To "Bypass" or to "Sleeve"?

[Vagrant Violet 17]

Hello, everyone!

This is my very first post on the message boards. I wanted to ask for your opinions, tips, feedback, and ideas regarding choosing one WLS (ie. Gastric Bypass) over another WLS (ie. Vertical Sleeve Gastrectomy).

Here's the deal: I live abroad where thankfully my procedure will be covered since I have a BMI of about 43, so factors like cost are not an issue. Apart from being obese, I am relatively healthy (no chronic conditions) and am 32 yrs old. I work as a teacher, so though I sometimes move around while I am teaching throughout the classroom, I can still afford to sit down most of the time while at work (keeping in mind my needed recovery time).

I have downloaded "The Big Book On the Gastric Sleeve" and also "The Big Book on Gastric Bypass," as well as skimmed various articles online. I am honestly very much on the fence as to which procedure would be best for me. Yes, books are helpful, but every case is unique and distinct. I've gone back and forth in these forums, but I would really like to hear from y'all regarding which procedure you chose, why you chose it over the other, pros, cons, and whether you have any regrets.

Any/all feedback would be very appreciated. Thank you!!!

[MinaT 669]

Do you now have any issues with Gastric Reflux? Have you had to take any sort of protonics? Do you sometimes eat and choke on your food? Do you have acid reflux when you lay down at night? If you answered yes to these questions then I would bypass Sleeve and go to Bypass. I think they are both good surgeries, but with the Gastric Sleeve, there is a greater tendency towards acid reflux. If you have reflux prior to sleeve, it could only get worse. I've always had a reflux issue had the sleeve and the problems got severe enough that with a bmi of 34 I had to go back in and convert to bypass.

There are people that believe if you are a chronic sweet tooth eater that you should chose bypass over sleeve, however there are a lot of posts by people with comments like "I ate Cookies and ice cream and I didn't dump and now I'm really upset". Let that sink in a bit. If you have gastric bypass and you are eating Cookies and ice cream and you are "mad"...after undergoing a serious surgery that you are not even trying to change your habits on your own and you expect a surgery to do everything for you....well, all you can do is shake your head.

Speak with your doctor and continue your research. I myself would have done bypass had I known the issues I would have the acid and the choking on meats due to spasms, which are more common than I thought they were. Pre sleeve I never read anything about 'esophageal spasms' or serious acid reflux.

Note: Not everyone that gets sleeved has this problem, I just always had a problem my entire life with acid reflux and was on two omeprazoles a day. I had acid issues drinking Water.

[Harsha 168]

I am following this post because I too am having the same questions. My surgeon told me either would be successful for me. I have no comorbidities, I take no medications, I have no acid reflux, my insurance covers both surgeries the same. I have been researching like crazy and I'm leaning towards the bypass just because it's been around longer and has more history. I would just hate to go through the bypass, and more things being done to my body if I could have the same result if I get the sleeve. Next week is my last doctor visit for my six months monitoring period, then I meet with my surgeon again to discuss which surgery I chose and get it set up. It's such an important decision.

[losing_jess 19]

Similar circumstances for me. I'm healthy and relatively young. I went in assuming sleeve because it was what I saw more online and I was trying to tell myself it was "less severe" (as a coping mechanism perhaps). My Dr. Said both would be fine but recommended bypass. 1. It's a bit higher for % of weight loss. 2. I like that there is more history on success rates. 3. I like that my parts are all still in there, just in case... 4. He called it the better "long term solution". Bottom line for me, I think it's more tested and it gives me a bit more confidence since I have young kids and I need to feel safe.

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[ange117 93]

It's also worth considering that there's a sleeve-to-bypass revision board on this forum. There are no revisions from bypass short of the very, very rare reversal. I had originally wanted the sleeve, but was advised against it because of my acid reflux, and this is one of the things that made me comfortable with the bypass.

Do most people with the sleeve love it and have success with only minor/no complications? Certainly! It's an amazing surgery. But I did find something reassuring in the fact that I was having the 'end line' surgery, so to speak, and there wouldn't be any chance for revisions in my future. I want this to be one and done.

