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Sleeve vs. Bypass

I am seriously thinking about switching from sleeve (which is scheduled for Sept. 18th) to a bypass. Any reasons why I should or should not. I KNOW it is an individual decision, I would just like some experienced feedback.

-Thanks-

Edited by RSM

  • Replies 53
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Featured Replies

24 minutes ago, RSM said:

Thanks for your inputs, I am taking some of your points of interest to my surgeon on this Friday and we will discuss in detail. Your posts have given me information I need so I have some valid points before me. I realize she is one surgeon out of MANY, but I will post on here your points with her responses.

this video is very helpful too...

12 hours ago, JohnnyCakes said:

i respectfully disagree.

the risk of dying during surgery is the same at around 0.5%. making both very safe, "routine" procedures. so your "simpler operation" rings irrelevant to me. i guess it's relevant if your surgeon sucks or if you're doing it on the cheap in a Mexican alleyway, but that's another issue.

risk of short-term complications? slightly higher with RNY, yes, but you have to consider relative risk. no complication goes over 5% (leak, stricture, etc). there's risk of leak with VSG too, it's a bit lower at 3%. now, if that 2% is enough for you to choose a less effective bariatric surgery? that's your choice. i guess i have a different calculus when it comes to those things.

the long-term risks you cite are rare and the patient has to purposely disobey basic rules of common sense to trigger. like going back to eating way way too much. don't want ulcers? don't take NSAIDS. it's quite simple, if you reach for Tylenol instead of Advil, your risk of ulcers is negligible. but the average American is stupid as hell, so even simple directions like that are routinely ignored. Petersen hernia? most studies have this occurrence as low as 1%, and is virtually not an issue with an experienced surgeon who knows where to connect the roux anastomosis.

now, you want to talk about life-altering long term risk? let's talk GERD. which i've seen studies range from 20-40% of VSG patients!!!!! this can range from merely annoying to life-crushing and needing revision to, yes, RNY. this message board is FILLED with these patients and my surgeon says about 20% of his operations are revisions from sleeve to RNY. now THAT is risk.

and perhaps the biggest risk not talked about is that of permanence. to me, it's very RISKY to do the sleeve because your stomach is thrown in the trash bin and it is completely irreversible. the RNY is reversible. ergo, much much less risk.

again, you mention the sleeve "doesn't alter the anatomy". first of all i don't understand this argument. what's wrong with altering anatomy if it makes your body perform better? by that logic, getting glasses to help you see is "altering your anatomy". getting a heart bypass if you have heart disease is "altering your anatomy". is this a God, intelligent design thing? i'm not going there. all i know is that cutting your stomach out (VSG) is very much altering your anatomy. much more than RNY which leaves it there to be a perfectly healthy functioning body part capable of getting back on the playing field if need be.

another risk of the VSG? not reaching your goal weight. and isn't that why we're doing this? the fact is RNY results in 70-75% excess weight loss on average. and that average is brought down a lot by a huge sample population of people who are too dumb to behave after surgery. VSG is, with a smaller and more motivated sample set of patients, at best 60-65%. i guarantee you that as time goes on and more and more VSG patients are tracked, that number will go down even further.

But the bypass also carries major risks of malnutrition, vitamin deficiencys, anemia, osteoporosis as well.

And Uhm glasses don't alter your anatomy at all, they go on your face. When you don't want them you take it off.

A sleeve doesn't alter your anatomy in a surgical sense, it makes your stomach smaller but that's it. There's no crossing wires or anything like that.

How about dumping syndrome with the bypass also? The risks of that I've seen range from 20-85% depending on the degree/incidence of it

You're argument is really stretching things and bending the truth. Both operations are good and serve a purpose. And there are patients who would be better off with one over the other. Again I'm getting a bypass for one of those reasons. But it's a much more serious and involved operation

Edited by Mhy12784

The malabsorption is a biggie for me, also recovery would be longer...but 95% excess weight loss IS enticing.

Sent from my SM-S820L using BariatricPal mobile app

11 minutes ago, heyvcom said:

The malabsorption is a biggie for me, also recovery would be longer...but 95% excess weight loss IS enticing.

Sent from my SM-S820L using BariatricPal mobile app

I don't think 95% is realistic with a bypass. I've seen 60-80% quoted with over 50-60% kept off long term

Of course those are averages so some will do better and worse

Edited by Mhy12784

Dumping is not common post-Gastric Bypass. I do not suffer from it. It's avoidable if you stay away from food that causes it, typically sugar-laden desserts, which aren't good (nutritionally) for anyone. What is more common is foamies, which may occur if you don't chew your food well or you eat too much. These are preventable if you follow recommended eating habits post-WLS. And taking vitamins and staying away from NSAIDs is true for VSG patients, not just RNY patients.

1 hour ago, heyvcom said:

The malabsorption is a biggie for me, also recovery would be longer...but 95% excess weight loss IS enticing.

Sent from my SM-S820L using BariatricPal mobile app

Where did you hear/read that recovery is longer for RNY patients than VSG patients? I did not experience that and I was not told that from any bariatric surgeons I spoke with pre-surgery.

