How did you choose between VSG and Bypass?

[Greyfaery 3]

Sorry if this has been asked before. I’m on my pre-op journey with no surgery date in sight yet. I am still going back and forth between the two surgeries and wondering what is best. The surgeon said I could choose either one, but there are so many pros and cons! I’m leaning toward the sleeve but worried about bad acid reflux after and the fact that there’s not really a “dumping” feeling (meaning if I’m not careful I could eat ice cream all day and gain it all back)..but on the other hand recovery is easier with the sleeve...ugh it’s such a hard choice!! Post-op peeps, what did you end up choosing and why?

[Matt Z 4,138]

@Greyfaery For me, the decision was advised by my surgeon, she installed the Lap Band for me back in 2011 and when I discussed revision, she refused to do the sleeve on previously banded folks due to increased staple line complications.

The sleeve has issues with reflux, and yes, you can *TOTALLY* "eat around" the sleeve, high sugar, high fat "sliders" are a real issue. Recovery between the sleeve and the bypass isn't that much different. In fact, the post-op process for the sleeve is actually harder than the bypass. Bypass patients are eating pureed food before they leave the hospital, sleeve patients are on liquids for a month afterwards.

I've had the band, and now the bypass. The band and the sleeve are pretty much the same idea for surgery, restriction only. And both can be "eaten around", neither have any negative reinforcement / punishments for eating badly. So, once you start realizing you can get away with things you probably shouldn't be eating, there really isn't anything physically stopping you from doing so.

Having healed both the band and the bypass now, I can say without any doubt that I really didn't notice a difference between the 2, if anything, the bypass was easier to heal, now that could have been because I knew what the process was like, or because I was thinner, but it was just easier.

I'm *VERY* glad I went with the bypass this time around and not just another restriction only surgery. In fact, sitting here now, I truly wish I went with the bypass the first time I had WLS... And not after years of failing with the band.

Either way, whichever you chose, understand it's ONLY a tool and will require lots of hard work and behavior modification, you *WILL* need to change everything about how you eat, your subconscious relation with food, any stress or comfort triggered eating habits will need to be adjusted or dealt with, for me, the bypass adds that extra layer of support, I can chose to eat a piece of cake if I truly wanted to, but I know it's going to really suck badly for a few hours or more if I do, so I really tend to not even risk it anymore. There are plenty of other things I can eat that are super tasty and good for me to chose from, it's harder when going out, but it's more than worth the added struggle!

Good Luck in your choice!

[Bryn910 519]

I had sleeve and the bypass (revision after 7 years) and I felt there was no difference in the recovery process. I felt about the same but experienced less gas pain with bypass. So neither one was easier in my opinion

[Sosewsue61 3,185]

I did not want malabsorption, so it was the sleeve. Also you can get ulcers in the unattached stomach portion left in and it's very hard to treat - the nurse at my PCP's office has one plus Vitamin deficiencies. The 3 ladies that gave testimony at wls group all had to have Iron infusions. The percentage difference in overall weight loss is not much different between bypass and sleeve. Each surgery, either way you are responsible for what you eat.

[KimTriesRNY 1,853]

You are not guaranteed to dump if you have gastric bypass surgery. I’m not sure why this is such a common misconception. And we have a few sleevers on here that have experienced dumping. Do not base this decision based on dumping, whether you find it desirable or not-you may not end up with it.

Both surgeries require Vitamin supplements for life.

It is possible to eat around either surgery eventually by eating frequent high calorie foods that are quickly digested.

If you have a starting BMI greater than 50, you should strongly consider gastric bypass.

Both surgeries require follow up care for life regarding lab work.

Recovery from both surgeries seems about the same.

Do you have any other medical conditions? Are you diabetic? Do you have reflux? All of these should be considered along with your BMI, and diet history.

Do your research and you will choose what is best for you.

[Sadiebug 206]

3 hours ago, KimTriesRNY said:

You are not guaranteed to dump if you have gastric bypass surgery. I’m not sure why this is such a common misconception. And we have a few sleevers on here that have experienced dumping. Do not base this decision based on dumping, whether you find it desirable or not-you may not end up with it.

Thank you for saying this! I was one of those people who chose RnY because of the "negative consequences" of eating bad food (i.e. dumping). My program talked about this as a major part of their education classes and never once did they mention that many patients never experience dumping. My entire plan post op was that I would get sick from eating bad food and then would never eat it again. I quickly discovered that I could eat whatever the heck I wanted with no physical repercussions and had to adjust my thinking to stay on track. In the long run I'm actually happy I have flexibility with food but it sure requires a lot more willpower than I initially thought it would.

