VSG vs RNY

[LaurieLee]

Hi, I have my consultation with my surgeon later this week. When I first started this journey, I was definitely going to have the sleeve. I have no reflux issues, diabetes, or high blood pressure and thought it would be least invasive. I have 120lb to lose and I am 56 years old. Now after reading the various posts, I am more confused then ever. It seems like most people who have the sleeve convert to bypass years later or do bypass to start. I am wondering if I should just go with the bypass to begin with. Maybe it is just people who had difficulties with the sleeve that post and others who have no problems haven't. Can I hear from some successful sleeve people or are there not any? I want to make an informed decision but also don't want to have another surgery in a few years. Of course, I will discuss all of my concerns with my surgeon, I just want to get some other opinions. Thanks in advance.

 

[dianeseattle]

When I had RYGB 14 years ago, the sleeve was not offered. Not only that, but laparascopic surgery wasn't available.

So I had an open procedure with a 7" incision and my gallbladder was removed (with 7 stones inside) at the same time.

My recovery was the same as anyone who had major surgery. It was painful, uncomfortable and successful. I lost 35 pounds the first month, 25 the second, and 15 the third. I stalled for a few months, nut then continued to drop about 15 pounds a month until I'd lost 115 pounds, 14 months after surgery.

In this group, my perception of the sleeve is that it's worked very well for most people. It's less invasive and recovery is easier. But I haven't read many accounts of sleeve recipients dropping 75 pounds in 3 months.

That doesn't mean the sleeve is less effective. But I think there's less nutrient absorption with the sleeve because the path to digestion is favored by gravity. Maybe because it's less involved and uncomfortable, people can be less compliant with the sleeve. If you mess with the digestive path of RYGB, your body will protest bigtime.

Now, this isn't true for everyone. Your body may not react the same way. Depending on your starting weight and state of health, it can be easier or harder. Although my numbers were phenomenal, I started at 240. Someone starting at 300 or more might lose a lot more, quickly. But damage in an obese body is often more severe at 300 than 240, so a lot more discomfort can happen.

Still, people who have the sleeve give glowing reports, and thanks to laparoscopy, they recover faster.

In the end, its a holistic experience, and your personal motivation, commitment and compliance have more to do with your success than the procedure you choose.

I also grieved the loss of the active life I had before i got fat. I joined the YMCA, trained for mountain hiking and walked 7 miles on a treadmill, watching tv (it was an exciting election year) 6 or 7 days a week.

And i had to buy NEW CLOTHES, which, for me, meant haunting the thrift stores. I still have most of those clothes and dressing up is still fun. I bought a Slimsuit and constantly took photos of my fit, firm body for my boyfriend. He actually thought I was too skinny, so I dumped him.

Sleeve or RYGB: if you have a goal, it doesn't matter.

 

[3momchaos]

I think a lot of people who end up going from sleeve to bypass ended up having reflux or other issues. I was going to have the sleeve sleeve, but I had slight reflux and family history of it as well. My surgeon felt that with my thyroid problems and weight I wanted to lose, 100lbs, bypass would be more successful. He would have done the sleeve if that’s what I wanted, but after seeing some signs of reflux during my EDG, I went ahead and decided on the bypass so I didn’t have to do the conversion.

 

[JudyNY]

I had VSG on June 25, 2020 so I am almost at my 1 year point. My weight at my first appointment was 344 and by the time my surgery date came around I was down to 300 (that took 5 months). Today I am about 208-210 ( I only weigh myself on Wednesdays) so I did lose a significant amount with the sleeve.

I knew a few people who had VSG and my primary doctor and my cardiologist both recommended the sleeve. (I was a previous lap-band patient who had regain). When I went in for my first appointment with the surgeon I pretty much had my mind made up to go with the sleeve because I heard so many good things about it. He really didn't even try to point out what the benefits of RNY would be or try to change my mind. Plus I wanted the least invasive procedure which is why years ago I had lap-band surgery and not RNY. So honestly he probably viewed me as someone who knew what they wanted and he just rolled with it.

I have to say that after listening to many here who have had RNY and more importantly watching a few YouTube videos by Dr. Matthew Weiner, that perhaps I should have had RNY since I had more weight to lose. But, it is too late now and I am thankful with all the weight I have lost. I am just hoping I can still lose some more as I've been in a holding pattern for the last 2 months.

Good luck with your journey and check out as much as you can about both surgeries, then decide what you think is best for you.

 

[WazzuCoug]

I have a very good friend who is 10 years post-op VSG and is still 100 lbs down from her starting weight and no complications. In other social media circles I participate in, there are many people who are several years post-op with the VSG and doing great. You can be successful with either surgery. The difference in weight loss between the two is fairly minimal, but the RNY has a bit of an edge there, although there are plenty of people getting the sleeve and losing 100 to 150+ lbs. Success is primarily centered on biology and life long food choices and healthy habits. Likewise, you can also regain weight after either surgery as well, so either option takes a new relationship with food for the long term.

