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 ).

Kindle

It seems everyone I speak to in my area has had the RNY with varying levels of great results. However, they all mention strict limitations or problems occur. Many of them refer to the VGS as the " new" option and feel they may have considered it over the RNY but are not disappointed with their choice.

Congratulations on your success, it's comments such as yours that make me comfortable pursuing VGS.

I just watched the video posted by MyBariatricLife titled "Does the Patient fail the Procedure or does the Procedure fail the Patient?" The name of the post is the same name of the video. I would recommend everyone watch it because I gained so much insight from the newer research that was presented. The studies showed that VSG and DS were more successful because they do a better job controlling hunger. They back up this claim with physiological facts and research.

According to the video, duodenal switch is the way to go with the sleeve coming in as a close second. I don't even know of a surgeon in my state that does DS because I was told it was too risky. Although lately I'm hearing that it has to do with more work for the surgeon for less monetary benefit. It's always about the money.

I chose sleeve due to bypass having more of a risk of dying after the fact. I don't know how to put it any other way. My pcp told me he was relieved that is what I chose, as he had a patient pass from a bypass. My pco and I have a very good relationship, he tends to be very honest with me about things. He has no affiliation with my surgery center.

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.

I don't know why you would want gastric bypass with these specs....you don't have a severe amount of weight to lose, and the sleeve ought to (easily) do the trick for you, without rearranging your insides and being a malabsorptive procedure.

Thank you Skywalker , I'm feeling skinny already ! Yes I agree, I will proceed with VSG and not RNY for the reasons you pointed out. Dec 19th.... just want to get it done and start my recovery.

I chose VSG because with the band you have a foreign object in your body and it has the potential of moving or eroding into your stomach. I did not want bypass because of the higher risk of complications. There was something that seemed a little extreme about rerouting my intestines. The sleeve seemed like a wonderful happy medium. I am 38 days out and thrilled with my decision.

All of the above... Maintain my normal anatomy, removal of the area of the stomach that produces Ghrelin, less chance of malabsorption issues. My sleeve has given me the results I wanted. I'm happy with my choice.

I have lived with a lap band for 7 years or so and just had it changed for a sleeve. My surgeon is very pro sleeve and was glad to revise my surgery. I picked a vsg because you can make healthy food decisions and the malabsorption isn't as big a deal as an RNY. My doctor said the sleeve is the best tool he's ever had in wls. Most if the staff in his office have had it and they are all thrilled.

I just watched the video posted by MyBariatricLife titled "Does the Patient fail the Procedure or does the Procedure fail the Patient?" The name of the post is the same name of the video. I would recommend everyone watch it because I gained so much insight from the newer research that was presented. The studies showed that VSG and DS were more successful because they do a better job controlling hunger. They back up this claim with physiological facts and research.

According to the video, duodenal switch is the way to go with the sleeve coming in as a close second. I don't even know of a surgeon in my state that does DS because I was told it was too risky. Although lately I'm hearing that it has to do with more work for the surgeon for less monetary benefit. It's always about the money.

The duodenal switch and the bypass are technically more sophisticated procedures, longer anesthesia. It's about as long as the bypass so the surgeon should be paid the same....but any time to care specialize in what is being demanded, it will be your cash cow.

Why I chose VSG:

1. Decreased risk of dumping syndrome. Three years from now, if I want a bite of donut, I can have a bite of donut - enjoy a bite of donut, and odds are, not feel like I'm going to fall out.

2. Increased ability to eat 'healthy' food.. Lean and green are the mainstays of this lifestyle.

3. I read a study that indicated that families where the mom has had VSG lose weight and the children are less likely to be obese. I think that has to do with #2.. I want that; I want my kids to see me eating healthy, not to see me able to eat 'whatever' and still lose weight.

4. I work with ALOT of people who have had both surgeries. It has been my observation that post bypass, while the weightloss is faster, the skin is MUCH looser, the overall appearance is less healthy (dry, ashen, etc..), and to quote my husband they look like 'a pillowcase with the s*t slung out of it'.

