My Surgeon gave me a choice to choose my surgery: Sleeve vs. Bypass vs. RNY

[AchieveGoals 46]

Have been visiting my Bariatric clinic initially for undergoing the Sleeve procedure, however with my last surgeon visit, he said he recommends that I get the Bypass.

With the increase of GERD after Sleeve, and the numerous revisions from Sleeve to Bypass...he says if you'd like to avoid this in the future and save a surgery then it would be better just to do Bypass. WHOAH! Bypass seems to me like the most drastic procedure for the most severe cases (IDK, I get that sensation).

My question to Sleevers: If you could do it again, would you choose Bypass? Does GERD really get that bad?

[JessLess 1,163]

I've had the sleeve for almost two years and haven't had any heartburn or GERD. If I had had GERD, I would have had the bypass initially. I've been very happy with the sleeve. It's a pretty personal choice based on preference.

[Lily66 425]

Initially I was head set on the Sleeve. When my surgeon asked if I ever have GERD and I replied “yes, once in awhile”, he drew a picture of what happens when GERD takes place with Sleeve (increased pressure in a much smaller pouch, that raises serious discomfort, and risk of potentially serious esophageal damage.) He went on to say if your tests indicate serious reflux issues I WON’T perform Sleeve on you. If they show minor issues, I’ll do Sleeve if you still choose to, but caution you it may result in a revision up the road if GERD persists. I would much rather you go through WLS surgery once and not have to do it twice.

He encouraged me to leave him, start the battery of testing and do more research. When I learned that RNY is still considered the Gold Standard of WLS, with the longest history of success, risks very low, slight potential for greater weight loss due to malabsorptive feature, my mind was well on its way to RNY. Three months out and No regrets, not at all. Challenges with both, but to be expected.

Many Sleevers are very happy and have done amazing, too! It’s your personal makeup that, along with recommendations from your Dr. that will guide you.

Mine is only one story. Good luck! I loved the excitement😃 and anticipation at the stage you’re in—-Enjoy the Journey!💖

[it'sonlythefirststep 141]

I nerve had Gerd before surgery... omg I was fine for 3 weeks after surgery then BAM! I thought I was having a heart attack... after visit to ER of course it happened on the weekend... I now know what reflux is...

[NovaLuna 710]

So my surgery requires a sleeved stomach and I was concerned about the GERD issue myself as I have EOS so I DID have increased acid issues... at night only. But... my acid issues are actually slightly better than they were. I used two take to antacids before bed and now I only have to take one and I'm fine so... I guess it just depends on the person really. It just comes down to whether you already have GERD or are willing to risk it. Not everyone has the issue. But it DOES happen, so just be prepared in case it does...

Edited June 7, 2020 by NovaLuna

[catwoman7 10,981]

I personally don't think bypass is that much more drastic than the sleeve. Removing 80% of your stomach and throwing it in the trash seems pretty drastic to me. And RNY is NOT the most drastic procedure and isn't for the most severe cases, either - DS is the most aggressive of the more common WLS surgeries and results in the highest weight loss. It's not nearly as common as VSG and RNY, but it is sometimes recommended for people who have a lot of weight to lose (like a 60+ BMI - although some people get it who are under that). There are many people on here who have had RNY at much lower starting BMIs - similar starting stats as the VSG.

if you have GERD now, I would definitely be looking at bypass. Sleeve doesn't always make it worse, but for about 30% of people, it does. I had GERD prior to surgery and wasn't willing to take that risk.

both are good surgeries and I've seen people on here who have been very successful with both. If you're willing to take the risk of GERD after surgery, then the VSG may be a good choice for you. As I mentioned, I had GERD before surgery and wasn't willing to take the risk. I've been very happy with my RNY.

P.S. From your title, it seems like you're not clear on "RNY vs bypass" - RNY is a gastric (stomach) bypass, and we use those terms interchangeably (there is some bypass of the duodenum, but most of the bypass is of the stomach). You may be thinking of the DS where a much greater portion of the small intestine is bypassed (??). The DS has a sleeve stomach, so the stomach is not bypassed.

I probably would have gone for the DS if my insurance covered it, given my starting weight, but my insurance only covered VSG and RNY. Although there was the GERD issue with me, too. Anyway, I'm happy with my choice, so it no longer matters.

Edited June 7, 2020 by catwoman7

[Lily66 425]

My main concern with RNY was the increased limitations, should we need a serious drug up the road that is not adaptable to our new system. I do believe with the huge (pun intended) increase in bariatric surgery, more and more pharmaceutical companies are taking our dilemma to heart (and to the bank also)!

Though surgeon said no more aspirin again, ever! You betcha one will be headed down my throat fast if a heart attack is suspected— Judgment in emergency situations. I believe NSAID’s are out for Sleevers just as they are for RNY-ers.? Not sure tho..

