RNY vrs VSG
I am very happy with my sleeve!! My doctor states that you lose about the same as the RNY without all the complications of the RNY.
You don't have some of the serious problems that you do with the RNY like malabsorbtion and the dumping syndrome because your body can function and absorb its nutrition exactly the same way as it did before. The only difference is you have a much smaller stomach and therefore eat much less. You lose none of your small intestine which is where we get our nutrients from our food.
I have a friend who had the RNY done about 7-8 years ago and she is having some serious health issues because of the malabsorbtion. She is having extensive dental work done and has lost some bone density in her hip bones due to not being able to absorb vitamin D. She has to take vitamin B12 shots on a weekly basis. This is a person who followed the doctor's instructions faithfully (still does) and took the daily vitamins, got plenty of protein, etc.
My doctor said that the VSG was first done on patients who were too large to undergo RNY surgery. It was thought that they would lose about 50% of their excess weight with the sleeve and then come back and get the RNY for the other 50%. They found that people lost all of their excess weight with the sleeve and never had to have the second surgery. The VSG started gaining notice in the medical community and more started being performed. The major medical insurance companies just started approving coverage for the VSG about 24 months ago which opened it up for people who could not afford to pay cash.
I haven't had any problems and the surgery and recovery went very well. The only other surgery I have had was a full hysterectomy and this was a walk in the park compared to it.
Hope this helps you in your decision making.
You don't have some of the serious problems that you do with the RNY like malabsorbtion and the dumping syndrome because your body can function and absorb its nutrition exactly the same way as it did before. The only difference is you have a much smaller stomach and therefore eat much less. You lose none of your small intestine which is where we get our nutrients from our food.
I have a friend who had the RNY done about 7-8 years ago and she is having some serious health issues because of the malabsorbtion. She is having extensive dental work done and has lost some bone density in her hip bones due to not being able to absorb vitamin D. She has to take vitamin B12 shots on a weekly basis. This is a person who followed the doctor's instructions faithfully (still does) and took the daily vitamins, got plenty of protein, etc.
My doctor said that the VSG was first done on patients who were too large to undergo RNY surgery. It was thought that they would lose about 50% of their excess weight with the sleeve and then come back and get the RNY for the other 50%. They found that people lost all of their excess weight with the sleeve and never had to have the second surgery. The VSG started gaining notice in the medical community and more started being performed. The major medical insurance companies just started approving coverage for the VSG about 24 months ago which opened it up for people who could not afford to pay cash.
I haven't had any problems and the surgery and recovery went very well. The only other surgery I have had was a full hysterectomy and this was a walk in the park compared to it.
Hope this helps you in your decision making.
I doubt you will find a single person here who would EVER get an RNY over a sleeve. Maybe a DS (duodenal switch) in some cases....but not an RNY. Why?
1. Severe vitamin issues due to malabsorption several years out (while calorie absorption rebounds)
2. No pyloric valve = dumping in some people, reactive hypoglycemia, etc
3. Higher risk of ulceration in pouch
4. Limited medicine use (no more NSAIDS)
5. A properly done sleeve will have nearly the same expected weight loss with less side effects.
Your doctor was right to recommend the sleeve to you.
1. Severe vitamin issues due to malabsorption several years out (while calorie absorption rebounds)
2. No pyloric valve = dumping in some people, reactive hypoglycemia, etc
3. Higher risk of ulceration in pouch
4. Limited medicine use (no more NSAIDS)
5. A properly done sleeve will have nearly the same expected weight loss with less side effects.
Your doctor was right to recommend the sleeve to you.
This is my standard reply when this question pops up every couple of days. I won't try to sway anyone one way or another, but I'll give you my reasons for choosing VSG over RNY for my revision from the band. You can also check out the revision, failure, and food issue forums on here to get an idea of some long term RNY patients. For me, it was never an option. The cons outweighed the pros.
The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.
1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.
2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.
3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.
4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me
5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.
6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,
7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.
8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.
9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.
I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!
Best wishes in your research!
P.S. I wrote this before pregnancy. And, just as an update, I'm almost 8 months pregnant and thriving. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.
The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.
1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.
2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.
3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.
4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me
5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.
6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,
7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.
8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.
9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.
I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!
Best wishes in your research!
P.S. I wrote this before pregnancy. And, just as an update, I'm almost 8 months pregnant and thriving. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.
Band to VSG revision: June 3, 2009
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
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