I'm scheduled for VGS Dec 19, I selected this method after much research to maintain my digestive tract. My concern is my surgical group is primarily bypass oriented but also does VGS ( 80% bypass and 20% sleeve ). It seems every person I speak to that has had WLS is a bypass, with impressive results.

I'm a relatively low BMI ( 38 ), surgery for severe hip and knee degeneration, but still need to loose 100 pounds for normal BMI. My overall health is good.

My surgeon is non committal, he simply states either option will work for me, but states he does far more bypass procedures. His group is well respected in our area and they work out of a hospital labelled as center of bariatric excellence.

I'm driving myself nuts second guessing the TYPE of procedure ( I'm mentally prepared for WLS and feel it is my best recourse ). Any help or insight would be appreciated !!! ( and yes I have searched this forum ).

Scstxrm, you stated that RNY complicates the colonoscopy procedure. How so? I had RNY in March and am due for a colonoscopy soon. I would like to know if any adjustments to the procedure would need to be made.

My doctor's office is opposite of yours, he is primarily doing sleeves now. But he educates patients and let's us make an informed decision.

I have wondered if maybe I should have gone with bypass. I respond well to negative reinforcement like dumping syndrome. i get really sick when I eat bread and you best believe I wouldn't touch it for anything. But I can eat sweets and I worry that my bad habits will creep back into place. I have also been losing slowly and would like the fast weight loss of RNY. (and that speech about slow weight loss being so great only sounds good if you're not the one losing at a snail's pace)

I will say that I learned a lot reading this thread. My doctor's office said that we can stretch the sleeve out but I read on here that bypass pouches stretch but not the sleeve. I sure hope that's true. Mine is still small and tight (like I hope my tush will be one day) LOL.

So I wish I had at least considered and researched RNY. I may have ended up making the same decision. Either way, it's done now and I will make it work. You will lose weight no matter which surgery you choose. Best of luck!

It is my opinion that anyone for high risk of reflux should go right to the bypass. Other than that, they are both statistically pretty comparable and each have risks, pros and cons. I think i just felt more "comfortable" with the sleeve but that isn't really a logic based conclusion.

Re:colonoscopy

In looking at the diagram of the intestines, where there used to ne a straight line with a finger sized branch for the appendix, there is now a fork in the road. For a straight colonoscopy.. Shouldn't affect anatomy there. An upper and lower gi, diverticulosis, crohns, anything involving bypassed tissue... I don't know what if anything would be different. I just know I would want a gi doc with a lot of post wls experience.

My logic says the sleeve is still a straight shot, therefore IMO less likely to have blind spots.

Also.. I take a lot of NSAIDs and steroids, and long term meds that have been studied in people with intact absorption. Not enough studies done for dosing after malabsorptive procedures for me to make that my first choice

I may be wrong but RNY would create issues for an endoscopy, not so with VGS. I believe a portal or separate laparoscopic approach would be needed with the RNY to scope the stomach.

A colonoscopy ( large intestines ) should have equal success with either VGS or RNY.

Klock,

I agree with you r/t just colonoscopy - I'm used to having cameras 'meet in the middle'. Definitely not a GI nurse here. I don't even enjoy it as a patient.

Psych and wound care, though - I am all over.

What they said

Looks like I will just mirror what everyone else said as far as not wanting to re-route my intestines, etc.. I have a friend that had RNY in April, 2014 and as of yesterday, she's down about 90 lbs. However, she said she's got quite a bit of loose skin. I was sleeved 9/23/14 and as of yesterday I'm down 30 lbs, but since I'm at the gym several times a week, I'm not noticing any loose skin yet. I'm sure there will be some at some point, I'm just hoping not too much!

I was a little concerned with "only" losing 30 lbs in 2 months, but my doctor confirmed that it's probably in large part due to building muscle, which we all know is denser than fat. He's very happy with the slower weight loss, as he feels it will be easier to keep off in the long run. All I know is that my donation pile is growing every week and while I'm still living out of my closet (you know, those clothes we all said we'd get back into "someday"), I'm about ready to go thrift store shopping! Oh, and I have a couple of tops with horizontal stripes that I'm not afraid to wear now!!!

