make you sick (dumping). Same can happen with fatty foods.

In short, I don't want anything that can/will make me violently ill. Dumping sounds like a nightmare, and most RNY patients have it at least a few times before they figure out how to control it. But I am not diabetic (yet), so I'd rather try the sleeve, work hard with it, and then reconsider other options if I'm not successful. However, I truly feel I can be successful with the sleeve.

Hope this helps!

It's true the sleeve has not been around as long as the bypass surgery, but I had read that it's essentially the same surgery that they've been using for decades for stomach cancer and ulcers.

Anyone else read this?

Gastrectomy (removing a portion of the stomach) has been around since the 1800s, actually. Not necessarily the sleeve gastrectomy, but removing part of the stomach to treat cancer and ulcers has been around a very long time.

I love a gal who's done her homework!

There are documented cases of the "sleeve" being performed as far back as as the 1970's. And many references to it being in existance as far back as the 1950's.

The "sleeve" as we know it was originally used as a weight loss procedure in very high BMI cases, when the patient was deemed to be too high risk for a full bypass(RNY). The surgeon would remove the pliable portion of the stomach rather than fashioning a "pouch" because this could be done without having suture lines at the esophagus & the intestine thus reducing the chance for complication. This was all performed with full intent of simply getting the patient down to an acceptable weight to go back in & complete the bypass procedure.

However it was not uncommon for the patients to experience significant weight loss & opt to not return & complete the procedure, hence having a sleeve procedure, though not called this at the time.

Since there is no formal documentation before the 1970's I don't lend much credence to that time period. Though I am lead to believe the earlier cases we're a result of stomach stapling gone wrong.

That's what I thought... Haha... we must have read the.same thing.

It's true the sleeve has not been around as long as the bypass surgery' date=' but I had read that it's essentially the same surgery that they've been using for decades for stomach cancer and ulcers.

Anyone else read this?[/quote']

A rule of thumb I used for choosing between sleeve and bypass is...if you like to get ur drink on go with the sleeve cuz with bypass there is a higher chance of ulcers if u drink alcohol as opposed to the sleeve....just a thought. Good luck!