[Ylime 453]

My actual decision was based on the fact that I have to pay for it myself and of the two the sleeve is significantly cheaper.

But in terms of a comparison of the surgical aspects, I feel more comfortable with the less invasive procedure. I like the idea of having the benefit of a smaller stomach without rerouting my intestines.

The decision for me was really about comfort level balanced with what is best for my goals and health.

[BajanSleeve 244]

A few people who have replied echo reasons that were also in my decision process. 1) less invasive than re-routing intestines 2) cost was a big factor 3) the statistics showed pretty much similar weight loss achievement 4) I am a diabetic and that was one of the main reasons I did WLS and both procedures showed reversal of type II Diabetes .

I have always understood from the start that any kind of WLS was an intervention and a re-set. Just to give me the time I need to change bad habits, retrain my system to be satisfied with less food and then once the bulk weight is gone enable me to start exercise again. None of these are quick fixes without the discipline following so that you wont regain.

I recommend that we all get counselling to understand the root reasons why we use food as an emotional crutch. I am hoping that loosing so much weight will give me the incentive to work hard to keep it off since I will finally be able to do things of life like normal people do and no more diabetes! My mother died at 65 of obesity illness and my grandmother at 53 of the same thing. We have to take responsibility for our own future.

Thank God for WLS!

[Frustr8 7,886]

Future RnY person in July 2018
Reasons and comorbidities
Arthritis since age 25 both varieties 2 knee replacements
Family history Cardiac-received clearance
Family history Diabetes-since child of 2 diabetics- always ranked as prediabetic
Moderate GERD with accomplifing gastritis and small gastric ulcer
Verified sleep apnea, pulmonary and sleep medicine clearances in place
BMI approaching 50 and 72 years of age.
And unlike my sleeve siblings I prefer potential,of dumping and perpetual vitamin/mineral supplementation to losing 3/4 or 7/8 of my natural stomach . They are already too many portions of me in pathologist jars
And without my surgical tool for assistance facing the specter of my own demise within very few years. This is,my once and only bariatric surgery and I want to best and most proven type for myself.
I will be having my surgery in a hospital which is a cutting edge teaching institution as well as a Center of Excellence.
I fear surgery much less than continuing my slow and steady downhill slide toward death. Although I am into my 7th decade of life I find I have many things to achieve, many places to visit, much more accomplishments , I want the health and endurance for them all. I am sick and tired of being sick and tired.😟 So I reach,out boldly and with confidence in my choices at this time.🌈😛

[BostonWLKC 806]

I had the bypass. I found that many sleevers end up revising to bypass and I didnt want two surgeries.
I also didn’t want the reflux possibility and wanted maximum loss . The bypass gives that maximum weight loss - the sleeve is close though!

I really don’t see why people say the sleeve is any easier of a recovery.
For me- the recovery was super easy. I had 5 small (1/4-1/2 in) incisions and was not in pain - took maybe 3-4 days to be back to normal after gas passing

Good luck with your decision

[kimberlymi 113]

When I had my consultation I was told by the doctor that the bypass would be better for me. A couple of reasons I am a type 1 diabetic and I have acid reflux I also have a highBMI. I know I will never get off of my insulin but I will be taking much less. I was told that my acid reflux should be almost gone. I can lose more weight with the bypass . Also I need that dumping syndrome to help me when I may think of eating something I know I should not have.
My post op diet will be the same as a sleeve diet but I will be on liquids for 3 weeks not 2 I just found out from my Nut.

[MdmMargott 20]

I first wanted bypass, mostly because of the percent of diabetes reversal, it sounded more promising than the sleeve and I just wanted the constant stress of managing diabetes to be gone. However my surgeon talked me out of it, he was confident that the sleeve will do the job as well because I didn't have diabetes for long time, I'm relatively young ect.

Other reason were I started with low BMI, I wouldn't have to worry about Vitamins deficiency so much (and I am planning a pregnancy in future) ,correct dosing of medications is not an issue with sleeve, would be able to take some NSAIDs when needed with much less risk, and if I ultimately fail or diabetes gets back, reversal to RNY or duodenal switch is simpler with sleeve.

Edited June 10, 2018 by MdmMargott

[Abrial 23]

When I started the journey I wanted VSG. My surgeon said it was possible but to keep RNY in mind. After going through the upper GI test and an esophagus motility test (which is the worst test I have had so far in my life) it was discovered that I have weak esophagus muscles and GERD (didn’t know). My surgeon recommended the bypass instead to prevent more acid reflux.

Per his earlier advice, I had researched both and was okay with his recommendation. I would have liked the VSG, but my body voted bypass. Lol sometimes it not about what we want but what we need instead.