Deciding between bypass & sleeve

[pinkneymm@aol.com 3]

Hi. I’ve just started my journey. I’m leaning towards the sleeve. How did you make your decision?

[Bypass2Freedom 1,001]

Hey! Welcome! And congratulations on starting your journey.

I spoke to my surgeon about the options available, and discussed my health and any conditions I had (PCOS & underactive thyroid), and he recommended a bypass. I initially wanted a sleeve, but I listened to what the professional suggested and it really helped me make my decision!

[summerseeker 2,380]

I looked at the price. Sleeve was 5K less than bypass

I chatted to the surgeon. He recommended Sleeve

I had sleeve.

With hindsight, I should have opted for Bypass because I have post surgery GERD

I flipped when I should have flopped as we say here

[catwoman7 11,278]

they're both good surgeries. There are some health conditions that would make one surgery more appropriate than the other for you, though. Your surgeon will - or should - let you know their thoughts - but if they say you're a good candidate for either, then it really comes down to personal preference.

I had the bypass and love it - and I would make the same decision today. I went with bypass because I had GERD prior to surgery. My surgeon said that although he'd do either surgery, he'd recommend that I least consider the bypass because of my past GERD. The risk of my GERD getting worse with the sleeve was about 30%, and it wasn't worth the risk to me. Another reason was that when I had surgery nine years ago, the sleeve hadn't been done as a standalone surgery for very long - it was just then overtaking the lap band as the non-RNY option. I didn't really want to go with something that didn't yet have a proven track record or much research behind it. However, at this point, the sleeve has been around long enough that I'd no longer have that particular concern, but I'd still go with bypass in my case because of my prior GERD.

[AmberFL 1,065]

I went with the sleeve. There are more restrictions with the bypass than the sleeve, so I asked My doc what he thought and he suggested the sleeve. I have been doing great thus far with it.

[NickelChip 1,358]

I went with the bypass because it had the better chance of resolving my issues with hypertension, cholesterol, and blood sugar, and much better chance of not developing GERD. I also know the 10-year weight loss/regain numbers are a bit better for bypass. And, just a minor consideration, but I felt better not having part of my body removed. I know, I had my intestines rerouted and all that, but my stomach is still in there and somehow that made me have more peace of mind.

2 weeks out today and my recovery has been fantastic. My doctor moved me along to basically a regular solid food diet at my appointment, with just some restrictions regarding excluding beef/pork/lamb and raw veg for a few more weeks. I've had no issues, only minor pain the first few days, and I feel fantastic. I can walk for an hour or more at a time with no problem. My recovery has been much easier than my brother's when he had the sleeve several years back, though not sure if that has anything to do with the surgery type.

[The Greater Fool 2,071]

I went with Bypass because the sleeve wasn't an option back when I had surgery. The lab-band was an option and all the sales points for sleeve now were the selling points for lap-band then. The problems with lap-band weren't well known at that time.

If the sleeve was available I'm pretty sure I would have still chosen Bypass. Other than being extremely over weight, my core health was pretty solid, but I could see that about to change. I was a binge eater and wanted a surgery that would restrict meal volume which I believe both Bypass and Sleeve would have achieved.

I also wanted the additional bit of malabsorption that comes with the bypass. Then comes the possibility of dumping which at the time I had surgery was about a 50/50 chance. I hoped I would get dumping and as it turned out, I dump on both sugars and fats. It took an amazingly few bouts of dumping to keep my eating in alignment with not dumping. So with restricted volume and very limited amounts of sugar and fats, how could I not succeed?

Good luck,

Tek

[Spinoza 1,518]

So interesting to read these replies - we all come from such different places! I was also a binge eater. I went for the sleeve because it felt less disruptive to my anatomy - didn't mind at all losing a big chunk of stomach. I also actively did NOT want a high risk of dumping (although I know some sleevers do). My one worry was my reflux getting worse. I gambled on it not getting worse because any other time I had lost a significant amount of weight it had actually improved. I won my gamble. The sleeve is suiting me very well so far.

[RnYBabe 36]

I went with the bypass as bypass patients tend to lose more weight as well as suffer less from GERD. I did not want to develop reflux and have to go through a revision if I could avoid it. I'm very happy with my decision, I only had about 100 lbs to lose and am already more than 2/3 of the way to my goal 5 months in.

[BlondePatriotInCDA 593]

On 3/5/2024 at 10:50 PM, pinkneymm@aol.com said:

Hi. I’ve just started my journey. I’m leaning towards the sleeve. How did you make your decision?

