Sleeve Gastrectomy - Long term results (> 5 years)

Cengelen
on 7/14/12 7:44 am - Sweden
Me and my partner at scheduled to make a Sleeve Gastrectomy surgery later on this year. This surgery is only performed at 2 private clinics in Sweden where we live. All other clinics and hospitals do Gastric Bypass and some even Duodenal Switch.

The Sleeve Gastrectomy is a quite new method here in Sweden. The first ones were made 4 years ago, which means that long term results are not available. As this is a quite new type of procedure in Sweden, a lot of surgeons and clinics are very very negative towards this method and don't recommend it at all. A lot of, in my opinion, faulty information is spread, such as:
- Weight loss will be lower with Sleeve compared to Gastric Bypass
- Much easier, or for certain, that you gain all weight back with Sleeve, but not with Gastric Bypass
- The sleeve can be stretched easily and therefore you can eat more and gain weight
- No long term results available for Sleeve surgeries, but most likely a not effective surgery in long term.
Etc...

Our surgeon at the private clinic where we have signed in said that this method is used in the USA for a much longer time than here in Sweden.

So I would like to hear from anyone at this forum who had this surgery done more than 5 years ago. How is it going? Have you been able to keep your weight loss? Have you experienced any problems or complications due to the surgery?

Thanks a lot in advance.

/Cengelen
rhearob
on 7/14/12 8:06 am - TN
VSG on 11/02/11 with
 You are correct in that what you have been told is incorrect.

THe sleeve has been around for quite a long time.  First in use as a treatment for stomach cancer, and other stomach issues.  Next it was used as the first stage in the duodenal switch operation.  That is how the sleeve came to be used as a stand alone WLS.  Surgeons noted that patients lost the weight they needed at a good pace with just the sleeve - and didn't need the malabsorptive portion of the procedure.

Weight loss is not necessarily slower with the sleeve than with bypass.  I have lost 150 lbs in 7 months.  Look at some of the other vets on here.  As with any endeavour - you only get out of the surgery the effort you put into it.  Again, look at some of the users on here.  You will see that some post about continually making bad food choices and then complain that their weight loss is too slow or that they aren't losing.

A popular axiom is that the surgeons operate on our stomachs, not our heads.  Its very true.

Weight loss is notguaranteed with the bypass.   That is a popular myth that is often prtrayed.  There is a woman I met early on who was transferring to my clinic.  She had her surgeon tell her she could eat anything she wanted and still lose weight.  She ate ice cream and candy bars and wondered why she only lost 10 lbs.  Again, you only get out of any of these surgeries what you put into them.

Second popular axiom - The surgery is only a tool - it is not a cure for obesity.

As far as the sleeve stretching, yes and no.  You can stretch your sleeve.  You will never stretch it back out to the size of a normal stomach.  The portion of the stomach left is not very elastic.  Trust me, the first time you give yourself the foamies you will learn that the hard way.  People who are determined to not work out their head issues and do the real hard work of weight loss will find a way to eat around their sleeve.  They will either eat the wrong foods, sliders and the like, they will eat too many times a day, they will over eat.

The best thing to do is to develop new lifestyle choices early on and hold oneself accountable.  Measure your portions and only eat planned meals.  Avoud snacking and grazing.  Frisco has many posts on here about undereating your sleeve - look some of those up.

The sleeve is a fantastic surgery that has helped me turn my life around.  Note I said helped me - I did the work, the sleeve was a major tool in that work.

Bets of luck to you and your partner.  Post on here often, ask any questions.  This site can be a terrific help to you, it continues to be for me.


_____________________________________________________________________
 160 lbs lost. Surgeons Goal Reached in 33 weeks.  My Goal in 37 Weeks.

VSG: 11/2/2011; LBL+Thigh Lift+BL: 10/3/2012; Brach+Mastopexy:  7/22/2013

roxyrocks808
on 7/14/12 10:00 am - Waialua, HI
VSG on 05/30/12
You are an amazing man your posts are full of inspiration and very helpful info thx
          
theshrinkingmimi
on 7/14/12 11:04 am
VSG on 06/10/11 with
yeah, what he said
Pre-liquid diet 392; VSG'd on 6/10/11; 5'9"; SW 368/ GW 195?
          
Pounds lost: mth1=26.7; mth 2=21.2; mth 3=24.8; mth 4=13.8; mth 5=14.2;  
            mth 6=11.8; mth 7=9.2; mth 8&9= 17.2    
Kadive
on 7/14/12 4:22 pm
 Hi!

I getting ready for the VSG and need to loose 150 pounds as well. How did you manage to loose 150 in 7 months? 

Thanks!