5. I'm not the best at taking supplements long term. I stuck with prenatals for a year of planning + pregnancy and then another year of nursing.. and then Vitamins became hit or miss for me. I don't want to lose bone mass, blood cells, etc because of massive supplement needs secondary to malabsorption.

6. Research indicates that the part of the stomach left after gb can restretch; not so much with vsg due to the fact that the fundus is removed.

7. The intestines increase their ability to absorb, it's a survival thing. What if I get used to being able to eat crap and lose weight, stretch my stomach out, and my intestines start absorbing enough calories that I put it back on?

8. I want a normal colonoscopy, where all my insides can be visualized without having to have a special procedure.

For me - bypass was a very brief fleeting thought. I believe the VSG will be effective. If it's not, I can always have a revision to the DS. If it is, I've avoided all the stuff that steered me away from gastric bypass for the last decade.

So confused, are you saying that mother's who get VSG verses no surgery at all lose weight?? And that RNY post ops tend to have children who are obese and people with children who have VSG are less likely to have obese children? And that ppl who have other surgeries other than VSG "can eat whatever they want?" As much as I've seen has said the RNY had greater compliance with avoiding excessive fats, carbs and sugars because of dumping syndrome. Yes, malabsorption is an issue but slider foods are across the board for everyone. I would love to see this study to which you refer and I can't imagine it being peer reviewed....this goes against all logic to me. People with biological children who are obese are going to create the propensity of obese children at least the nature part due to genetics. I can't imagine its correlated to a surgery type.

MisForMimi

I respectfully disagree with your conclusions regarding Scstxrn's comments.

I interpreted Scstxrm's generalization regarding children of WLS moms to providing an environment of healthy eating which would benefit their children, I see no reference where RNY contributed to weight gain in children.

Perhaps it would have been better to state that " increased ability to eat healthy food ".....applied to Both RNY and VGS which certainly would have a positive effect on preventing childhood obesity.

I just read a research article that stated that the top part of the stomach is more inclined to stretch. Therefore, some patients with gastric bypass end up stretching their pouch since their pouch is made from the upper part of the stomach. The stomach of sleeve patients can stretch due to chronic overeating, but not nearly as much as the gastric bypass pouch. Even though the sleeve can stretch, it will never stretch back to its pre-surgery size or capacity. I will try to find the article and post it later.

It would be interesting to read that article about the sleeve as I hear more of the sleeve stretching than the bypass.

MisForMimi

I respectfully disagree with your conclusions regarding Scstxrn's comments.

I interpreted Scstxrm's generalization regarding children of WLS moms to providing an environment of healthy eating which would benefit their children, I see no reference where RNY contributed to weight gain in children.

Perhaps it would have been better to state that " increased ability to eat healthy food ".....applied to Both RNY and VGS which certainly would have a positive effect on preventing childhood obesity.

Thanks! Phew! I appreciate and welcome respectful disagreement and the rephrase. That's why I stated up front that I was confused and doubtful rather than some of my first thoughts. When you factor in the original question, it made it seem like the statements were being said in a verses the bypass or other WLS sort of manner. If the ideas where from a 'why I chose weight loss surgery in general perspective', that makes a world of difference! Easy mistake. I'm not here to defend anyone's decision but my own (to myself). But as a (pre-op) I'm still doing research and was more than a little caught of guard by some of the things said. I'm reading mostly research to make my decision and straying from anecdotal evidence, stories or advice.....scientific/social research is comforting to me on some level.

MisForMimi

I too am a " pre-op ", with VSG scheduled for Dec 19. I have researched medical articles and online sources such as " bariatric pal ".

The best conclusion I have come up with is that there is no longer a " gold standard " for WLS. Advancements, changes in approach , statistics, all are influential but ultimately it seems like the final decision rests with the patient ( provided other criteria are satisfied ).

I ( as of today ! ) am still positive on VSG, I feel it will work best for me based on my specific concerns. Good luck with your research, I hope you find the method that best suits you.