Can't decide between Sleeve and By-Pass

[Doo Lally 8]

Hi, Would anyone be willing to share how you made your final decision on which procedure to choose? I simply can't decide as there are pros and cons to both the Sleeve and By-pass. I'm brand new here and look forward to getting to know other members. I know my surgery is in February, but just starting out so no date set. Thanks for any help you might be able to give.

[Marblicious 130]

It depends on how much you have to lose, whether or not you have co-morbidities. If you have type 2 diabetes, they tend to recommend the Gastric Bi-pass. There is a lot to consider

[dreamingsmall 1,125]

2 hours ago, Doo Lally said:

Hi, Would anyone be willing to share how you made your final decision on which procedure to choose? I simply can't decide as there are pros and cons to both the Sleeve and By-pass. I'm brand new here and look forward to getting to know other members. I know my surgery is in February, but just starting out so no date set. Thanks for any help you might be able to give.

You have not really given any info on you self, it doesnt really matter what anyone else decided, you may have a whole different set of things to consider from the next person, your surgeon will have all your history and what you tell them to help you come up with the decision.

But to answer your question anyway.

I chose sleeve.

Because I did not want malabsorption problems.

I felt 85% of my tummy removed was enough of a tool for me .

No history with any acid refux etc , so .. I dont know it was cheaper too , and less time in recovery, less time in surgery, so sleeve worked for me.

[FluffyChix 17,410]

You need to really lean on your surgeon to understand your particular needs and to see what they advise, then make a decision from there.

For me personally, my surgeon was hoping for a sleeve for me because of being post cancer and having to take a cancer drug for 4 more years. She wanted to avoid the possible malabsorption of the drug. But my EGD came back showing pre-cancerous cells in my esophagus, stomach, and duodenum because of GERD, so I think that pretty much will mean that I have to go with the bypass--which is the way I was leaning anyway. If I'm gonna do this, then I want to have one of the maximum chances of having a metabolic reset and give the highest chances for a risk of cancer recurrence.

[Ldyvenus 317]

I feel like 300lbs. Should be the cut off for the sleeve. The bypass generally allows for more weight loss because of the malabsorption. But, I also know people on here at much higher weights who are rocking the sleeve. I guess it really depends on your desired goal weight...

[Berry78 4,259]

BMI over 52? Sleeve or Duodenal Switch.

GERD? RNY Bypass

Significant food addiction? Counseling and RNY Bypass (or D.S. if BMI over 50)

Type 2 diabetes (long term or insulin dependent)? RNY Bypass

PCOS? Probably Bypass.

None of the above? Sleeve.

If y'all scratch your head at my recommendation for the sleeve for the heavier patients.. it's because the sleeve is a simpler procedure for the surgeon when there is so much fat in the abdominal cavity. Heavier patients are going to be the riskier surgical candidates to begin with, so the sleeve is safer for them too. Also, the sleeve can later be converted to bypass or D.S. if a revision is needed. (Granted, revisions aren't as powerful as the first surgery, but at least it's an option.. and if they get the bypass first, there is nowhere else to go).

[Lannie 135]

I had the same debate. I was nervous about the malabsorption of bypass, so I was leaning towards the sleeve. It seemed like a more "simple" procedure. I had bmi of 47 no comorbidities. My surgeon said for me there was about a 30lb difference in expected loss between the two. He thought bypass would be a good option but also said the best option is the option I'm most comfortable with. He directed me to sleeve- saying I needed to be totally comfortable with the procedure....if I was confident I would be more successful. He said the additional loss with bypass didn't offset the pro of my confidence in he decision.

That is a long way of saying talk to you doctor.

[Doo Lally 8]

9 hours ago, Laggy said:

It depends on how much you have to lose, whether or not you have co-morbidities. If you have type 2 diabetes, they tend to recommend the Gastric Bi-pass. There is a lot to consider

Thank you for your thoughtful answer. My list of pros and cons for either procedure is daunting. I've only just been accepted for surgery sometime in February.

[Doo Lally 8]

2 hours ago, Lannie said:

I had the same debate. I was nervous about the malabsorption of bypass, so I was leaning towards the sleeve. It seemed like a more "simple" procedure. I had bmi of 47 no comorbidities. My surgeon said for me there was about a 30lb difference in expected loss between the two. He thought bypass would be a good option but also said the best option is the option I'm most comfortable with. He directed me to sleeve- saying I needed to be totally comfortable with the procedure....if I was confident I would be more successful. He said the additional loss with bypass didn't offset the pro of my confidence in he decision.