3 hours ago, MarinaGirl said:

Dumping is not common post-Gastric Bypass. I do not suffer from it. It's avoidable if you stay away from food that causes it, typically sugar-laden Desserts, which aren't good (nutritionally) for anyone. What is more common is foamies, which may occur if you don't chew your food well or you eat too much. These are preventable if you follow recommended eating habits post-WLS. And taking Vitamins and staying away from NSAIDs is true for VSG patients, not just RNY patients.

Some people get it from any carbohydrates over like 5g which takes it to far.

VSG can definitely take NSAIDS though. I think for 6 months to a year after surgery they might ask you to avoid them, but then you're good to go for the rest of your life. Some surgeons might feel differently but a quick Google search makes it does state that they are generally allowable after a VSG.

And I think the vitamins/malabsorption thing is substantially more serious with a bypass. With a bypass the way your body absorbs vitamins and minerals is substantially shortened and different. With a sleeve you're just eating much less for the most part. I don't think supplementation is an absolute must for a sleeve while it definitely is for life with a bypass

  • Author
1 hour ago, JohnnyCakes said:

Edited by RSM

24 minutes ago, RSM said:

To Mhy12784 ,,,may I ask what makes you an expert? I don't mean to talk you down but please have a little compassion for those who are evidently not as "smart" or as "experienced" as you make yourself out to be. Now log off your mom's computer and please don't bother to post on any of my forums again. I am not using these nor do I post in a forum to be scolded or talked down to, and I don't think this website is designed for that kind of activity. By the way, you have been ignored from posting anymore on this forum. Have a Good day!

Pretty sure you confused me and JohnnyCakes as I was only speaking politely and having a intelligent discussion on a message board as it is intended.

All the ranting/raving/cursing/insults above was entirely him responding to a quote from me, thus he typed those words in red. Sorry I dont act like a deranged lunatic on the internet and start flipping out cursing and throwing insults. His ignorance in suggesting that the Bypass is a 100% superior operation than the Sleeve and is better in everyway is incorrect and dangerous, and has no place on a message board where people are trying to inform themselves about a life altering surgery. Both surgerys have advantages and disadvantages that is a fact. Labeling one as "clearly superior" is not proper or correct

Unless I did/said something otherwise that I missed...

Edited by Mhy12784

  • Author
9 hours ago, JohnnyCakes said:

this video is very helpful too...

JohnnyCakes thanks for the video,,appreciated

2 hours ago, RSM said:

JohnnyCakes thanks for the video,,appreciated

no problem. i think this guy's advice (about many topics, lots of videos) is seriously on point and progressive. :1312_thumbsup_tone3:

3 hours ago, Mhy12784 said:

I dont act like a deranged lunatic on the internet and start flipping out cursing and throwing insults. His ignorance...

this sentence and a half. wow. this says it all... LOL!!!

oh my... can't make this stuff up. :lol:

  • Author
3 hours ago, Mhy12784 said:

Pretty sure you confused me and JohnnyCakes as I was only speaking politely and having a intelligent discussion on a message board as it is intended.

All the ranting/raving/cursing/insults above was entirely him responding to a quote from me, thus he typed those words in red. Sorry I dont act like a deranged lunatic on the internet and start flipping out cursing and throwing insults. His ignorance in suggesting that the Bypass is a 100% superior operation than the Sleeve and is better in everyway is incorrect and dangerous, and has no place on a message board where people are trying to inform themselves about a life altering surgery. Both surgerys have advantages and disadvantages that is a fact. Labeling one as "clearly superior" is not proper or correct

Unless I did/said something otherwise that I missed...

I will make the right decision (as everyone else does) with my surgeon and not by someones post. However, posts to the original subject matter is valuable to me as others experiences give me talking points to share with my surgeon. I don't know it all folks, that is why I am here. I appreciate everyone's input.

Edited by RSM

14 minutes ago, RSM said:

I will make the right decision (as everyone else does) with my surgeon and not by someones post. However, posts to the original subject matter is valuable to me as others experiences give me talking points to share with my surgeon. I don't know it all folks, that is why I am here.

Of course, I agree completely. I think both procedures have their advantages and are both terrific procedures and everybody's circumstances are different . And thats why its important to remain open minded going into the process. I had originally gone to my surgeon wanting a sleeve because of my lower BMI and risk aversion, but my surgeon convinced me that the bypass was a better option. That was kind of the only point I was really wanted to make.

Edited by Mhy12784

  • Author
6 minutes ago, Mhy12784 said:

Of course, I agree completely. I think both procedures have their advantages and are both terrific procedures and everybody's circumstances are different . And thats why its important to remain open minded going into the process. I had originally gone to my surgeon wanting a sleeve because of my lower BMI and risk aversion, but my surgeon convinced me that the bypass was a better option. That was kind of the only point I was really attempting to make.

My BMI is 41 and I have diabetes 2. Since diabetes is rampant in my family, I'm geared more to the bypass. My grandmother lost a leg to diabetes,,,,,,, naturally I want to keep both of mine! My understanding is the bypass can cure diabetes if you lose weight with of course sticking and staying to the plan. I am sure the sleeve has good results as well, but there is not enough long standing data as there is with the bypass. But, the meeting with my Dr. this Friday will be fruitful I am sure.

Edited by RSM

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