Jessie 
rhearob
on 7/14/12 4:29 pm - TN
VSG on 11/02/11 with
 I was very strict on my diet and exercise routine.  I complied with surgeons program to the letter.  I focused on my mental issues with food and tried to learn as much as I could about both my condition and myself.  I log every bite that goes into my mouth and hold myself accountable.

Its really that simple.  You have to be committed to using the tool and your honeymoon period to focus on fixing yourself.  Many people will tell you to take "the long view" and build the habits of a lifetime during the first few months.  I would tell you spend those months working on the issues from your past life, and use the tools from there to work on building your new lifestyle habits.

I am about to enter maintenance and am actually stepping up my psychological tools to make sure that I am armed to deal with the transition and the long term.

_____________________________________________________________________
 160 lbs lost. Surgeons Goal Reached in 33 weeks.  My Goal in 37 Weeks.

VSG: 11/2/2011; LBL+Thigh Lift+BL: 10/3/2012; Brach+Mastopexy:  7/22/2013

normalagain
on 5/3/14 3:08 am

I had the sleeve over a year and a half ago and I love it.  Everything this person said is true.  I am a nurse and I was inspired to do the surgery by a co worker who had it and looked absolutely stunning! However her long term results were totally opposite from mine.  After I had my surgery she began to sabotage her surgery by eating continually and eating all the wrong things, like chips and cokes.  She lived on these and did not eat anything healthy just sugar, sugar, sugar!  She regained her weight and more and at the two year mark looked horrible.  By then I had already had my surgery and I'm glad I did not see her do thus before or I might have discounted the surgery and not had it.  But for me it is the best thing that I could have done.

I DO eat the right things and I do not eat through my sleeve, eating three small meals a day.  I have lost 61 lbs because I was right at the 30% mark  and did not need to loose all that much.  I am in my 60s and it remains to be seen if it has extended my life, but my quality of life is much better and my self esteem much improved.  My high blood pressure and high cholesterol are gone. 

My obsession with food is gone! I still like food but I am not  obsessed with it.   I have a bit of gastric reflux, but I have ways to deal with it, without the pills, which are not good for you anyway.  And the reflux is not all the time anyway. 

It was a known fact  that my co worker had mental problems, so she should have never had the surgery in the first place. So bottom line is, if you have these psychological  problems, get them fixed first and it will work for you.  If on the other hand you just love food and eat too much, but are otherwise mentally stable and happy, go for it and put your all into making it work for you.

summer24
on 7/14/12 8:33 am
All rhearob said :)

I am a four year vet, not five, but pretty far out compared to many here on the boards.  I can tell you that from my personal experience, you wield the power.  You need to establish new habits and stick to them.  After a while, they become second nature, and you will feel strange eating differently.  I had a medical emergency a month ago, needed emergency surgery and ended up losing 10 additional pounds, which was NOT what I wanted.  I have struggled putting the weight back on because I had to eat foods that I have avoided for four years.  I have accustomed myself to eat only until I feel a slight pressure in my stomach, so forcing myself to eat more has been difficult as well.

I appreciate not having to worry about malabsorption.  I have always felt that the sleeve was MY best option.  I have a friends who are approaching 7 years from her sleeve surgery and she is now struggling with some mild weight gain, but because she never developed new eating habits.  She used to think that I worried too much about sticking to my plan, but now she acknowledges that I did the right thing and wants to get her head in gear now.  As with anyone, whether you had any surgery or none, you will gain weight if you don'****ch what you eat.  The sleeve was the tool I needed to get my weight under control.

Good luck on your decision!
Louisianawench
on 7/14/12 8:34 am, edited 7/14/12 8:36 am - New Orleans, LA
VSG on 03/21/12
I Had a VSG in March this year.I have lost over 100 lbs since the procedure. I eat very small amounts of food because I feel so full, so quick. I personally don't think I would be able to stretch out my sleeve. Once I'm full, thats it. My stomach will not accept anymore food.
I do try to stay away from most carbs and stick to a high protein diet, which has become a second nature to me. Proteins fill me up pretty fast and I have no complaints about it. Infact I LOVE IT!!!!
" Time,indeed is a sacred gift, and each day is a little life"
happyteacher
on 7/14/12 9:33 am
 I am not personally convinced that the RNY has a faster speed of weight loss compared to the sleeve.  I truly feel it is dependendent on the person.  We had a poster here recently lose 160 pounds in 4 months from the sleeve surgery- he was highly motivated, strict diet, lots of exercise... in short did what he was supposed to do.  Many lose a 100 pounds by 6 months.  RNY has the advantage of malabsorption for only a set period of time with calories.  In essence, you can lose the weight still eating more, but what happens when the calories start to count against you again?  You at that point still need to deal with poor eating habits.  

