How to choose? Sleeve vrs RNY

[tnpeach 41]

I have just started this process. I went to the Dr on Tuesday. I was thinking the sleeve was my choice. (no malabsorption and no rerouting of body parts) I asked Dr Smith his thoughts and he was leaning toward RNY (More weight loss, but more malabsorption and may help with Diabetes) Has anyone had problems meeting their goal with the sleeve? I am not sure why I am swaying now. I really want to lose weight and want the best possible outcome. I think I am concerned of the rerouting of the body parts. Did anyone else have this weighing (lol) the decision?

[Koofka 59]

My understanding is that the RNY is a more severe surgery that takes additional recovery and has a mortality risk above that of VSG. Also believe the long term food restrictions are more significant then the VSG. For instance, believe you are limited to liquid form medicines for good with the RNY.

From my experience so far with the VSG, if you stick with the recommended post-op program its pretty effective.

[tnpeach 41]

I did not realize you could not take pills. I currently am on about 8 to 12 a day. This would be a big problem unless I could come off of all the drugs. What a blessing that would be. Thanks for the info.

[Cupcake 801]

Please research both rny has extensive history and most people are off all meds, as well it's reversible as where the sleeve is not , both are effective but if you have gerd or ACID reflex the sleeve makes this worst, also some had to have revisions from the sleeve to rny. Discuss all options with your surgeon yo determine which one is best for you. Good luck .

Edited March 22, 2014 by Cupcake

[Amyllf2 206]

I too went in to my first appointment with the intension of having the sleeve. I wanted to avoid the malabsorption issue and just really didn't want to have my intestines rearranged. My surgeon said he will perform any of the surgeries as long as his patient is well informed. We discussed both the VSG and RNY. I left very confused.

I am having RNY on 4/15. Why? For me it came down to 4 things. 1) Heartburn, which I have on occasion, which means the likelihood of having it long term and more severely is high with VSG. 2) long term outcome data. The RNY has decades of data and the VSG is the new kid on the block. 3) god forbid something happens and I need my original stomach restored. Not an option with VSG. 4) I'm a sugar addict and VSG would not restrict me from that problem.

You will find fans of both procedures. People who swear by each. Only you can decide based on your research.

[tnpeach 41]

This is all great info. This is why I am now second guessing myself. I know I still have time. I am in the process of getting all of the items off the checklist. I am blessed and do not have heartburn or stomach issues. I do have everything else. Weight, health issues and do not want to fail at this. I have lost weight in the past but can not keep it off. I know this will assist in that issue.

[gomekast 559]

To be fair to VSG, its been arouns for decades for stomach cancer and ulcers. They just did it for other reasons.

I went in thinking rny. But i learned about the vsg and was sold on that.

For me, i need to be able to take pills. Rny, you will not be able to even take cold pills or allergy pills for example.

And the more i thought about it the more i decided i didnt need the rest of my tummy. For me it was personally about not allowing my brain a back up plan.

I wasnt comfortable re-routing my insides at all. My last point was this..ive dealt with low vit d, sodium, and magnesium off and on all of my adult life. Vsg will not increase the chances because i will absorb nutrients from food and Vitamins.

Vsg patients still get dumping too. I get it from too much fake sugar.

Regardless of your choice, you need to remember that you wont be eating much. Ever. Can you live with the malabsorbtion issue for the rest of your life?

Taking a prilosec type pill for a while is just a sort of gaurantee in my head. I thought i would be bothered by it but im really not. I see it as my, keeping my sleeve healthy pill. Im happy to give it that treat i guess.

Ultimately it comes down to ourselves personally. Regardless of the choice we all still need to make the choice to have healthy on plan foods and Snacks. The choice of surgery wont prevent you from having that treat or chips etc. Youll still find a way to eat it if you really want it.

Read read read! All over the internet too. Get many points of view and get to a place k

Of peace with your choice.

Good luck!

[tnpeach 41]

I did not realize that you could not take pills with RNY. Interesting. I am happy with my decision but still doing research. Thanks for all of the info

[angelface811 100]

It is true that sometimes with RNY certain medications may not be tolerated but there is usually a remedy for that. It is untrue that you can never take pills. Most people who have WLS surgery are on at least one but typically more potentially life saving medications. Such as diabetic, high blood pressure, and anti-depressants etc. Doctors would not assume the liability of their patients not being able to take necessary medications. There is an issue, however, with extended release and sustained release formulas I learned. It can be a problem with all WLS surgery. Because of the new alteration to the digestive system it can affect these meds. The extended release formula is made so that layers of it dissolve a little at a time in your body. So check with your docs because many people have to change to original formulas.

