My surgery date is set.. (June.7) and I am about to start my 3 week liquid diet. Only problem is, I can't decide which surgery I want. My surgeon has said I am a great candidate for both (he said he would lean on the side of bypass but would be happy with either choice). I initially thought I was going to chose the bypass but after more research the possible side effects scare me. Maybe I am just thinking too much now. I would love to hear your stories and opinions!! How did you choose and are you happy with your choice?

If it makes a difference my CW is 266 and I am 5"4.

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Biggest thing I have seen in my research is that if you have problems with acid reflux, go with bypass, otherwise sleeve.

I have some family medical history that makes the sleeve a better choice for me. Otherwise, complications with the bypass are minimal and I would have likely chosen the bypass.

If you have pre-existing health issues, such as acid reflux or diabetes or anythign that would require you to lose the weight extremely quickly, then RNY might be the best option. Otherwise, I would go with sleeve. Since I didn't have any comorbidities and my starting BMI was just over 40, I felt like I didn't need as "extreme" a solution as RNY. Here were my main concerns about RNY for myself:

• low starting BMI, no real need for the malabsorption
• hated the idea of my intestines being rerouted
• hated the idea of my unused stomach staying inside my body where it could get ulcers or cancer and not be accessible with a normal endoscopy
• more joins meant more potential for leaks
• didn't want to lose the use of my pyloric valve
• saw no need to commit to a lifetime of malabsorption, when restriction would be sufficient
• didn't like the idea of dumping syndrome
• the idea of my pyloric valve still being over there attached to my old stomach and opening and closing based on signals from my pouch really weirded me out
• higher risk of late onset complications years down the road

what Jamie said ^ and in MY mind it was most logical - smaller stomach, eat less.

jane

I did the sleeve and couldn't be happier but we are all different.

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....

• hated the idea of my unused stomach staying inside my body where it could get ulcers or cancer and not be accessible with a normal endoscopy....

I used similar rationale based upon my medical history and gave the same thoughts (along with reviewing studies and clinical data from reputable sources)

I never thought of that one though. Interesting concept.

To the OP:

You still have time. Either decision is good, each has its pros and cons. Research, research, research (oh yeah, did I forget to mention research) and discuss it further with your surgeon so the correct decision is made for your specific needs and medical history.

I want the sleeve but i do suffer from acid reflux at times.I know sleevers who said the reflux Got better after and some who say it Got worse.You have to decide whats best for you I got scared with all the side effects of bypass myself but its suppose to be the best one.

P

Edited May 16, 201610 yr by Kendell Thatsme

@@slvarltx I'm planning on the sleeve. After discussion with my surgeon, nutritionist and psychiatrist (all part of the Bariatric Program) - we felt this was good for me. I don't have reflux so that wasn't an issue. I'm not diabetic, not a big sweet eater, don't graze and only need the restriction (not the mal-absorption of deterrent of dumping syndrome). Hopefully all will go as planned - I'm really don't want Bypass.

If you have pre-existing health issues, such as acid reflux or diabetes or anythign that would require you to lose the weight extremely quickly, then RNY might be the best option. Otherwise, I would go with sleeve. Since I didn't have any comorbidities and my starting BMI was just over 40, I felt like I didn't need as "extreme" a solution as RNY. Here were my main concerns about RNY for myself:

• low starting BMI, no real need for the malabsorption
• hated the idea of my intestines being rerouted
• hated the idea of my unused stomach staying inside my body where it could get ulcers or cancer and not be accessible with a normal endoscopy
• more joins meant more potential for leaks
• didn't want to lose the use of my pyloric valve
• saw no need to commit to a lifetime of malabsorption, when restriction would be sufficient
• didn't like the idea of dumping syndrome
• the idea of my pyloric valve still being over there attached to my old stomach and opening and closing based on signals from my pouch really weirded me out
• higher risk of late onset complications years down the road

this covers a lot

for me the sleeve made more sense. I didn't think that I wanted to reroute my insides when just a smaller stomach works. I am super happy with my sleeve. I have lost 175 lbs with my sleeve and am 8 months post op

