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Hello I am in the pre-surgery process and have yet to decide which surgery to get. I am currently 373 lbs and 5'11 bmi 50+. My highest ever weight was around 400. I am considering vsg or ds(which I am leaning towards) I know surgery is a tool and requires hard work. I have done multiple diets and the yo yo effect of it. I will be having surgery this summer and just want to hear your thoughts. VSG or DS.

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Hi!

I am also 5'11, my high weight was 460. I lost about 50 pre-op, and almost another 100 post op. But I plateaued and then started to regain. I had my surgery in 2012. I'm also having some complications now, I go see a surgeon tomorrow and may be revising to DS.

The sleeve was an amazing tool and it really is my fault that I didn't continue to lose with it. I fell wayyyy off post-op diet and then got pregnant. I'm currently still well below where I started at 460, but I want to lose more and since my complication will likely require surgery, I may go for DS as well so I can get back on the losing track!

I opted for sleeve initially because I felt it was the best of my options and I knew there was the option to revise to DS if needed. Personally, I would recommend starting with a sleeve as post-op DS is a bit more intense because of the malapsorptive effect it has.

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Thank you for the information. I know the malabsorption can be an issue but I don't want to have to go back under the knife for a revision.

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Honestly @pitts, it seems like you have a good grasp on what you need to be successful and that is a great starting point. What is pushing you one way or the other regarding VSG vs DS?

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Ds will in my opinion help me get to my gw of 200. However I hear people worried about the rearranged intestinal tract. Whilst the risk for complications are up for ds the research shows it has better long-term effects. I am trying to get feedback from those who have taken the journey before me.

Edited by pitts
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I didn't have the DS or the Sleeve but I did have a RNY. I just wanted to add my 2cents worth. You hear people state that they had the Sleeve because it is less invasive. Well I think removing 80 to 85 of your stomach seems like it is pretty invasive. I have heard of lots getting revised to the RNY because of complications from their Sleeve. Lots with acid reflux. I had lost my weight in 6 months. My lowest weight was 117#'s but I did gain 8#'s back, Health wise those 8#'s made a huge difference in how I felt. So I have maintained my 125#'s for over 3 years. I know your ?'s were which surgery should I go with. If someone said I opted for the Sleeve because of the malabsorption that is a little better to swallow than not getting the RNY because it is to invasive is another thing. I know that each of us need to investigate every WLS offered. Just do yourself a favor and look at all of the offered surgeries!! Let your DR help you decide because they have been in this for qui and know which is best for you!! Sorry for blowing up your post. Have a great day!!te awhile

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Thank you so much. Rny is an option for me. But I have hear with that one the bm when feel the pain go immediately to bathroom. I teach and would hate for an accident to happen

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Actually that isn't the whole truth. I think years ago it was a problem. Now I hear of it going the other way. My hubby had a Sleeve last June and he has the back door trots almost daily. Especially if he eats something that doesn't agree with him. Coff/cream to much fat almost always with sugar. Check it out.

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I am still pre-op but just waiting for insurance approval now. When I started I thought the sleeve was the one I wanted because I was afraid of the malabsorption issues and about changing the way my body works by moving my intestines around. My surgeon went over all the options with me, but recommended the DS because it has the highest long term success rate and is very effective at reversing type 2 diabetes. So I researched, and researched, and researched some more. It took months, but the more I learned, the less scary the other surgeries became. I've decided on the DS because I hope to have the best long term outcome for the health conditions I currently have.

I watched some videos that a doctor at another practice did to explain all the surgeries. If I can find them again, I'll post the link if you'd like.

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I'd still start with the sleeve. Ask the surgeon if you are approved for a DS whether the surgery could be a two-parter. That way you still have the DS covered, but you could change your mind after the sleeve too.

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chaos please do.

berry, That would be an option but as a teacher my insurance can change yearly what is covered this year may not be next.

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My wife had a DS 12 years ago and I had a VSG 6 years ago. She started out at a mid 60's BMI and I was a near 50. During her pre-op period of trying to get insurance to cooperate (it was still "investigational" then) and we did the semi-typical insurance 6 month diet/exercise program, I lost around 50lb - about 1/3 of my excess weight - and subsequently kept it off for a number of years (settling out around a 40-41 BMI. Once we got her on the table, and into the losing phase, I felt I was too low to go for the DS, and still had some prospect of maybe losing some more on my own. Ultimately, I maintained what I had lost and when our insurance started covering the VSG, I went for it. Had I regained what I had lost, as often/usually happens, I would have gone for the DS as that would have shown me that I needed its better regain resistance.

A few things that I have picked up over the years in DS-land:

A 2-step DS is a good option for those who are too ill to withstand the longer 1-step procedure. As a "plan B" option in the event of regain it is less satisfactory. Discussing this with our surgeon, his experience has been that the second step works best if it is done before any substantial regain is experienced - the weight loss after revision is usually less than what would have been experienced with a "virgin" DS. There is a general characterization that is sometimes used that "the sleeve loses your weight, while the switch keeps it off." That may not be entirely correct, but it's probably an 80/20 thing.

Another consideration is that the DS is usually performed with a larger version of the sleeve than the VSG, so the restriction is a little less than the VSG, offset for weight loss purposes by the malabsorption. This also means that reflux problems that are a not unusual problem with the VSG is less common with the DS.

These above considerations really tend to push one toward an either/or decision, rather than a more casual approach of "I'll go with the VSG and the DS is always there if that doesn't work out."

We often see threads here about VSG vs. RNY or DS, and it is common for thsoe who decided on the VSG to state that they didn't want their guts rearranged, etc., which is a fair perspective - who does? But we all got comfortable with the idea of removing 80% of our stomach, which many consider a radical step. Fact of the matter is that some people need a malabsorbing procedure to get that job done. In my mind, the more one is inclined toward yo-yo weight patterns and increasing weight over time, the more appropriate the DS becomes over the VSG (and RNY, for that matter.) Indeed, some who fit that pattern do succeed long term with the VSG, but it's more of a long shot; OTOH, I see several 10-15 year DSers every month at our support group who continue to maintain well (and wake up every morning with one!)

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@RickM Thank you so much for your opinion. You were able to put the reason I am leaning towards DS in a very concise and precise manner thank you

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@pittsHere is the link to the site I was telling you about, there are a lot of videos so you have to scroll down to the Weight Loss Surgical videos, there are separate ones for each surgery. The first one, "part one" explains the normal anatomy. I like the explanations he gave, and he's just so darn cute with his little bow tie, lol.

https://www.dssurgery.com/resources/videos/

Edited by ChaosUnlimited
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Hello I am new here. Had my bypass in Jan. 2017. I have trouble with feeling hungry all the time. Also some days I just can't hardly eat anything. Anyone else have these issues? Thank you!


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