In my research I found out that lap-band is no longer going to be covered in the near future by insurance because of poor results. However I know many of you, including my own sister, have done great with it! The sleeve is all the new rage but as one person pointed out we don't have a whole lot of long term research in. But it does look promising. Many doctors do not recommend it if you already have esophageal issues or heartburn. The sleeve can potentially be harsh on the esophagus and recent journal publications have shown a small percentage of esophageal cancer related to the surgery. But it's all about being aware of your own body if you do have the sleeve. If you are still experiencing esophageal problems even on meds you need to get it checked out ASAP. Depending on severity doctors may recommend conversion to RNY.

The RNY is still considered the gold standard in weight loss but typically comes with the potential of more complications. This is where having an experienced surgeon and following all directions decreases that likelihood but of course not totally. All 3 of these surgeries have a less than 1% mortality rate. I know many people argue that the RNY is just so drastic but I believe the sleeve to be equally as drastic. So much to take in right!! So point being do your own research, ask questions, make sure when you read publications to look at the date they were published. Try and aim for the past couple of years. Many people don't do that so their info is off by several years. We have to jump through quite a bit of hoops to get to the actual surgical part of all of this. You are doing the right thing to use this time to do your research. You will get plenty of opinions from people who have had the surgeries which is great but also do the research. I feel confident that when you do this you will know which WLS is right for you...best of luck!

[Amyllf2 206]

I take heart, cholesterol and BP medicines. I've been told I will continue to take all of them for the first few months but will need to use a pill splitter. I was told the splitter will become my friend long term because I will always need to reduce the size of any pill I take.

I've also been told I will never be able to use Advil, Motrin or Aleve. I believe that is RNY specific.

[Mrs. Whatsit 33]

My surgery is scheduled for March 31st. I am scheduled for a GS but I am still not 100% sure. My doctor told me I can change my mind right up to the minute they're wheeling me into the OR. My main concern with RnY are the potential complications. I am the person who always has the strange health problems, the person who has the weird side-effects, the person who has the rare complication. I do not want a bowel obstruction and that is not an unusual complication. My husband and I will be traveling this summer and I don't want to end up having bowel complications in some little town in the middle of nowhere. A bowel obstruction can require emergency surgery and I simply do not want to be away from home and end up having this complication.

I don't know why this is such a difficult decision. I'm very informed and I'm a nurse. Ack! I just need to make the decision and quick second quessing myself.

[Scraglycat 19]

I also was recommended to do a rny. I refused, I didn't feel comfortable with the complications and potential dumping.

The sleeve resolves diabetes in 82% of cases, rny only slightly higher. If you go to the section in this site for research on gastric sleeve, look for my post from the bariatric journal.

Anyway I had surgery December 11 last year. I had type 2 diabetes, was on insulin and metformin...I am now off all my meds, and a1c is 5.6. God is good :-) love my sleeve.

[iowagirl865 1]

Good info! I'm at the beginning of this process but I was pretty set on the sleeve. Gerd and heart burn is a daily issue for me so maybe sleeve isn't the best option. I love all the information in this site!

[tnpeach 41]

I am so glad I asked the question. Thanks for all of the info. I see I am not the only one with questions.

[WhoKnows 288]

Once I get approval from my insurance, my plan is to be sleeved. My reasons for choosing sleeve over RNY are pretty much all the ones everyone else has already said, but there's also one more. I realize that this sounds alarmist and kind of nuts, but in the event of some sort of major disaster, I don't want to be in a position where I can't absorb nutrients from food. I'm only in my 20s (which hopefully means under the best of circumstances I have another five or six decades ahead of me), and within that time, who knows what could happen? I know people say you can't worry about that sort of thing, but if you listen to what a lot of top scientists are saying (here's a report on a recent NASA study: http://www.policymic.com/articles/85541/a-nasa-study-comes-to-heavy-conclusion-our-civilization-will-come-to-an-end-in-only-a-few-decades?utm_source=policymicTBLR&utm_medium=main&utm_campaign=social)

it only makes sense to at least consider the possibility. I'd feel differently if I were older, but at 27, I have no idea how the world will look in 30 or 40 years (or what sort of income level I'll be at, whether I'll have insurance, and how expensive Vitamins will be), and it just doesn't seem wise to plan on being reliant on supplements for the rest of my life. (I know the sleeve requires upkeep too, but comparatively less in the long run it seem like.)