There is a risk of reflux issues with the VSG, which is very, very rare with the RNY. RNY has its own potential for complications. Both surgeries have risks, and both can lead you to success. It all depends on what you desire, and what level of risk you are willing to take.

I chose VSG because I wanted to keep my intestinal tract in tact, however if my surgeon had a good reason for me to get the RNY, I would have done that in a heartbeat. I have no regrets of my choice at this point, but there are a lot of years ahead, so who knows, things change. For now I'm just concentrating on keeping what I've accomplished.

If you have any concerns, the RNY is certainly a safe choice.

 

[Alocasia]

It partially depends upon how tolerant you are of significant specific food limitations required with the RNY. Understanding the specific differences in these surgeries is important.

The RNY creates a "pouch" and a restriction area between your stomach and intestines, leaves a "blind" stomach which no longer has food pass through it, and still leaves all of the original glands which produce ghrelin (the hormone responsible for creating the urge to eat and for your body to store fat). Your food will no longer be slowed and controlled by the valve in your stomach which currently controls how quickly food enters your intestinal tract (the pylorus), so consuming fats and sugars can make you EXTREMELY ill (a condition called "dumping syndrome" because the food dumps straight into your intestine). This is an extremely unpleasant experience and is why most RNY patients try to refrain from eating sugars in particular. It also reroutes part of your intestinal tract so that you aren't able to absorb all of the nutrients you consume which also means you'll be needing to watch vitamin levels and take supplements to compensate. This surgery is reversible (or can be converted to other surgeries by a surgeon skilled in that specialty).

The VSG creates a smaller stomach, not allowing you to eat at much as you currently can, but food still travels through your entire remaining stomach. Your pylorus is left intact, so that valve controls how quickly food enters your intestine and there is no dumping syndrome. The portion of your stomach which is removed is the part which contains most of the ghrelin secreting gland areas, so most patients experience less significant food cravings. There is no intestinal portion to this surgery, so no malabsorption of most vitamins (though some people do need to take iron and/or vitamin B-12 as those are partly absorbed in the stomach). Some people go to later have the intestinal bypass added if they need to achieve greater weight loss or control diabetes (which turns the surgery into a biliopancreatic diversion with duodenal switch - BPD-DS or DS for short). The VSG is not reversible as it specifically removes a portion of the stretchy area of your stomach, but the stomach can stretch out a bit over time which helps to stabilize weight loss long-term.

If you are able, I would suggest attending a support group which allows both pre-op and post-op patients to attend and ask a lot of quality of life questions of the post-ops -- how was their surgery and weight loss, how happy are they with the surgery they chose, how do they feel about their eating requirements as post-ops, did they reach and stay at their goal weight, is there anything they would do differently?

Good luck with your decision. It's such a personal choice for everyone on their journey and getting ALL of the info you can ahead of time is crucial to making the right choice for you.

 

[LaurieLee]

When I had RYGB 14 years ago, the sleeve was not offered. Not only that, but laparascopic surgery wasn't available.

So I had an open procedure with a 7" incision and my gallbladder was removed (with 7 stones inside) at the same time.

My recovery was the same as anyone who had major surgery. It was painful, uncomfortable and successful. I lost 35 pounds the first month, 25 the second, and 15 the third. I stalled for a few months, nut then continued to drop about 15 pounds a month until I'd lost 115 pounds, 14 months after surgery.

In this group, my perception of the sleeve is that it's worked very well for most people. It's less invasive and recovery is easier. But I haven't read many accounts of sleeve recipients dropping 75 pounds in 3 months.

That doesn't mean the sleeve is less effective. But I think there's less nutrient absorption with the sleeve because the path to digestion is favored by gravity. Maybe because it's less involved and uncomfortable, people can be less compliant with the sleeve. If you mess with the digestive path of RYGB, your body will protest bigtime.

Now, this isn't true for everyone. Your body may not react the same way. Depending on your starting weight and state of health, it can be easier or harder. Although my numbers were phenomenal, I started at 240. Someone starting at 300 or more might lose a lot more, quickly. But damage in an obese body is often more severe at 300 than 240, so a lot more discomfort can happen.

Still, people who have the sleeve give glowing reports, and thanks to laparoscopy, they recover faster.

In the end, its a holistic experience, and your personal motivation, commitment and compliance have more to do with your success than the procedure you choose.

I also grieved the loss of the active life I had before i got fat. I joined the YMCA, trained for mountain hiking and walked 7 miles on a treadmill, watching tv (it was an exciting election year) 6 or 7 days a week.

