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Gastric bypass over sleeve



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Hello all and please excuse if this question is in the wrong forum....

I'm relatively new to the process, have had some appts and have 3-4 more to go. When I initially met with my to be surgeon, he said I would probably qualify for all the procedures (BMI 48 with few other medical problems).

First, I thought the sleeve was the best, seemed less invasive, etc. But, now I am understanding that I will need to take Vitamins with both ( one or two more doesn't seem like a big deal), major dietary changes with both and the recovery time doesn't seem that much longer with the bypass PLUS the overall success rate seems better with the bypass.

I do understand the bypass comes with additional risks. But, as this is a long complicated process, I want to make sure it sticks and long term success is my overall goal.

What made you select the bypass over the sleeve? Thanks in advance for the feedback.

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Welcome @@Good apple

I initially went into the process dead set on the sleeve. I too had no compelling medical conditions, and was given the choice of either the sleeve or bypass. My BMI when l started the process was 46, but by the time I got to surgery it was a high 39.

I had a number of reasons for finally opting for the bypass. One was the GERD issues that some, but definitely not all, experience with the sleeve as post ops. There are even a few who have had to revise from sleeve to bypass for this very reason. I just didn't want to take the chance that I might be one of the unlucky ones to develop this issue. I don't think I could have handled the possibility of a revision down the line.

I also thought that I might benefit more having the restrictive and malabsorption components working together to help me reach my ultimate goal weight, and more importantly, maintain it. I had a very wicked sweet tooth and knew the mere "prospect" of dumping would aid me in keeping that in check. I was never really concerned about the Vitamin deficiencies as I've always taken them.

Now at five months out I can say in all honestly that I made the right decision. I feel better than I ever have, have more energy, and I'm only 22 pounds away from goal. I've never dumped, had no complications, an easy recovery, and I stick to a very healthy diet. I finally kicked a lifetime soda habit, don't eat bread, Pasta, rice, or sweets. I never could have accomplished any of this on my own, because I've certainly tried. I was always hungry before, no matter how much I ate, but now I'm in control of my life again. It is amazing, simply life changing. I feel reborn!

Either procedure is great. If the sleeve had been my only option I would have taken it in a second. But I had a choice and this was the best one for me. Good luck!

Edited by The Post Op

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Hello all and please excuse if this question is in the wrong forum....

I'm relatively new to the process, have had some appts and have 3-4 more to go. When I initially met with my to be surgeon, he said I would probably qualify for all the procedures (BMI 48 with few other medical problems).

First, I thought the sleeve was the best, seemed less invasive, etc. But, now I am understanding that I will need to take Vitamins with both ( one or two more doesn't seem like a big deal), major dietary changes with both and the recovery time doesn't seem that much longer with the bypass PLUS the overall success rate seems better with the bypass.

I do understand the bypass comes with additional risks. But, as this is a long complicated process, I want to make sure it sticks and long term success is my overall goal.

What made you select the bypass over the sleeve? Thanks in advance for the feedback.

Hello all and please excuse if this question is in the wrong forum....

I'm relatively new to the process, have had some appts and have 3-4 more to go. When I initially met with my to be surgeon, he said I would probably qualify for all the procedures (BMI 48 with few other medical problems).

First, I thought the sleeve was the best, seemed less invasive, etc. But, now I am understanding that I will need to take Vitamins with both ( one or two more doesn't seem like a big deal), major dietary changes with both and the recovery time doesn't seem that much longer with the bypass PLUS the overall success rate seems better with the bypass.

I do understand the bypass comes with additional risks. But, as this is a long complicated process, I want to make sure it sticks and long term success is my overall goal.

What made you select the bypass over the sleeve? Thanks in advance for the feedback.

I went with the sleeve due to my conditions example I have type 2 diabetes and high blood pressure/ high blood cholesterol. since the sleeve has been known to have a higher success rate at reversion type 2 diabetes and high blood pressure and cholesterol I went with the sleeve over the by pass. you have to look at the pro's and cons of all the procedure options before making your choice and your surgeon will also give you a recommendation based on your personal condition as to what's best for you.

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I just had my 2nd WLS from lapband ....to bypass..I am not sure where Scottmyself got his data...incorrect.

All I can say is do as much research as you can to see which procedure matches you and your lifestyle and go from there,I am not interested in a third operation.I went for the "Gold Standard "and I am very happy.

I also have friends that have chosen the sleeve....one is doing great the other is struggling.YOU have to really talk to your surgeon and do what you think is the best fit.

I made a decision the first time and it sucked...2nd time I finally picked bypass which suits me better.

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i was initially going to go with sleeve as i thought it was the less invasive of the two as well. but then when i took a long hard look at my lifestyle and exercise habbits along with being a diabetic and having pcos i decided to go with bypass. im really happy with my surgeon and i know i only want to have wls one time so i might as well go with the gold standard

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I chose the sleeve because I don't like the thought of having my digestive system re-routed, and the sleeve keeps everything in its original place. I also don't like the thought of having my stomach/other detached parts remaining dormant in my body, where they can still grow ulcers or cancer.

A lot of people think the RNY is the way to go because it's the "gold standard," but my surgeon/team at Beth Israel in Boston made compelling arguments why that could soon change. There simply isn't enough/old enough data on the sleeve yet to compare to the RNY, but all indications are pointing to the sleeve overtaking as the new gold standard based on new data, so I'm told. People are generally having as good of results with the sleeve, without all the complications (e.g., dumping).

Just my two cents.