That is a long way of saying talk to you doctor.

Malabsorption and dumping are 2 things I really don't want to deal with. But, I look at greater weight loss with the bypass. I do not meet my surgeon until next year, and am expected to complete pre-op requirements before that. I anticipate my surgery to happen in Feb. of 2018.

Thank you for taking the time to talk to me.

[Hopep4673 120]

I chose bypass because of my type 2 diabetes... my doctor told me that patient with type 2 diabetes have a really high like 70-80% cure rate with gastric bypass... If i did not have that i would probably go with the sleeve.

[Doo Lally 8]

5 hours ago, Berry78 said:

BMI over 52? Sleeve or Duodenal Switch.

GERD? RNY Bypass

Significant food addiction? Counseling and RNY Bypass (or D.S. if BMI over 50)

Type 2 diabetes (long term or insulin dependent)? RNY Bypass

PCOS? Probably Bypass.

None of the above? Sleeve.

If y'all scratch your head at my recommendation for the sleeve for the heavier patients.. it's because the sleeve is a simpler procedure for the surgeon when there is so much fat in the abdominal cavity. Heavier patients are going to be the riskier surgical candidates to begin with, so the sleeve is safer for them too. Also, the sleeve can later be converted to bypass or D.S. if a revision is needed. (Granted, revisions aren't as powerful as the first surgery, but at least it's an option.. and if they get the bypass first, there is nowhere else to go).

Thank you for your concise yet informative message. I don't get to consult with the surgeon until closer to my tentative surgery date of Feb, 2018, but am set up for my 2nd appointment with his nurse. She recommended bypass for the simple reason that my diabetes will disappear after surgery. That seemed weak reasoning to me.

[Doo Lally 8]

9 hours ago, Laggy said:

It depends on how much you have to lose, whether or not you have co-morbidities. If you have type 2 diabetes, they tend to recommend the Gastric Bi-pass. There is a lot to consider

Your response is appreciated. I have done a great deal of research on this in the past month. I was just looking for the opportunity to actually get some feedback other than my own. Yes, there is a lot to consider.

[Doo Lally 8]

9 hours ago, dreamingsmall said:

You have not really given any info on you self, it doesnt really matter what anyone else decided, you may have a whole different set of things to consider from the next person, your surgeon will have all your history and what you tell them to help you come up with the decision.

But to answer your question anyway.

I chose sleeve.

Because I did not want malabsorption problems.

I felt 85% of my tummy removed was enough of a tool for me .

No history with any acid refux etc , so .. I dont know it was cheaper too , and less time in recovery, less time in surgery, so sleeve worked for me.

I shared the info on myself that I thought was most pertinent, I don't have a surgery date set, won't even meet the surgeon for months yet. I tried to go back and edit in my weight etc., but find it a challenge to do so. I was not aware that I had to provide certain info to post.

I'm glad your choice worked out for you so well.

[Doo Lally 8]

6 hours ago, FluffyChix said:

You need to really lean on your surgeon to understand your particular needs and to see what they advise, then make a decision from there.

For me personally, my surgeon was hoping for a sleeve for me because of being post cancer and having to take a cancer drug for 4 more years. She wanted to avoid the possible malabsorption of the drug. But my EGD came back showing pre-cancerous cells in my esophagus, stomach, and duodenum because of GERD, so I think that pretty much will mean that I have to go with the bypass--which is the way I was leaning anyway. If I'm gonna do this, then I want to have one of the maximum chances of having a metabolic reset and give the highest chances for a risk of cancer recurrence.

I won't meet my surgeon for several months yet. My apologies, I wasn't clear in my request. I see pros and cons for bypass and sleeve and just having a tough time deciding, and wondering what deciding factors others used. For instance, I don't want to deal with malabsorption or possible dumping, but bypass is known to have greater weight loss. I guess my question sounds kind of goofy. lol

Thank you for taking the time to respond and my best to you in the challenges you are facing.

[Doo Lally 8]

10 hours ago, Laggy said:

It depends on how much you have to lose, whether or not you have co-morbidities. If you have type 2 diabetes, they tend to recommend the Gastric Bi-pass. There is a lot to consider

Yes there is a whole lot to consider. Thank you for taking the time to respond to my question. Much appreciated.