I am hoping to have either a Gastric bypass or Gastric Sleeve in the near future. I had a gastric band approx 10 years ago.

I have 2 questions that I really hope some kind souls may be able to advise me with or share an opinion.

Question 1: Which in your opinion is the best option Gastric Bypass or Gastic sleeve.?

Question 2: As I've had a gastric band before are both of these options avaiilable to me.

Many thanks in advance for any help or support. I really appreciate it.

Lou

Edited March 18, 20233 yr by LouiseCorn

Full disclosure, I haven't had surgery yet, but I wanted to share how I made my decision (surgergy is April 24th). I chose gastric bypass (RNY) because I have GERD, and the overall outcome is slightly better than sleeve. There are pros and cons on both surgeries, so it really comes down to what you're willing to live with. And what actually transpires is different for everyone, so there is no way to predict what will happen until after the procedure. For example, RNY can cause dumping syndrome, and sleeve can increase GERD, but not in everyone. I recommend doing your research and speaking with your surgeon about any concerns you have. It is such a big decision. Best of luck!

I will be having surgery soon and I chose gastric bypass (RNY) because I was just diagnosed with T2 diabetes and the remission rates for T2 are better with RNY than sleeve. Also, I did not want to risk GERD with the sleeve and have to go through a corrective surgery later.

I had the sleeve and chose it for these reasons: 1) I don’t have GERD, just occasional acid reflux, 2) the sleeve doesn’t re-route inner plumbing, 3) i have less weight to lose overall, 4) the sleeve has a higher absorption rate which I prefer and 5) I can revise to RNY if the sleeve doesn’t work, fails or causes GERD.

This doesn’t mean RNY is bad. My mom had RNY and it worked great for her. She lost over 125lbs and it helped correct her GERD. She also deals with malabsorption issues, had her gallbladder removed last year and struggles with dumping syndrome. All of these are okay with her. To this day, she wouldn’t change her mind. She’s also kept the weight off for over a decade easily.

I recommend talking to your doctor about YOUR specific issues/lifestyle and what you’re willing to live with.

there's not really a best option. They're both good surgeries and you'll find people on here who've been very successful with both.

there are some medical conditions that might make one surgery more appropriate for you than the other (for example, GERD), but if you don't have any of those conditions, it really comes down to personal preference.

I chose bypass because I had reflux issues before I had surgery. There's a chance sleeve can make those worse, whereas bypass usually improves or even cures them. So I decided not to risk it and went with bypass. I've been very happy with my bypass and would make the same choice if I had to decide today. But you'll find people who are just as happy with their sleeve.

I know it's a hard decision. Even with my reflux issues, I still went back and forth before deciding for sure.

P.S. in response to the comment above, malabsorption issues aren't very common as long as you keep on top of your supplements (most sleevers have to take supplements as well - although the consequences aren't as severe if you slack off). Also, about 30% of bypass patients dump, but it can be controlled by limiting the amount of sugar and fat you eat at one sitting. So those issues really didn't affect my decision. For me it came down to my reflux issues - and the fact that at the time I had my surgery almost eight years ago, sleeve was still kind of new, and I was more comfortable with a surgery that had a lot of history and research behind it. The latter reason wouldn't really apply today because the sleeve has now been around long enough to prove itself, but I personally would have still gone with RNY because I didn't want to take the risk of having my GERD getting worse (it doesn't happen to everyone - and not even to the majority - but I was worried I'd turn out to be one of the unfortunate ones, and I didn't want to go there)

I think the suggestion to talk to the surgeon about your lifestyle, etc, is a good one. It might help you make a decision. Good luck, though - I know it's not an easy decision.

As @catwoman7 said both surgeries are good & will work to help you lose your weight. And you’ll hear from people who swear one or the other is the best. But remember it was best for them. Do lots of reading including people’s stories & experiences here, ask your surgeon lots of questions & for their recommendation. The decision will come down to your personal health & medical needs & history & your personal choice on how you want to live your life.

Both share some similar considerations in regard to dumping & malabsorption, the post surgical recovery & plans (differences are more from surgeons or your specific needs). Dumping & malabsorption are possible with both but a little less common with sleeve - luck of the draw - but both can be managed. I don’t dump but I do have some malabsorption (protein & some meds) but it’s from my lack of gall bladder not my sleeve & I don’t need to take additional vitamins.

I was leaning towards a sleeve from my research and after my conversation with my surgeon, who thought it would work best for me, I decided it was for me. I had mild reflux which I managed 99% with dietary choices (still do, it’s different, need meds every day but is manageable). Decided if I needed to (for gerd, extra weight loss help, etc.) I could revise to bypass in the future. I didn’t want to depend on vitamin supplements if I could. I didn’t have any co morbidities. I lost all my weight & more with my sleeve & have maintained (+ 1 kg).