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I did the bypass because the thought of losing 85% of my stomach which is to held by staples scare me.

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Plus I can't undergo a 3rd WLS surgery if the sleeve fails.....chose the lapband initially over bypass and that was my biggest mistake.Gold Standard once and for all.

No more Gerd.

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I wasn't sure which surgery I wanted when I first started this journey. After attending the informational session I was 100% sure I wasn't going to get the Lap Band (high rate of returned weight gain, poor long term loss).

After talking with my surgeon I decided on gastric bypass. Primarily because everything is still there and can be reconnected to God's original configuration if need be. Once you lose 85% of your stomach...it's gone.

Additionally, I had done research on my own and found some great benefits of GB over Sleeve gastrectomy.

1. GB has been shown to restore normal ghrelin hormone regulation.

2. GB patients lost more belly fat and had improved insulin secretion rates compared to SG.

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My surgeon highly recommended the full gastric bypass for me. I have a very high BMI, I've lost 25 lbs prepping for surgery and my BMI is still over 50. I also have terrible acid reflux and a complication from it, Barrett's Esophagus. She explained that the reflux would not go away with the other procedures.

My mother-in-law had the gastric sleeve last year and that's been perfect for her, but I'm a whole lot heavier.

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Before I met with my surgeon, I was leaning toward the sleeve. One reason is I have a friend whose husband was very successful with sleeve. The second was I felt it was less complicated and therefore safer. Then I decided I would let the surgeon decide because of my high BMI and well the doctor was surely smarter than I about the various surgeries. So when I met with him he recommended Roux NY gastric bypass because of my really high BMI, my admitted outrageous sweet tooth, and because bypass is actually safer than the sleeve. He explained that with the sleeve a large part of the stomach is completely removed with lots of staples holding together the new stomach. It's a smaller but long stomach so there is more area for possible leaks, infection. He also explained the high incidence of gastric reflux with the sleeve. I have just over the past year (before surgery) developed GERD. That is one of the most unpleasant experiences of my life. The surgeon said that with gastric bypass, no GERD. If you had it before surgery you would have it no more. Immediately. I liked that. So we agreed on gastric bypass all the way around. Remember the friend who had the success with the sleeve. Well I called his wife to tell her I was having gastric bypass and she started warning me of changes I would face and said, did they tell you will get acid reflux? I heard her husband in the background say no, that only happens with the sleeve and he is thinking about a revision to gastric bypass. So that is my long story. I had surgery on October 26, 2015 and I feel better each week. I feel better about myself than I have in decades. I'm so glad I did this. Oh no more GERD. Not ever. My blood pressure is back to normal. This is really a fine thing to do!

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Welcome @@Good apple

I initially went into the process dead set on the sleeve. I too had no compelling medical conditions, and was given the choice of either the sleeve or bypass. My BMI when l started the process was 46, but by the time I got to surgery it was a high 39.

I had a number of reasons for finally opting for the bypass. One was the GERD issues that some, but definitely not all, experience with the sleeve as post ops. There are even a few who have had to revise from sleeve to bypass for this very reason. I just didn't want to take the chance that I might be one of the unlucky ones to develop this issue. I don't think I could have handled the possibility of a revision down the line.

I also thought that I might benefit more having the restrictive and malabsorption components working together to help me reach my ultimate goal weight, and more importantly, maintain it. I had a very wicked sweet tooth and knew the mere "prospect" of dumping would aid me in keeping that in check. I was never really concerned about the Vitamin deficiencies as I've always taken them.

Now at five months out I can say in all honestly that I made the right decision. I feel better than I ever have, have more energy, and I'm only 22 pounds away from goal. I've never dumped, had no complications, an easy recovery, and I stick to a very healthy diet. I finally kicked a lifetime soda habit, don't eat bread, Pasta, rice, or sweets. I never could have accomplished any of this on my own, because I've certainly tried. I was always hungry before, no matter how much I ate, but now I'm in control of my life again. It is amazing, simply life changing. I feel reborn!

Either procedure is great. If the sleeve had been my only option I would have taken it in a second. But I had a choice and this was the best one for me. Good luck!

So much good info here -- thank you! I too had been assuming I'd get the sleeve but my surgeon recommends bypass.

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I knew almost immediately that I wanted the Roux en Y. I am heavy and I think, after all my research, it's the BEST option for me. I meet with my surgeon on the 28th and I am almost certain he is going to recommend the same thing for me.

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I went in thinking I wanted the sleeve because the idea of rerouting the pipes really worried me. I went to the seminar session and after listening to what my surgeon had to say and to what other people had to say, I chose bypass because of these reasons: the success rate, the solid 25yr+ research and history supporting the RNY's success. The fact that I wasn't going to lose 85% of my stomach which may come in handy later in life if I should develop esophageal cancer or severe erosion from GERD. The "spare" stomach left behind from the making of the pouch can be used to rebuild the esophagus. With the the sleeve, you are just SOL. The fact that GERD does often get worse with sleeve and the "cure" is to convert to bypass. Then there's the fact that I am a sugar addict and that the sleeve is only really effective at quantity eating control. My problem was multi leveled. I needed to find a way to control my sugar addiction(dumping is a good and scary deterrent to eating too much sugar), and it's a good deterrent against my other love of greasy food too. The whole thing just motivated me to go for RNY. I knew I didn't want to have another surgery down the road if the sleeve didn't work out. I don't regret my choice and honestly my rerouted pipes are much nicer than my non rerouted pipes. Really it was a lot more worry than I should have had.

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