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Why did you prefer Gastric Sleeve over Gastric Bypass?



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I chose sleeve over bypass because at the time it was considered a safer profile surgery with the same effectiveness.

I had other medical conditions I needed to focus on and could not risk dealing with complications. It still makes sense to that past nervous version of me. However this version of me (which needed to be revised from sleeve to bypass from complications from sleeve 🤣) would choose differently.

All things considered, All things being equal and if I had to choose again I would pick bypass over sleeve (especially if I was a self pay patient or my insurance excluded revisions).

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My surgeon and I spoke about my other health diagnosis and food habits at length. I was very adamant about wanting to be able to eat a variety of foods after if possible. Since I didn’t have previous GERD issues, and based on my other health and meds requirements, she suggested the sleeve was the best option. I also in my research saw there were just a few less complications with it so I was comfortable with that.

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I did some of my own research first and I had a friend who had got a sleeve about a year previously and I picked her brain a bit. The surgeon went through each of the surgeries listing pros & cons of each. He also discussed my eating habits and weight loss and gain history. Though I had reflux I managed it with dietary choices and maybe took medication 5 times a year he still recommended the sleeve because of my history & eating habits and I had no co morbidities or other health concerns. It was the way I was leaning too so the decision was easy after that.

My brother recently had sleeve surgery too. He didn’t have any co morbidities either. The surgeon said he would be considered very healthy for someone in a healthy weight range let alone some one at his weight and recommended sleeve because of that. (Interestingly it was the same surgeon but my brother didn’t know the name of my surgeon to tell him he’d done my sleeve too.)

Edited by Arabesque

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Sleeve was recommended to me by the surgeon as I have pernicious anaemia and after reading up on both I felt the sleeve was more for me, so I could be in more control, especially given that I could then get a revision to bypass if needed.

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I got the bypass because I had bad gerd and also I hear regain is harder so yay!

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For the longest time I wasn't even eligible for any bariatric surgery, by the time I reached BMI 33 (which still doesn't make me eligible in some regions), I also had no comorbidities and no past history of obesity (only was overweight for the past 5 years and most of my weight was gained after a very bad ankle sports injury). I needed to lose weight to relieve my ankle pain, so my surgeon only agreed to VSG.

Surprisingly though, I've occasionally gotten very bad indigestion pain that caused me a lot of discomfort, which is considered a symptom of GERD, but I haven't had any episodes except for maybe twice this entire year post VSG and only took medication twice, which I'm thankful for.

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Well, you didn't ask, but I'll let you know why I chose bypass vs sleeve:

  • On average, bypass generally leads to a slightly higher percentage of excess weight loss. I wanted every advantage I could get.
  • Because it has a bigger restriction and also has a non-absorption component, it's generally considered more suitable for severely obese people, which is where I started.
  • Although I really had no history of GERD, they discovered something during my workup that made the surgical team concerned that sleeve could lead to GERD for me.
  • Bypass is completely reversible, unlike sleeve. In a sleeve procedure, the "unused" part of your stomach is removed from your body and disposed of. In a bypass, even though it's a more complex surgery overall, nothing is removed. If there were ever a need, it's possible to put everything back like it was.

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Sorry posts duplicating today!

Edited by Spinoza

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Just now, Spinoza said:

Oh this is so interesting. Having seen your other posts OP I think you're still just at the stage of considering all options? Can you tell us a bit more about yourself and we might be able to help more? What's your current weight/BMI, activity level, co-morbidities, etc?

I chose sleeve over bypass because it needed the least anatomical rearrangement. I thought that the less internal stitching of parts to other parts the better. 2/3 of my stomach being removed didn't bother me at all - in fact I welcomed that because I could eat mega amounts pre-op. Also the physical removal of stomach tissue I think immediately cuts down hunger hormones (although they eventually recover unfortunately). I know the bypass is more metabolically significant though. If you have diabetes that might be the one for you? Not sure - I didn't.

Also I hated the prospect of dumping - I know it does happen with sleeves but not nearly as much and I've been lucky and not had that.

I did have reflux but it was well controlled with PPIs and it had always gotten better when I had lost significant weight at other times. So I gambled on it getting better again and I was lucky and it did.

I will admit that a tiny part of getting the sleeve was to keep my options slightly open and have an escape hatch too - there was the option to revise the surgery if I hadn't lost what I wanted or needed, or developed significant side effects. Although my surgeon did not at all like that thinking - he treats WLS as a once in a lifetime opportunity.

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