Please Help! Bypass vs. Sleeve Which one to Choose?😅

[xxtrinaxx 8]

So I am at the point where it’s my decision to choose which surgery I want and it’s been so dang hard to choose. I was scheduled to have the sleeve done but then with possible revision of sleeve was not as successful. But got word my insurance only covers one surgery in a life time. So I only have one chance at this. So now I’m having to make the decision again bypass or sleeve?!? I have Dr. Chylsta and I am thinking he likes to do the sleeve but I can’t gauge his opinion. So just wanting to ask others who have been down this journey.

What surgery do you think would be most successful? Just asking opinions ... I know it’s ultimately my decision. Thanks in advance!😊

[MargoCL 677]

This is really a personal decision. Everyone makes their choice for their reasons. The success rate of both surgeries these days are very similar. Have you discussed your concerns about either surgery with your surgeon?

For me, I chose the sleeve because it's least invasive in terms of change to my anatomy. I personally believe that I am strong enough to maintain the healthy lifestyle required with the new tool / gift I've been given. I am 4-weeks post op and so far I've had zero regrets and few to no complications.

I'd review every piece a literature available to you regarding the surgeries and ask the questions you are not sure of. I researched my options 6 months prior to seeing a Bariatric group to discuss surgery and even when I had my first appointment I was on the fence as to whether or not I wanted surgery or continue with medically supervised weightloss. But I've always known for me, the sleeve was going to be my choice.

[GreenTealael 24,867]

1 hour ago, xxtrinaxx said:

So I am at the point where it’s my decision to choose which surgery I want and it’s been so dang hard to choose. I was scheduled to have the sleeve done but then with possible revision of sleeve was not as successful. But got word my insurance only covers one surgery in a life time. So I only have one chance at this. So now I’m having to make the decision again bypass or sleeve?!? I have Dr. Chylsta and I am thinking he likes to do the sleeve but I can’t gauge his opinion. So just wanting to ask others who have been down this journey.

What surgery do you think would be most successful? Just asking opinions ... I know it’s ultimately my decision. Thanks in advance!😊

No one here can possibly gauge what surgery will be most successful for you. It will be a guess at most. People tend to go with the sleeve if that don't have GERD/reflux don't want malabsorption, don't have multiple 100s to lose. RNY for the opposite reasons, but that is just a quick rundown. There's alot more to it.

A few weeks ago I even asked why people chose the least effective surgery for their situations. But further research, open-mindedness and discussions led me to realize it's not as simple as we think. Genetics, biology, illness, habits, mental health, and sometimes pure chance can play a role too.

What may work on paper in perfect conditions may not always be the outcome we received.

Sometimes it's far better than anticipated sometimes far more disappointing. Some people do everything right and biology works against them, some people do everything their way and have great results no matter what.

I say all of this because you will get responses in a range from this spectrum and in no way will it correlate to your outcome.

Do what you think will be best for you with the recommendation of your surgeon. Take that serious, He/She has directly influenced the changes of many people's weights and has data on trends based on the procedures they perform.

(Goodness that was long in the tooth , sorry.)

Edited September 17, 2018 by GreenTealael

[xxtrinaxx 8]

Thank you for that GreenTealael! I would go with the recommendation of my surgeon if he was to give me one. He won’t tell me either way and said it’s up to me and that I could do either. He will only answer my questions. So I am struggling to know what to do. I know no one can decide for me just wanting to see others opinions and maybe why they made the choices they did. You said you wondered why people chose the least effective one? Which surgery were you referring too?

[xxtrinaxx 8]

Thank you MargoCL. I have talked with my surgeon just today. He won’t really give me what he thinks is best. Says I can go either way. Which really does not help me. I think the more I read the more confused I get about which surgery to go with. :(

[GreenTealael 24,867]

37 minutes ago, xxtrinaxx said:

Thank you for that GreenTealael! I would go with the recommendation of my surgeon if he was to give me one. He won’t tell me either way and said it’s up to me and that I could do either. He will only answer my questions. So I am struggling to know what to do. I know no one can decide for me just wanting to see others opinions and maybe why they made the choices they did. You said you wondered why people chose the least effective one? Which surgery were you referring too?

I was talking I terms of the three major wls offered :

VSG, RNY & DS.