For me the decision was fairly easy, I didn't want to risk GERD chances (I have the worst luck and if there was a chance - even a small one I'd get it) and I didn't want to risk yet another surgery AND the possibility of my insurance declining another bariatric surgery.

The second reason was usually you lose more weight with a bypass and I've had a few surgeries with organs removed...I just wanted at least one after a surgery (my stomach) to not being one of them, stupid I know but ...its what helped me decide.

Lastly, I'm a researcher and all the numbers in the medical studies journals / research papers looked better to me they pointed to better overall outcomes with bypass, more weight lost, less weight regain, better chances of reducing my pre-diabetes etc. I'm fairly anal retentive so I knew I'd be the same way on making sure I took my Vitamins so I didn't worry about that aspect of it.

I listened to my surgeon who didn't really help..he said both were good choices for me, so that left me having to research on my own.

Good luck on your journey!

Edited March 17, 2024 by BlondePatriotInCDA

[cutlass6521 127]

Hello Everyone:

I am getting my gastric band removed on May 17 and going with the gastric sleeve as per my surgeon's suggestion. He feels I will do well with it. I managed to lose 150lbs with the band ( surgeon told me it was not a typical result). I started having trouble getting food to go down. I guess I created a pouch and have a lot of scar tissue. Had to have all the Fluid taken out of the band while I was in Nevada. The surgeon performing this (not easy to find anyone in Las Vegas who would even look at removing the fluid) advised what was going on. There are only 5% of surgeons still installing the band in the entire country. Many, many complications with it. I was fine until a year ago. Had fluid put in (the doctor back home put too much in), then the chest and back pains started. Food would go down sometimes and sometimes not. I managed to regain 15lbs. Struggling every day. I hope the revision to the sleeve will be a success.

[lily06 54]

It’s really interesting reading about how and why everyone chose their surgery

My surgeon actually told me at the very earliest : he would not make the choice for me as if i wasn’t the one making the surgery type choice it opened up the possibility of regretting whichever i went with.

I asked him what he recommended he told me there are no specific advantages of bypass over sleeve or vice versa.

He did however explain that 30% of vsg patients end up with GERD (especially it already having reflux without surgery) and that dumping was way more frequent in bypass patients.

He also told me that age factors in : younger women for example can use the sleeve then may need to convert to bypass later in life (after several pregnancies for example) to continue being able to face fluctuating weight from such events.

In the end i went with the sleeve, hoping i wouldn’t be one of the 30% who develop GERD. 1 month post up tomorrow - So far so good no reflux but i am taking medication that could be masking it

[Jalapeño 13]

I have always had a dilemma about the sleeve, because patients can expand their stomach pouch, by poor compliance. The majority of people who have bariatric surgery experience psychological problems with their relationship with food rather than a physiological problem. Therefore, not withstanding a brain transplant, I don't think a sleeve would be successful for such individuals. I think that's one of the main reasons for revision from sleeve to bypass. With bypass, this is my own experience, you can eat as much as you want, but you don't put on the weight. I feel sleeve is suited to people who need a helping hand to lose weight but are strong enough to comply with a lifestyle diet change. Those of us who would continue to struggle with our relationship with food regardless, I think are better candidates for the bypass. The bypass comes in various strengths.

There are several variations of the bariatric gastric bypass surgery, including:

1. Roux-en-Y gastric bypass (RYGB)
2. Mini gastric bypass (MGB)
3. Biliopancreatic diversion with duodenal switch (BPD/DS)

and

While Roux-en-Y gastric bypass, mini gastric bypass, and biliopancreatic diversion with duodenal switch are the most well-known variations, there are other less common types of gastric bypass surgeries, including:

1. Single Anastomosis Gastric Bypass (SAGB)
2. Loop Gastric Bypass
3. Sleeve Gastrectomy with Transit Bipartition

[NeonRaven8919 584]

I chose the sleeve. My mother had the bypass back in 2008 and had a lot of problems. She couldn't keep anything down for months after the sugery and the had to operate again and they made a mistake. So she basically couldn't really eat anything at all and suffered for years. She had a bowel perforation due to clot in April of 2023 that they couldn't diagnose until a month later and they couldn't repair because of what went wrong with her bypass surgery and she died in May of 2023. So I'm too afraid of having the same kind of problems. It's not the same hospital or the same surgeon, but I'm still scared.

I did wonder if I should even consider any type of surgery at all, but my mother did lose weight and it did extend her life.