In my opinin there is just no way around changing your eating habits, but the sleeve makes that so much more easier to do.  It provides a window where you can reset your eating habits, then the weight loss reinforces that.  

If I were you though, I would find out how many procedures your surgeon has performed.  Ask questions on how it is completed... things like is it over sewn, size of the bougie, how much fundus is left intact, etc.  Also ask what the success rate has been for patients that are a year out or so.  What is the average percent of the EWL?  My sugeon has an average of 80% at 6 months, and 90%-100% by the 1 year mark.  I think Ciragnle's patients have even better stats, but they can verifiy that as I am not certian.  

Good luck with your research!

  Surgeon: Chengelis  Surgery on 12/19/2011  Carb eating loose sleever here!  "Dying is easy. Living is hard."

1Mo: -21  2Mo: -16  3Mo: -12  4MO - 13  5MO: -11 6MO: -10 7MO: -10.3 8MO: -6  9 MO: -5 with slight regain from the original -10   MO 10: -8  MO 11: +1  MO 12: -1.4  Mo 13-14: 0  Mo 15:-10 (meds side effect) Month 27: maintenance so far so good!  Plastic surgery Abdominoplasty month 24        BMI 23  CW: 179  Goal in 8 months 4 days!!   6' 2''  EWL 112%  Starting size 28 or 4x (tight) currently a size 12 or large, shoe size 12 w to 10.5   150+ pounds lost 

Maureen K.
on 7/14/12 9:44 am
 You may want to post this in the vsg Maintenance board as that is where you will find more vets I am not 5 years but I am 4 and I am still maintaining my loss still have restriction. Yes you have to make the decision to make this work but I could not do it without my sleeve . I have had no problems what do ever. Best wishes to you. 

SW - 223  CW- 130 GW- 140  Start Sz 18 Current Sz 4 Ht. 5'6"
 BA- LBL/TT 11/3/09

   

  
Cengelen
on 7/14/12 10:26 am - Sweden
Maureen K. How do I find the VSG Maintenance Board?

Thanks.
PrettyEyes_41
on 7/14/12 10:52 am - MS
VSG on 06/12/12
I think this is the maintenance board link:  http://www.obesityhelp.com/group/VSGM/discussion/

Gale     Age: 55, Height: 5' 5.5", HW: 236, SW: 210, 1st GW: 150.  Surgery BMI: 39.3  Extremely HBP, High Cholesterol & borderline diabetic.      

    
Pkrplyr777
on 7/14/12 10:39 am - CT
VSG on 08/01/11 with
11.5 months out..
I freakin love my sleeve!

The freedom from the food addiction alone is worth it.
Now, i eat pretty much whatever I want....just very little of it to be satisfied and full.

Still losing weight bust should settle down soon.

cheers,
donna
  HW/233 *  SW/212 * CW/133 *GW/132 * 100 Pounds of FAT gone FOREVER!
 
Sometimes the questions are complicated and the answers are simple~Dr.Suess            
hrford
on 7/14/12 11:15 am
VSG on 03/19/12
 I have 2 friends that had the RNY around the time I had the VSG.  One does the right things, exercises, eats right etc. we started at similar weights and we've lost almost identically.  The other relies on her RNY and eats whatever she wants.  At 5 months out she hasn't lost in over 4 weeks.  So both are tools and honestly I think we'll find in another 5 years that the VSG will become THE weight loss surgery because it doesn't seem to have the long term health implications.

HW: 270 SW: 234.4 CW: 135.0 1stGW:149 (GOAL MET)afreshstart-hreneeh.blogspot.com/
1st 5k: 5/12/12 44:55  PR 4miles: 12/31/2012 35:49
  

FloridaVSG
on 7/14/12 11:32 am - FL
VSG on 07/16/12
Look at Ryan's story here! Also look at Nick's video below (also try to find his before videos). You'll be amazed! Best of luck on your decision!

RYAN:
http://www.obesityhelp.com/forums/VSG/4542362/Gooooaaaaallll-And-in-under-4-months-PICS/
NICK:
http://www.youtube.com/watch?v=JFLQnf0QPCw&sns=em
Pre-op/HW: 302- SW (7/16/2012): 296 lbs- GW: 160-150 lbs. Month 1: -32 lbs.- Month 2: -16 lbs.
www.theskinnygirlinsideofme.blogspot.com  
      
Carmelita
on 7/14/12 5:40 pm - Four Corners, NM
 You've got lots of time to research Cen!!   So much information available on the net...here...keep looking for your answers to draw your own conclusions.  Up in the search bar above enter "VSG" and whatever your question is...always VSG first...will narrow down your search

On weight loss lower with the sleeve compared to RNY....NO not true. In fact I saw a recent ASMBS (american society for metabolic bariatric surgery) video interview...saying VSG is expected to REPLACE RNY as the GOLD STANDARD for bariatric surgery.  RNY has been done for some 60 years...VSG only done since 2000  (I believe Dr. Hess --a DS surgeon performed it) For VSG  to replace an old bariatric surgery...so soon out the starting gate...has got to say sumthin about it!