And i had to buy NEW CLOTHES, which, for me, meant haunting the thrift stores. I still have most of those clothes and dressing up is still fun. I bought a Slimsuit and constantly took photos of my fit, firm body for my boyfriend. He actually thought I was too skinny, so I dumped him.

Sleeve or RYGB: if you have a goal, it doesn't matter.
View attachment 3856
View attachment 3857View attachment 3858View attachment 3859

Thank you!

 

[LaurieLee]

It partially depends upon how tolerant you are of significant specific food limitations required with the RNY. Understanding the specific differences in these surgeries is important.

The RNY creates a "pouch" and a restriction area between your stomach and intestines, leaves a "blind" stomach which no longer has food pass through it, and still leaves all of the original glands which produce ghrelin (the hormone responsible for creating the urge to eat and for your body to store fat). Your food will no longer be slowed and controlled by the valve in your stomach which currently controls how quickly food enters your intestinal tract (the pylorus), so consuming fats and sugars can make you EXTREMELY ill (a condition called "dumping syndrome" because the food dumps straight into your intestine). This is an extremely unpleasant experience and is why most RNY patients try to refrain from eating sugars in particular. It also reroutes part of your intestinal tract so that you aren't able to absorb all of the nutrients you consume which also means you'll be needing to watch vitamin levels and take supplements to compensate. This surgery is reversible (or can be converted to other surgeries by a surgeon skilled in that specialty).

The VSG creates a smaller stomach, not allowing you to eat at much as you currently can, but food still travels through your entire remaining stomach. Your pylorus is left intact, so that valve controls how quickly food enters your intestine and there is no dumping syndrome. The portion of your stomach which is removed is the part which contains most of the ghrelin secreting gland areas, so most patients experience less significant food cravings. There is no intestinal portion to this surgery, so no malabsorption of most vitamins (though some people do need to take iron and/or vitamin B-12 as those are partly absorbed in the stomach). Some people go to later have the intestinal bypass added if they need to achieve greater weight loss or control diabetes (which turns the surgery into a biliopancreatic diversion with duodenal switch - BPD-DS or DS for short). The VSG is not reversible as it specifically removes a portion of the stretchy area of your stomach, but the stomach can stretch out a bit over time which helps to stabilize weight loss long-term.

If you are able, I would suggest attending a support group which allows both pre-op and post-op patients to attend and ask a lot of quality of life questions of the post-ops -- how was their surgery and weight loss, how happy are they with the surgery they chose, how do they feel about their eating requirements as post-ops, did they reach and stay at their goal weight, is there anything they would do differently?

Good luck with your decision. It's such a personal choice for everyone on their journey and getting ALL of the info you can ahead of time is crucial to making the right choice for you.

Thank you!

 

[LaurieLee]

I have a very good friend who is 10 years post-op VSG and is still 100 lbs down from her starting weight and no complications. In other social media circles I participate in, there are many people who are several years post-op with the VSG and doing great. You can be successful with either surgery. The difference in weight loss between the two is fairly minimal, but the RNY has a bit of an edge there, although there are plenty of people getting the sleeve and losing 100 to 150+ lbs. Success is primarily centered on biology and life long food choices and healthy habits. Likewise, you can also regain weight after either surgery as well, so either option takes a new relationship with food for the long term.

There is a risk of reflux issues with the VSG, which is very, very rare with the RNY. RNY has its own potential for complications. Both surgeries have risks, and both can lead you to success. It all depends on what you desire, and what level of risk you are willing to take.

I chose VSG because I wanted to keep my intestinal tract in tact, however if my surgeon had a good reason for me to get the RNY, I would have done that in a heartbeat. I have no regrets of my choice at this point, but there are a lot of years ahead, so who knows, things change. For now I'm just concentrating on keeping what I've accomplished.

If you have any concerns, the RNY is certainly a safe choice.

Thank you!!

 

[LaurieLee]

I had VSG on June 25, 2020 so I am almost at my 1 year point. My weight at my first appointment was 344 and by the time my surgery date came around I was down to 300 (that took 5 months). Today I am about 208-210 ( I only weigh myself on Wednesdays) so I did lose a significant amount with the sleeve.

I knew a few people who had VSG and my primary doctor and my cardiologist both recommended the sleeve. (I was a previous lap-band patient who had regain). When I went in for my first appointment with the surgeon I pretty much had my mind made up to go with the sleeve because I heard so many good things about it. He really didn't even try to point out what the benefits of RNY would be or try to change my mind. Plus I wanted the least invasive procedure which is why years ago I had lap-band surgery and not RNY. So honestly he probably viewed me as someone who knew what they wanted and he just rolled with it.