@@slvarltx I'm planning on the sleeve. After discussion with my surgeon, nutritionist and psychiatrist (all part of the Bariatric Program) - we felt this was good for me. I don't have reflux so that wasn't an issue. I'm not diabetic, not a big sweet eater, don't graze and only need the restriction (not the mal-absorption of deterrent of dumping syndrome). Hopefully all will go as planned - I'm really don't want Bypass.

even if you were diabetic, the sleeve would still be a good choice

If you have pre-existing health issues, such as acid reflux or diabetes or anythign that would require you to lose the weight extremely quickly, then RNY might be the best option. Otherwise, I would go with sleeve. Since I didn't have any comorbidities and my starting BMI was just over 40, I felt like I didn't need as "extreme" a solution as RNY. Here were my main concerns about RNY for myself:

• low starting BMI, no real need for the malabsorption
• hated the idea of my intestines being rerouted
• hated the idea of my unused stomach staying inside my body where it could get ulcers or cancer and not be accessible with a normal endoscopy
• more joins meant more potential for leaks
• didn't want to lose the use of my pyloric valve
• saw no need to commit to a lifetime of malabsorption, when restriction would be sufficient
• didn't like the idea of dumping syndrome
• the idea of my pyloric valve still being over there attached to my old stomach and opening and closing based on signals from my pouch really weirded me out
• higher risk of late onset complications years down the road

I have been really struggling with the sleeve vs rny decision as well. The way you laid it out has put things into perspective for me. Thanks!

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I had GERD, so I went with bypass. GERD is completely gone. I've had no "side effects" other than two strictures early out (which are an easy fix). I don't dump, either.

If you have pre-existing health issues, such as acid reflux or diabetes or anythign that would require you to lose the weight extremely quickly, then RNY might be the best option. Otherwise, I would go with sleeve. Since I didn't have any comorbidities and my starting BMI was just over 40, I felt like I didn't need as "extreme" a solution as RNY. Here were my main concerns about RNY for myself:

• low starting BMI, no real need for the malabsorption
• hated the idea of my intestines being rerouted
• hated the idea of my unused stomach staying inside my body where it could get ulcers or cancer and not be accessible with a normal endoscopy
• more joins meant more potential for leaks
• didn't want to lose the use of my pyloric valve
• saw no need to commit to a lifetime of malabsorption, when restriction would be sufficient
• didn't like the idea of dumping syndrome
• the idea of my pyloric valve still being over there attached to my old stomach and opening and closing based on signals from my pouch really weirded me out
• higher risk of late onset complications years down the road

Thanks you!!! This was very informative.

I do have mild reflux. This was really the only reason my surgeon brought up bypass. But it is controlled well enough with a proper diet that he said I may be okay with the sleeve.

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I had GERD, so I went with bypass. GERD is completely gone. I've had no "side effects" other than two strictures early out (which are an easy fix). I don't dump, either.

I think I am worried that I am going to be the person that dumps all the time

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....

• hated the idea of my unused stomach staying inside my body where it could get ulcers or cancer and not be accessible with a normal endoscopy....

I used similar rationale based upon my medical history and gave the same thoughts (along with reviewing studies and clinical data from reputable sources)

I never thought of that one though. Interesting concept.

To the OP:

You still have time. Either decision is good, each has its pros and cons. Research, research, research (oh yeah, did I forget to mention research) and discuss it further with your surgeon so the correct decision is made for your specific needs and medical history.

I think I am driving myself crazy with all the research lol. I don't really have any medical history other than mild reflux. That's what's making the decision so hard. No medical history = my choice. He said I would do well with both.

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Good list, @@JamieLogical , and good discussion.

I had a sleeve and had mild reflux pre-op. Twenty-one months post-op, I still have mild reflux that's controlled by an H2 blocker antacid Rx (Ranitidine HCl 150 mg. taken twice a day), which is the same med I took pre-op.

I try to follow most eating instructions for those who have GERD, e.g., I stop eating at least two hours before going to bed at night, and minimize eating / drinking acidic foods at night, e.g., tomato sauces, sweet foods, coffee, etc.

During the first four months post-op, my surgeon changed my antacid to a PPI (Protonix). Then I went back to Ranitidine.

IMHO, there is no generally superior bariatric surgical choice. Your best choice depends on your own medical situation and your comfort with the choices.

And don't forget -- for some patients, there are nearly half a dozen other WLS choices besides sleeve or bypass that might be better for you.