Help! VSG or Bypass

[RaisnHL 20]

I’m so torn right now. I meet with my surgeon next week to discuss things but thought I’d. one here first… should I go with the sleeve or the bypass?? I was set on sleeve but now I’m having second thoughts… I feel like my eating habits/cravings/pcos will just find a way around sleeve and bypass is going to make that more difficult.

BUT bypass is more expensive, and I’m self pay.

What would you guys suggest!? SN- I have NO issues with gerd or reflux.

[catwoman7 11,278]

I know this doesn't help, but both good surgeries, and you'll find people on here who've been very successful with both.

the discussion you'll have with your surgeon may be helpful - he/she may bring up some issues that you haven't thought of that may help you make your decision.

it's tough, though. My decision was easier since I had GERD, but a lot of people have been faced with the same situation you're currently in. Hopefully your conversation with the surgeon will help you decide.

[I♡BypassedMyPhatAss♡ 807]

7 hours ago, RaisnHL said:

I’m so torn right now. I meet with my surgeon next week to discuss things but thought I’d. one here first… should I go with the sleeve or the bypass?? I was set on sleeve but now I’m having second thoughts… I feel like my eating habits/cravings/pcos will just find a way around sleeve and bypass is going to make that more difficult.

BUT bypass is more expensive, and I’m self pay.

What would you guys suggest!? SN- I have NO issues with gerd or reflux.

These are my thoughts, coming from a patient going through a revision from Lap Band to Bypass...

If you ultimately go with Sleeve, you may encounter complications like GERD years down the road. This is due to the Sleeve being a high pressure system. The high pressure created in the pouch puts pressure on the esophageal sphincter and causes it to fail, which results in GERD. It often takes years to manifest, and when it happens, it ultimately forces your hand to revise to Bypass. That's my current situation. When I got Lap Band, I was scared of Bypass. But as I've investigated more about Bypass, I understand now why it is the Gold Standard of weight loss surgeries. It's been around longer than other weight loss surgeries, so it has been perfected over the years. I wish I would've chosen Bypass from the beginning and saved myself a lot of unnecessary complications and I never made it to goal weight either.

As for being self pay, and Bypass costing more... imagine a few years down the road having untreatable GERD and having to have a second surgery. So think of the increased expense of Bypass now as an investment if you choose to go that route.

If you're having doubts about your PCOS causing cravings, Bypass might help to keep your eating on track, if you're a patient that gets dumping.

I'd say you should trust your instincts.

Best wishes on your journey!

[liveaboard15 1,294]

57 minutes ago, BypassingMyPhatAss♡ said:

As for being self pay, and Bypass costing more... imagine a few years down the road having untreatable GERD and having to have a second surgery. So think of the increased expense of Bypass now as an investment if you choose to go that route.

SOOOOO TRUE!!! The price difference for my place between sleeve and bypass was about 5K. but like you said. If you need revision down the road... that $5K blows up to around 25K. Very good thing to think about

[Therese22 38]

I definitely understand the thoughts behind this decision. I am also self-pay. My GERD Score was in a range where I had either as an option but after hearing about potential for worsening of GERD, my history and continued work with my relationship with food and goal to lose more than 100 Ibs, I opted for Bypass. It is an investment for sure. I do not feel there is a wrong choice.

[Dogmom68 135]

Not sure if this helps but I had VSG in Feb 2020 and never had any problems with GERD prior to surgery. Since my surgery I have terrible GERD and am now getting ready to have a revision to a bypass. Also, I only lost 40 lbs after my VSG. Wish I had just had the bypass to start with!

[Jeanniebug 476]

The threat of dumping and the reduction in reflux were the two main reasons why I've chosen the bypass.

[Dogmom68 135]

On 07/01/2022 at 00:03, Jeanniebug said:

The threat of dumping and the reduction in reflux were the two main reasons why I've chosen the bypass.

Definitely a good choice having the bypass especially if you already have issues with acid reflux. I’m getting ready to have a revision from sleeve to gastric bypass because of the terrible reflux I have.