You can "eat around" (intake a surplus of cal) all of the surgeries but only RNY & DS have malabsorption as an added layer to expedite weight loss and effectiveness.

There is tons of research out there that states the further out you get the less effective the malabsorption. On the flip side VSG has become popular because the anatomical change doesn't *appear* as extreme as the others and everyone worries about malabsorption isssues long term.

If the choice is yours consider:

Do you have/or at risk of developing GERD? (Some get it anyway years later)

Are you willing to have a revision surgery to correct it or for insufficient weight loss? (You may get different insurance, can't predict the future)

Do you have additional medical/concerns ailments?

How much do you have to lose? How fast? Why?

Do you have eating/food issues that are not well managed/unaddressed?

I personally only decided to go with VSG over RNY because I have medical issues & Vitamin deficiencies that would have gotten much worse immediately with a super rapid drop , I didn't think I could physically handle it and if I ever need a revision (medical only) I will push for DS as it was the natural progression of the VSG path (originally designed as stage 1 of 2 of DS)

Hope I was helpful, let me know

Edited September 17, 2018 by GreenTealael

[Frustr8 7,886]

Let us know sometime in 5he future which you😝 and your surgeon 😷 have chosen!

[JessLess 1,163]

On 9/17/2018 at 5:16 PM, xxtrinaxx said:

I have talked with my surgeon just today. He won’t really give me what he thinks is best.

I think if it were me, I would find this a little confusing. My surgeon told me that VGS is best for people like me (BMI 40) unless I had GERD. I wonder if he is worried you will blame him if you later feel that you did not get the best surgery for you? I like my doctor to be able to make good recommendations for me so I can decide what to do with her.

My suggestion, if your insurance covers it, would be to have an initial apt. and get a second opinion from another bariatric surgeon at a different hospital and see what they say. I am excited to get the VGS because it seems like the least invasive and I think I will be successful with it, but of course, everyone is different. Good luck to you!

[elcee 3,340]

A sleeve is not less invasive, it chops off your stomach and throws it away. It can't be reversed.

If you only have the option of 1 surgery I would speak to a couple of surgeons and get their honest opinion. Forget your own biases, don't look at whatever everyone else is getting, ignore what seems to be the flavour of the month.

[Frustr8 7,886]

And do what is BEST for YOU! I could not be are the thought that another part of me was going to be dumped like garbage. And the idea of a garden hose digestion , nope didn't thrill me. So I said 1 Surgery, Done surgery. "But everyone to their own taste "said the woman👩 as she kissed her🐄 cow!

[elcee 3,340]

Thanks Frustr8. You obviously have an RNY. Can you tell me what your experience has been - I’m currently investigating revision options and my surgeon has made a very good case for having an RNY

[Frustr8 7,886]

it has been wonderful, my surgeon was great, did not leave me bashed, a little gashed but they are now healing well. At 72, I was afraid I would not. My only problem was Precious Pouch, she was very tempermental but today I am happy to report she has been peaceful, my Soup did well as did 1/2cup of cottage cheese. Last week she was playing Elevator Lady, "everything going up!" but I think she has settled down. It is a new experience, but I am So So Happy! I fought for over 3 years, past You're Too Old, You can't Handle It, and my personal favorite You are not worth My Time, the last from a previous surgeon, Guess What it turns out He wasnt worth my Time instead. I found a better, kinder, technically superior surgeon, and Pfft to Dr Malcontent,

[JessLess 1,163]

On 9/24/2018 at 7:44 PM, elcee said:

A sleeve is not less invasive, it chops off your stomach and throws it away. It can't be reversed.

If you only have the option of 1 surgery I would speak to a couple of surgeons and get their honest opinion. Forget your own biases, don't look at whatever everyone else is getting, ignore what seems to be the flavour of the month.

Yeah, that's a great point. There was a woman in my nutrition class getting an RNY reversed and getting sleeved. I didn't realize that was possible until today. I agree, getting lots of medical viewpoints is the way to go.

[RapidFirePickle 119]

For me it was less about the amount of weight I had to lose, and more about the reversal/remission of my diabetes. RNY gastric bypass is more efficient at diabetes reversal than the sleeve. I am happy to say that 4.5 months later I am pretty dang happy with the choice.