[CHM 1,011]

Personally, I went in to meet my surgeon set on bypass for a couple of reasons:

First and foremost was the presence of dumping syndrome, which I view as a benefit rather than a complication. As it turns out, I can handle both fat and sugar just fine. I haven't deliberately tested it or anything, but hey, I'm still human, life happens, and I've made out just fine. It has, however, given me a good kick in the pants the couple of times I've O.D'd on carbs, which I greatly appreciate as a recovering carb addict.

Second is that, as previously mentioned, the average percent of excess weight lost is higher with bypass than with sleeve. Having said that, I have since read articles that indicate that the weight loss rate from the sleeve does catch up to bypass somewhere in the 2-3 year mark. Therefore, depending on how patient you are, this one may not be a factor for you.

In the end, my preference for bypass was enthusiastically supported by my surgeon. She stated that bypass is what most surgeons will recommend in the presence of a very high BMI (mine was 55.6), and that it was what she would have guided me towards anyway had I been undecided. So bypass it was!

[liftedjeep06 10]

So has anyone considered the Duodenal Switch? It combines the restriction of the sleeve with the malabsorption of bypass. That is what I am choosing although I am still pre-op. I guess many surgeons don't so it, hence the smaller group that have it. The sleeve is the first part and then they bypass a portion of the intestines with about a 100 cm common channel. The difference in the way it bypasses is that they leave the pyloric valve intact so there really isn't any dumping.

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[jnt1 37]

Have a look on the website of Dr Rutledge about bypass. I was unsure but after wzter hours of video content I'm gaving a bypass on April 19th.

The sleeve stats show weight regain after 2 years, bypass is successful longer term and you keep the digestive acids from your stomach which makes a difference.

I'll try and paste another link to a video here soon

Good luck

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[mytwopugs 1]

I'm scheduled for RNY Monday. I just had my pre-op visit with my surgeon this morning. He was telling me I may be better off with the sleeve because I like sugar, which contradicts the surgeon I met with at my first consult last month. He said although I have reflux (which has only developed since I've gained a lot of weight) that I should wait a couple of weeks, see if reflux meds would control it, and if it does, go for sleeve. Now I'm second guessing my decision and certainly don't want to postpone my surgery date and most likely have to go through the approval process with my insurance again??? I told him I wanted to stay with bypass just in case I have complications that need reversal down the line. He said "ok, see you Monday". But the conversation is not sitting well with me. Doctors usually know what's best, but which Doctor do I listen to?? Ugg

[liftedjeep06 10]

I'm scheduled for RNY Monday. I just had my pre-op visit with my surgeon this morning. He was telling me I may be better off with the sleeve because I like sugar, which contradicts the surgeon I met with at my first consult last month. He said although I have reflux (which has only developed since I've gained a lot of weight) that I should wait a couple of weeks, see if reflux meds would control it, and if it does, go for sleeve. Now I'm second guessing my decision and certainly don't want to postpone my surgery date and most likely have to go through the approval process with my insurance again??? I told him I wanted to stay with bypass just in case I have complications that need reversal down the line. He said "ok, see you Monday". But the conversation is not sitting well with me. Doctors usually know what's best, but which Doctor do I listen to?? Ugg

In the end, it is your body and your decision...don't hesitate in making sure all your concerns are addressed!

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[rusticlemon 9]

I took 2 years of classes (nut classes) for the sleeve, and at the 6 month mark I just wasn't ready. 5 years total, I finally last week had the bypass. What I learned is the sleeve is the only one not reversible. I wanted the sleeve however I have huge acid problems and got the bypass. I'm a week out today and having the OMG what did I do thoughts so I'm not helpful past what I learned in years of classes.

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[mytwopugs 1]

Rusticlemon, are you regretting having the bypass or just in shock?

[rusticlemon 9]

I was regretting have any surgery but now almost 3 was post op I'm glad I did it, I think it was the pain and oh, what did I do to myself worries.

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