So the sleeve has definitely been a blessing for me, and since I had my surgery two days before my birthday, my birthday celebration will take on a whole new meaning from now on!!!

NavyMom2006

Congratulations on your success. 30 Pounds in 2 months is great, keep it up. I must admit dropping 90 pounds in seven months also sounds good ( your friend ), looks like your on the same track as her.

The more testimonials I see like this makes me much more confident with VGS, Im on deck for the 19th.

I think the reasons everyone has posted cover most of why I chose the sleeve. But I will say that as a high BMI individual the thought process is that you can get a revision to a bypass to lose even more. So if my weight loss were to peter out (I won't lie, things have slowed, but I still seem to lose 9 to 10 lbs a month these last couple months). I can revise to a bypass. I don't want to, but I could. I don't like the idea of having innards that are blind should something go wrong.

Also, I am diabetic and I was completely off my medications within a week of my sleeve. I just like to put that out there for diabetics, that the sleeve can also help with type II should you have it. Since then my HgA1C is at 5.5%, which is normal for anyone and well beyond the well controlled goal of less than 7%.

Im also in two minds with which procedure to chose from.

My surgeon's advised a Bypass for me.

He has said that sleeve's can be stretched, especially if your a grazer/snacker.

He also has said about the lack of documentation regarding long term sleeve, and that a lot of people come back to have a further Bypass as they have gained the weight back.

The bypass scares me due to being more invasive. But I think it has better recorded results.

You can still gain the weight back on both surgeries. Will power is key.

To be honest I was originally going to get the lapband because I know a few people who had had it with great success. After I attended the seminar I started leaning toward the vsg. I then met with my surgeon, who told me he doesn't recommend the lapband because of the failure rates. Then we discussed bypass vs vsg. Simply put I made my decision because the idea of rerouting things in my body made me a little freaked out. I was much more comfortable with shrinking my stomach. I'm about two weeks out from sleeve surgery and so glad that I made this decision.

@@scstxrn

According to what my doc told us in one of our pre op group meetings, it will not make any difference. A colonoscopy looks at the large intestine. The bypass is done on the small intestine. We were instructed that we could see any GI doctor for colonoscopy, but had to see a certain GI doctor for anything to do with our pouch. Hope this answers your question.

Re:colonoscopy

In looking at the diagram of the intestines, where there used to ne a straight line with a finger sized branch for the appendix, there is now a fork in the road. For a straight colonoscopy.. Shouldn't affect anatomy there. An upper and lower gi, diverticulosis, crohns, anything involving bypassed tissue... I don't know what if anything would be different. I just know I would want a gi doc with a lot of post wls experience.

My logic says the sleeve is still a straight shot, therefore IMO less likely to have blind spots.

Also.. I take a lot of NSAIDs and steroids, and long term meds that have been studied in people with intact absorption. Not enough studies done for dosing after malabsorptive procedures for me to make that my first choice

I am having the sleeve because I have already had a colon resection. The bypass is not an option for me, according to my doctor. I do not know the plumbing well enough to explain why he would not consider the bypass for me. However, a lot of it may be due to the trauma that my body has already been through ( 2 surgeries last December, within a week of each other and now I have a massive incisional hernia from the second surgery).

I personally know 3 people that have had bypass. I talked to them when making my decision and none of them regret their surgeries. All of them have lost their weight and kept it off. however, there are a lot of foods each of them can't tolerate...and it's different for all. One of them vomits a lot. they all dump. And two have suffered from various nutritional deficiencies/dehydration/anemia through the years. So my main reason for choosing VSG over bypass were the malabsorption and food intolerance issues.

BTW, I started with a BMI of 39 and have lost just over 100 pounds. good luck.