All the best whichever surgery you choose.

Chat to your surgeon, they have years of experience and knowledge.

I went with RNY b/c I had GERD issues (which 100% went away after my RNY!). I also don't take any medications, so wasn't concerned about malabsorption, etc.

I've been very happy with my results, but also know many VSG people who are just as happy! All a matter of personal choice! Good luck!!

15 hours ago, catwoman7 said:

there's not really a best option. They're both good surgeries and you'll find people on here who've been very successful with both.

there are some medical conditions that might make one surgery more appropriate for you than the other (for example, GERD), but if you don't have any of those conditions, it really comes down to personal preference.

I chose bypass because I had reflux issues before I had surgery. There's a chance sleeve can make those worse, whereas bypass usually improves or even cures them. So I decided not to risk it and went with bypass. I've been very happy with my bypass and would make the same choice if I had to decide today. But you'll find people who are just as happy with their sleeve.

I know it's a hard decision. Even with my reflux issues, I still went back and forth before deciding for sure.

P.S. in response to the comment above, malabsorption issues aren't very common as long as you keep on top of your supplements (most sleevers have to take supplements as well - although the consequences aren't as severe if you slack off). Also, about 30% of bypass patients dump, but it can be controlled by limiting the amount of sugar and fat you eat at one sitting. So those issues really didn't affect my decision. For me it came down to my reflux issues - and the fact that at the time I had my surgery almost eight years ago, sleeve was still kind of new, and I was more comfortable with a surgery that had a lot of history and research behind it. The latter reason wouldn't really apply today because the sleeve has now been around long enough to prove itself, but I personally would have still gone with RNY because I didn't want to take the risk of having my GERD getting worse (it doesn't happen to everyone - and not even to the majority - but I was worried I'd turn out to be one of the unfortunate ones, and I didn't want to go there)

I think the suggestion to talk to the surgeon about your lifestyle, etc, is a good one. It might help you make a decision. Good luck, though - I know it's not an easy decision.

47 minutes ago, ChubRub said:

I went with RNY b/c I had GERD issues (which 100% went away after my RNY!). I also don't take any medications, so wasn't concerned about malabsorption, etc.

I've been very happy with my results, but also know many VSG people who are just as happy! All a matter of personal choice! Good luck!!

Thank you so much for taking the time to respond. I had decided more or less before that the sleeve was the way to go for me. I like the idea of less being done inside to re-route things with the prospect of a hernia etc later on. As I say Ihae had Gastric band previously for over 10 years and the lifestyle/eating regime is very very similar so not a lot Im not sure about apart from you don't experience dumping syndrome.

I also need to check with my surgeon that as I have had a gastric band before after having sepsis and it being removed in an emergency op what damage if any this may have caused my stomach. Luckily I am having the same surgeon who put my band in and took out again and I trust him implicitly (he saved my life before, my husband was told it was very touch and go that I would survive).

15 hours ago, Arabesque said:

As @catwoman7 said both surgeries are good & will work to help you lose your weight. And you’ll hear from people who swear one or the other is the best. But remember it was best for them. Do lots of reading including people’s stories & experiences here, ask your surgeon lots of questions & for their recommendation. The decision will come down to your personal health & medical needs & history & your personal choice on how you want to live your life.

Both share some similar considerations in regard to dumping & malabsorption, the post surgical recovery & plans (differences are more from surgeons or your specific needs). Dumping & malabsorption are possible with both but a little less common with sleeve - luck of the draw - but both can be managed. I don’t dump but I do have some malabsorption (protein & some meds) but it’s from my lack of gall bladder not my sleeve & I don’t need to take additional Vitamins.

I was leaning towards a sleeve from my research and after my conversation with my surgeon, who thought it would work best for me, I decided it was for me. I had mild reflux which I managed 99% with dietary choices (still do, it’s different, need meds every day but is manageable). Decided if I needed to (for gerd, extra weight loss help, etc.) I could revise to bypass in the future. I didn’t want to depend on Vitamin supplements if I could. I didn’t have any co morbidities. I lost all my weight & more with my sleeve & have maintained (+ 1 kg).

All the best whichever surgery you choose.

I have completed all my classes, I see the surgeon on Thursday (3/23) then I am told my surgery will be 5-6 weeks out from there, I keep going back and forth on which one to have, Bypass or Sleeve. I have Gerd bad, and its been getting worse, and I am morbidly over weight and need to loose like over 150lbs, so the bypass was recommended, but I hear and have been reading so many stories about dumping and not being able to eat a lot of certain foods anymore and I am not sure I want to live like that the rest of my life. I am a very picky eater all ready and i am worried the things i do like I wont be able to eat at all and then what??? Maybe I am just thinking to much into this, I just don't know but I need to decide in 3 days!!