Hi all,

I'm contemplating whether to have the gastric sleeve or duodenal switch. I am 5'2-3 with just over 150 lbs to lose. I have heard that the sleeve is wonderful but that folks struggle with maintenance so many folks wind up revising their surgery to a DS. I would love to hear your experiences and what to look for in a doc and the size of the sleeve itself. Does sleeve size matter as far as results and complications? Any and all input is greatly appreciated. I'm in the Durham NC area, if you know of a great sleeve doc with lots of experience, please let me know. Thank you so much!

The sleeve size is generally pretty similar regardless of bougie size used. The only people I've heard of who have especially large sleeves are folks with lots of scar tissue from the lap band or who have anatomically "long" stomachs.

I did a ton of research about the VGS, DS, and Rouen X/Y before I even went to see a surgeon. For me the idea of purposely putting my body into mal-absorption was really scary. I was freaked out enough about the permanent surgery, and then adding worries about nutritional deficits for life just didn't work for me. I have friends and acquaintances that have had the DS or the Rouen X/Y and everybody is very happy with their choice.

I think for me I had to get very real with myself about the root cause of my over eating and what I was willing to do and not do to get healthy again. Each person's decision process will be different and you need to weigh out all the options to see what is right for you.

Within reason sleeve size does not impact overall weightloss. I have a slightly larger than average sleeve due to having a long stomach so I can eat (gasp) around a quarter of a cup more food than most other sleevers. Those who were sleeved many years ago before the exact "just right" size range was perfected, may have TOO LARGE of a sleeve where some of the fundus (stretchy part of the stomach) was not removed so THAT can impact overall loss but the difference between a 32 bougie and a 40 bougie is really small in terms of how much food your stomach can hold, but a slightly larger sleeve can help prevent strictures and be better for those with acid reflux.

I'd MUCH rather go back years later and get DS than have my intestines rerouted and deal with malabsorption unnecessarily. DS is a VERY powerful surgery and it has it's place but I'd rather avoid it.... As long as I can stay under 230ish pounds I wouldn't do the DS even if I don't maintain my goalweight.. If I found myself ballooning back up over 300 pounds then yes, I'd absolutely go get the DS.

I agree that the DS sounds super scary to me b/c of the degree of malabsoption. Even the RNY was more complex than I wanted. I would consider revising to RNY if I was unable to lose weight, but I think maintaining it will likely have less to do with my surgery and more to do with my own habits, so I'm trying to work on those seriously. For me, DS wasn't even a consideration.

It's my understanding that the Vertical Gastric Sleeve is the first part of the DS. If you were over a certain weight, like 400 or 600 lbs, they would do the Gastric Sleeve and then wait until the patient was in better health after losing a couple of hundred pounds. Many were still losing at a good rate so they never had the DS finished.

Finally it was approved as a procedure in itself a couple of years ago. I don't believe those who have had a Vertical Gastric Sleeve are able to be modified to a Gastic Bypass because there isn't usually enough stomach left to make a pouch. But if you got the sleeve and you could only get so far down, you could probably get approved to modify to the DS.

You can be modified from a sleeve to a bypass. My Dr. at Kaiser Fremont mentioned this is done if GERD is very bad post-op.

I wouldn't say many people revise to DS, but some do. There is a DS board on Obesity Help so you could get more info about DS there. There are many more side effects with DS, but for some it is a life saver if they can't take the weight off another way.

The restriction alone has been enough to get me to goal. My program uses a 40 bougie to size the stomach. I have started a blog on this site and discuss bougie size there:

http://www.verticals...-and-then-some/

For North Carolina references, check the Gastric Sleeve Surgery Support Groups → Local Gastric Sleeve Surgery (VSG) Support Groups → USA Local VSG Support and then search for North Carolina. I found three threads for that state.

Best wishes on your journey!

Lynda

Thank you for all your replies. Have any of you had any problems with vitamin deficiencies so far with the VSG?

Thank you for all your replies. Have any of you had any problems with Vitamin deficiencies so far with the VSG?

I was told to quit taking my b-12 because my levels were so high.. All other levels were perfect at 3 months... I am 99% compliant with my Vitamins.. like most, I occasionally miss a dose but it's rare that I do.

I have not had any issues with vitamins and they have been checked at 6 months, 1 year, and 2 years out. My program requires a lot of vitamins and I am very compliant at taking them. And I eat a well balanced diet with low fat protein, whole grains, vegetables and fruit.