[SleeveToBypass2023 2,680]

How is everything going now? I am 3 1/2 months out from my sleeve and for the first time in my life, I started having HORRIBLE gerd symptoms 2 days ago. I'm uncomfortable during the day, but at night is when I'm in agony. I'm on 40mg of Omeprazole for 6 months because of the surgery, so I'm shocked this is happening. I made a post titled "Is this GERD?" because I literally have never felt anything like this before and it's freaking me out. I'm scared that if GERD is starting 3 1/2 months out from surgery, I'm going to have to be miserable for years before I can be approved for a revision. And I thought bypass was kind of the gold standard for eliminating GERD, and now I'm nervous having read a few threads on here about people getting the bypass and developing GERD after, or getting it because of GERD and it not going away.

[HeatherE 203]

Although it’s more expensive, I would go with bypass. Mine was covered by insurance, but I was originally thinking sleeve, but ended up choosing bypass. Bypass is the gold standard, The only reason I’d recommend sleeve over bypass is if you’re not willing to commit to daily Vitamins for the rest of your life. Bypass causes malabsorption and vitamins are a must. I’m fine with taking a daily Vitamin and a Calcium chew each day. For me, it’s worth it.

[BlessedMomma91 21]

I'm on the fence too. Back in February/March I was sure I wanted the sleeve. My main reason is it won't mess with my mental health meds. Now I'm hearing horror stories of sleeve patients getting GERD and being forced to get the bypass for relief. I don't currently take any meds for acid reflux except an occasional Tums/Rolaids. So do I get the sleeve and risk getting GERD and hoping I have the funds later to get a revision or do I just get the bypass now and risk my my mental health meds not working? It took me years to finally find a medicine that helped my anxiety/OCD and I don't want to risk going down that terrible road again. However long lasting severe physical pain from the GERD is not good either. I may not have the finances later to get the bypass for relief. Decisions... decisions...

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[Muffinman1119 84]

Just about a month post-op sleeve here. I went with the sleeve because of lack of complications/intensiveness of the surgery compared to the bypass. My own opinion is that the bypass is for those who are incredibly morbidly obese, such as 400, 500, 600+ lbs. I think the sleeve is better geared towards those who are overweight and obese, but not to the extent of the bypass. Ultimately, it's between you and your surgeon/doctor. I wish you the best of luck!

[HeatherE 203]

1 minute ago, Muffinman1119 said:

Just about a month post-op sleeve here. I went with the sleeve because of lack of complications/intensiveness of the surgery compared to the bypass. My own opinion is that the bypass is for those who are incredibly morbidly obese, such as 400, 500, 600+ lbs. I think the sleeve is better geared towards those who are overweight and obese, but not to the extent of the bypass. Ultimately, it's between you and your surgeon/doctor. I wish you the best of luck!

I agree with you that it is a personal decision between the patient and physician. That said, I was 226 pounds at my highest and had gastric bypass (covered by insurance). It reduced my Gerd and has been fabulous for me. Duodenal switch I’ve seen recommended for morbidly obese. Sleeve or bypass can be for either. I’ve heard of cases of larger individuals getting the sleeve because they were high risk and it was less time on the operating table. Also, I had no complications after bypass. One night in the hospital, and then at the playground with my son the following day. I’m 1.5 years out, lost all my excess weight and have been maintaining my goal weight .I couldn’t be happier with my choice for bypass or my results.

[St77 87]

I had severe GERD and because of that my surgeon recommended the bypass for me. Since then the only time I've had issues with GERD is when I've had episodes of vomiting.

[LookingForward22 320]

I asked my surgeon what they recommended based on my medical history - and why.

I really thought she was going to say bypass because of my high BMI and reflux, but she suggested sleeve.

I mentioned I was taking Pepcid for reflux - but she pointed out that was only since January and mostly from my hiatal hernia… so fixing that should resolve my reflux. (Only a week out too soon to tell). When I asked about my high BMI she told me that she had some high BMI patients do very well with sleeve - but that she normally recommends a duodenal switch for high bmi and being a 10 hour surgery (with my hernia repair) she likes to do those in two stages… which this allows us that option.

Honestly I’m hoping to loose enough that I don’t need to convert. I’m not working towards a specific number - I wanted my liver to improve (it already is showing improvement) and to get healthier. When I hit the number / goal where I feel good then I’ll settle in there. Hopefully I can do that with just the sleeve.