Nutrient absorption was also a RNY concern..but if you are a disciplined person who will take your supplements FAITHFULLY, for life, and ensure you eat balanced NUTRIENT RICH foods, I believe all will be well. Certainly will be healthier than the SICK route I faced with obesity.🤧

Edited June 7, 2020 by Lily66

[California Guy 131]

I had occasional GERD. Surgeon did a repair with mesh as he did the sleeve in 2013. Acid reflux was almost eliminated with only two incidents. In my case, I'll only get acid reflux if I eat then immediately lay down to sleep. There are certain foods that produce acid. When I reduce or avoid them, I do well.

I initially requested a DS but the surgeon said the sleeve was the first half of the DS and we'd see how I do with that alone. Earlier this year, I went back for the DS. I was given many options and selected the SADI-S. I picked this newest form of DS being safer with fewer potential complications.

I was not a severe case at 5'10" 300 lbs. I wanted the most effective WLS aid to get out of the obese classification.

[New&Improved 1,780]

9 hours ago, AchieveGoals said:

Have been visiting my Bariatric clinic initially for undergoing the Sleeve procedure, however with my last surgeon visit, he said he recommends that I get the Bypass.

With the increase of GERD after Sleeve, and the numerous revisions from Sleeve to Bypass...he says if you'd like to avoid this in the future and save a surgery then it would be better just to do Bypass. WHOAH! Bypass seems to me like the most drastic procedure for the most severe cases (IDK, I get that sensation).

My question to Sleevers: If you could do it again, would you choose Bypass? Does GERD really get that bad?

I personally chose the RNY BYPASS because of many reasons but yes a big one is seeing so many ppl starting with the sleeve ending needing a bypass anyway and I could only do one surgery so the bypass was the best choice for me.

I've been very lucky with no complications and only a week stall here and there but still managed to surpass all my goals and currently MAINTAINING BELOW my goal weight after losing 157lb

Bypass isn't that drastic the more intense ones are DS.

You take Vitamins with sleeve or bypass. Sleeve just limits the food where bypass changed your metabolism.

[catwoman7 10,981]

4 hours ago, California Guy said:

I was not a severe case at 5'10" 300 lbs. I wanted the most effective WLS aid to get out of the obese classification.

not all are. I have a friend (female) who was around 250-ish lbs who had the DS, so you're right - not all are severe cases.

[MaybeMeow 129]

9 hours ago, AchieveGoals said:

Have been visiting my Bariatric clinic initially for undergoing the Sleeve procedure, however with my last surgeon visit, he said he recommends that I get the Bypass.

With the increase of GERD after Sleeve, and the numerous revisions from Sleeve to Bypass...he says if you'd like to avoid this in the future and save a surgery then it would be better just to do Bypass. WHOAH! Bypass seems to me like the most drastic procedure for the most severe cases (IDK, I get that sensation).

My question to Sleevers: If you could do it again, would you choose Bypass? Does GERD really get that bad?

My BMI is 36 with my only co morbidity being GERD and I'm getting the Bypass. I admit I felt the same way. I wanted a Sleeve. Surgeon recommended the other. Said I could decide. Then he said this. Sleeves lose an average of 70% of their excess weight. So you would go down to about 170. Well I was 170 eight years ago and I felt fat then. I wanted more. So after a couple sleepless nights I decided Bypass. I think the straw than broke the camels back was that and the fact that the surgeon said "I can't tell you for certain which is the better choice for you. But I can say with certainty that the Bypass will cure your GERD." So there you go. I'm still nervous about it. My surgery is in 2 days. BEst of luck with your choice.

[GreenTealael 24,964]

13 hours ago, AchieveGoals said:

Have been visiting my Bariatric clinic initially for undergoing the Sleeve procedure, however with my last surgeon visit, he said he recommends that I get the Bypass.

With the increase of GERD after Sleeve, and the numerous revisions from Sleeve to Bypass...he says if you'd like to avoid this in the future and save a surgery then it would be better just to do Bypass. WHOAH! Bypass seems to me like the most drastic procedure for the most severe cases (IDK, I get that sensation).

My question to Sleevers: If you could do it again, would you choose Bypass? Does GERD really get that bad?

IMHO... Listen to your surgeon. GERD *may* get worse then you'll end up with a bypass anyway.

Good Luck ❤

[New&Improved 1,780]

Bypass is very common and known as the gold standard these days!

Nothing drastic about it. Was a very quick surgery and easy recovery.

[ChubRub 1,702]

The reason I chose bypass was b/c I read so many stories about people converting after the sleeve, and I didn't want to have a 2nd surgery down the road. I also had GERD, and didn't want it to get worse. My GERD completely went away after my bypass. I don't even need TUMS anymore...it's amazing!

[LovingmeForever 337]

I had my sleeve in June, 2012 and I haven’t had any. On my day of surgery I was 230 pounds and I lost 100 pounds a year later and I do have to said that last year I gained about 40 pounds, however I went back and addressed my eating habits and I am back to 125 now.