HELP! Sleeve vs RNY

[cmcgonigal 0]

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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[slvarltx 332]

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

[Bufflehead 6,358]

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.

[JamieLogical 8,684]

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

[jane13 2,256]

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

jane

[CelesteMarie 129]

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

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[4MRB4PHOTO 3,899]

....

• 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.

[Kendell Thatsme 39]

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, 2016 by Kendell Thatsme

[KristenLe 5,979]

@@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.

[Sophie74656 1,572]

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

[Sophie74656 1,572]

@@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

[audaciousmarie 161]

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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[catwoman7 10,907]

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.

[cmcgonigal 0]

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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[cmcgonigal 0]

....

• 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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