I have to say that after listening to many here who have had RNY and more importantly watching a few YouTube videos by Dr. Matthew Weiner, that perhaps I should have had RNY since I had more weight to lose. But, it is too late now and I am thankful with all the weight I have lost. I am just hoping I can still lose some more as I've been in a holding pattern for the last 2 months.

Good luck with your journey and check out as much as you can about both surgeries, then decide what you think is best for you.

Thank you!

 

[LaurieLee]

I had my consultation with my doctor and he recommended RNY so that is what I am going with. I have slight GERD and he doesn't want that to get worse if I have VSG. Now I only need to have my psych eval and nutrition assessment and I am good to schedule the surgery.

 

[JudyNY]

I had my consultation with my doctor and he recommended RNY so that is what I am going with. I have slight GERD and he doesn't want that to get worse if I have VSG. Now I only need to have my psych eval and nutrition assessment and I am good to schedule the surgery.

I think that is a wise decision since you have some GERD. Surgery won't be long now, good luck with everything!

 

[Tokash]

If you have GERD have the full bypass done. I did the sleeve and at times have horrible issues. Apparently I had some mild issues prior to surgery based on my stech lining. If I could go back I would have done the full bypass to prevent this. It doesn't seem to take much to have a flare up and it can last a day to weeks. The last 2 weeks have not been pleasant amd then all of the sudden it seems to have stopped until next time.

 

[LaurieLee]

I have my surgery (RNY) scheduled on July 29. Yay!

 

[Bill sperry]

I was advised to get RNY because of acid reflux . After the surgery a year and a half later I haven’t had Gerd once

 

[Andi]

Hi, I have my consultation with my surgeon later this week. When I first started this journey, I was definitely going to have the sleeve. I have no reflux issues, diabetes, or high blood pressure and thought it would be least invasive. I have 120lb to lose and I am 56 years old. Now after reading the various posts, I am more confused then ever. It seems like most people who have the sleeve convert to bypass years later or do bypass to start. I am wondering if I should just go with the bypass to begin with. Maybe it is just people who had difficulties with the sleeve that post and others who have no problems haven't. Can I hear from some successful sleeve people or are there not any? I want to make an informed decision but also don't want to have another surgery in a few years. Of course, I will discuss all of my concerns with my surgeon, I just want to get some other opinions. Thanks in advance.

My doctor told me that if he did the sleeve, any medical conditions that happened due to the sleeve would allow him to do a bypass without the Insurance company getting involved. If he did the Bypass first, he'd have no recourse.

 

[Roni]

I will be thinking of you on your surgery it is my birthday. I had RNY on feb 15. It is a learning experience for sure. Your bariatric team is your final say. Ask them about meals as you progress. They give you a list of foods but how to make a meal in 3-4 oz still escapes me. Be positive you can do this

 

[Hershey]

When I had RYGB 14 years ago, the sleeve was not offered. Not only that, but laparascopic surgery wasn't available.

So I had an open procedure with a 7" incision and my gallbladder was removed (with 7 stones inside) at the same time.

My recovery was the same as anyone who had major surgery. It was painful, uncomfortable and successful. I lost 35 pounds the first month, 25 the second, and 15 the third. I stalled for a few months, nut then continued to drop about 15 pounds a month until I'd lost 115 pounds, 14 months after surgery.

In this group, my perception of the sleeve is that it's worked very well for most people. It's less invasive and recovery is easier. But I haven't read many accounts of sleeve recipients dropping 75 pounds in 3 months.

That doesn't mean the sleeve is less effective. But I think there's less nutrient absorption with the sleeve because the path to digestion is favored by gravity. Maybe because it's less involved and uncomfortable, people can be less compliant with the sleeve. If you mess with the digestive path of RYGB, your body will protest bigtime.

Now, this isn't true for everyone. Your body may not react the same way. Depending on your starting weight and state of health, it can be easier or harder. Although my numbers were phenomenal, I started at 240. Someone starting at 300 or more might lose a lot more, quickly. But damage in an obese body is often more severe at 300 than 240, so a lot more discomfort can happen.

Still, people who have the sleeve give glowing reports, and thanks to laparoscopy, they recover faster.

In the end, its a holistic experience, and your personal motivation, commitment and compliance have more to do with your success than the procedure you choose.

I also grieved the loss of the active life I had before i got fat. I joined the YMCA, trained for mountain hiking and walked 7 miles on a treadmill, watching tv (it was an exciting election year) 6 or 7 days a week.

And i had to buy NEW CLOTHES, which, for me, meant haunting the thrift stores. I still have most of those clothes and dressing up is still fun. I bought a Slimsuit and constantly took photos of my fit, firm body for my boyfriend. He actually thought I was too skinny, so I dumped him.

Sleeve or RYGB: if you have a goal, it doesn't matter.
View attachment 3856
View attachment 3857View attachment 3858View attachment 3859

That's so awesome! So proud of you!