Does anyone feel pressured by their surgeon to do the RNY/bypass over the sleeve?

Like everyone else, I sat through the initial info session my surgeon offered and I felt like she was really selling the RNY. The whole session was about the RNY, in fact, and how it's the "gold standard" and best procedure.

Then, I met with her for my initial appointment. She predictably said I was a better candidate for the RNY. I am 5'2" and weigh 250. Fair enough. I went home and had my mind set on the bypass.

But then I started doing my homework and, after much thought, I decided the sleeve may be better for me for many of the same reasons as others who make this decision: I have no comorbidities, research seems to say it's less invasive, no rerouting, no dumping, no vitamin/medicine probs and it would cut out the hunger hormone grehlin. Equally as important it would restrict the amount I can eat and, according to the many pieces of research I read, offer practically the same amount of weight loss as the RNY over the long term, albeit at a slower rate.

I am also a cancer survivor and I had concerns about the malabsorption that comes with the RNY and whether or not I could effectively be treated in the future (if needed) if my body would no longer absorb medicines (including oral chemo).

That said, I did have a couple of concerns about the sleeve. One, I'm not a necessarily volume eater and this is obviously a purely restrictive procedure. And two, I have a career, a lot of business travel, and a toddler, so I can't commit to constantly exercising like others do. I wondered if I wouldn't lose enough and then regain what I do lose because I won't have that malabsorption so many people benefit from with the RNY.

So, I made a second appointment with my surgeon to discuss all of the above and she was still all about the RNY -- which is totally fine. She is the expert and I am turning to her to help me make an informed decision. However, she mentioned several things that were contrary to everything I've read. She said...

--Malabsorption only lasts six months at the most for both calories and nutrients/medicine (yet, her required nutrition classes talk about the life long Vitamins, etc???)

--People don't lose weight from the RNY because of the malabsorption or restriction; they lose weight because they're bypassing all the hormones in the first part of the small intestine, something you don't get with the sleeve (so malabsorption has very little to do with the weight loss)

--The RNY is safer than the sleeve; the sleeve is actually more invasive and dangerous to recover from because it's more prone to leaks due to the length of cut and pressure that builds in the sleeve.

--The sleeve causes less weight loss and you will regain more in the long term. I have read that the long term results are VERY similar to the RNY. She says no, long term for RNY is much better.

--The least I can ever weigh with the sleeve is 180-190 lbs (currently 5'2" and 250 lbs) and I likely won't get that low.

--I can take time release medicines in the future and they will probably work.

--The sleeve will rarely be performed five years from now because it's not effective; but I thought the sleeve was becoming the WLS of choice

I was confused by what she was saying, so she referred me to the Cleveland Clinic's "Stampede" study, as it compares the RNY to the sleeve. But I read it and it is all about the effects of both surgeries on diabetic patients. I don't have diabetes.

Does any of this sound like what you've understood from your surgeons?

My surgeon is loved by all. She is smart, has great bedside manner, has been doing this for over ten years and has one of the Bariatric Centers of Excellence. I do trust her, but some of this sounds strange to me. In the end, I want solid info so I can make the decision that's best for me.

Any thoughts on why surgeons might try to "sell" the bypass more often?

Also, any thoughts on what she said to me when I went in to ask her about doing the RNY vs. the sleeve?

Thanks!

I went to my first appointment undecided, but leaning towards the RNY, for the slightly higher percentage of weight I may lose. Through testing it was discovered I had bad GERD and that sealed the deal for me. My surgeon and I both agreed RNY was the best choice. I didn’t feel pressured. My surgeon also informed me that because they’ve been doing RNY surgeries for longer, there is simply more research available on outcomes. This doesn’t mean the sleeve is any less successful, it just means there is less available research about long term success/complications because its newer. As evidenced on these forums, there are lots of people who have plenty of success with the sleeve. I think it’s all about doing what’s best for you and your case.

Yes my surgeon also thinks RNY is the gold standard and better than the sleeve. I saw a lecture he did on YouTube at a conference and he said people choose the sleeve because they understand it more easily.

So in this agreement who is winning, VSG vs RnY? I do know in my facility is you are self-pay RuN costs about $2000 more, hate to imply why your surgeon was leaning that way, but not impossible. Let us pray she only has your best interests at ❤ heart!???

An update on my post now that I’ve had my sleeve. When I was in the room just outside the operating theatre, my surgeon came to see me and said that if he goes in, and it looks like I need a bypass, then he’ll do a bypass. I told him no bypass; if you go in and can’t do the sleeve, then do nothing and come out.

Why ? Surely it would be better to have a bypass than wake up with neither.

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no i was actually pushed to have the sleeve because i have type 1 diabetes and the risk of complications increase with the bypass

Cheyenne I am in Mount Vernon, had my surgery at OSU in Columbus on September 5th. Where are you having your surgery done?