On weight regain with sleeve...oh you betcha..typically by 2 years out some rebound regain..definately "possible"  ....at.5 years out is the line in the sand. But again compared to RNY ...not true!!  I personally know 2 men were SMO had RNY...by 15 years out ...were BOTH  SMO  again!!  metabolic programming/adaptation. mcrocilia of lg intestine...REGROW to compensate, reach homeostasis for lack created by RNY...by 2 years out. The body has an outstanding desire to LIVE...no matter what we may do to 'try' n  outsmart it. 

An individual can outeat, underexercise any WLS...including DSrs.  Its NOT only about commitment, diligence, lifestyle changes and psychological support to assist our emotional-food attachment issues...frequently found "buzzwords" in the weight loss word. ITS ABILITY TO MAKE ADJUSTMENTS  to outstanding events in our lives that impact our weight...accidents, injury, illness, medications, stress, childbirth, hormonal metabolic altering events like menopause, thyroid i.e

 I didn't have a crystal ball tellin me I would get injured..placed on combined topical,oral, IM steroids, and physical therapy for 8 months...and the impact of eating the same yet exercise taking a nosedive...that it would cause me to REgain 25 pounds. Absolutely my surgeon told me that at 5 pounds regain..ACT, make my adjustments....but I didn't ".feel like it " lmao...It took 8 months to put on 25.
When I got my head back in the game...I lost 20 in 4.5 months.  Now I teeter 3-10 pounds of that regain...have for gosh...almost a year. A work in progress...EVERYDAY!! Im workin it Cen...Im an old goat...my metabolism has indeed slowed as Ive aged. I certainly can eat even eat less with an altered stomach..if not for that little voice sayin EAT LOTS OF CARBS!! lmao!! I post frequently about my struggles here...this forum is my only WLS support, unfortunately for me..but it does help me! ....I could never be the poster girl of VSG...but I could never say that VSG has NOT saved my life in more ways than the physical either.

The Sleeve CANNOT BE STRETCHED!!!  a quote from this forums sponsor LapSF/Dr. Cirangle on my bougies in VSG blog....in the Stretching in VSG section I believe.  Don't MISTAKE a fully dilated matured sleeve (~1 year out) with being STRETCHED by sheer will...ain't true!! 

BOUGIES in VSG 

Of the thousands of VSGs done by Dr. Cirangle.. there are 5 "vets"  maybe on this forum ..2 of whom both women..have posted about their regain at ~3 yrs out. In regain w/ VSG ..best to look at those over 2 years out.  There is data out there..on regain. I have links but can't find em right ..a needle in a haystack, nor can I remember them.  RNYrs are quite capable of stretching their stomach "pouch" as the fundus (the stretchy, expandable portion of stomach's greater curvature), removed in VSG, is retained in RNY to form it. 

On long term complications ...10-40 years out...maybe take a look at this post I wrote recently.
gotta scroll down some.  Altho Im unable to edit my posts at this time...I needed to add in the OSTEO problems related to VSG...that smoking with an altered stomach is a cause of calcium leeching from bones..therefore a contributor to Osteo problems post VSG.

LONG TERM COMPLICATIONS affecting VSG 


On old-time VSGrs 5+ and out...used to link em...I don't no more. I leave em alone.  But here's an old post of mine...with links of VSGrs 5+ years out and their stories.  Most pop up here ...like Rana n Abbey, Amy...we all send em to the maintenance forum...usually they don't stay there either. Some have been able to keep ALL the weight off...a few have have regained substanitally.  

5+ out VSGr post

On learning to undereat sleeve capacity...take a look at Hara Hachi Bu -  japanese taught to undereat their stomachs capacity since childhood Some techniques that can be mastered by all..normal stomachs or altered stomachs 

UNDEREATING SLEEVE CAPACITY

HOPE THIS HELPS ya some Cen ,-)
Lee ~
on 7/14/12 5:44 pm - CA
 Welcome to the group. You are asking excellent questions.

I am 29 months out from my surgery and can eat a lot more than two years ago.

I can tell you from my experience that not every sleeve is created equal.  The size of the sleeve can be different, but more important is the technique used by each surgeon.  Some are 32f bougie, some bigger. I personally have a 40f.  Some are oversewn to make them smaller, mine was not.   While my particular surgeon performed hundreds of RNY, the sleeve was relatively new.  

I Love my surgeon.  That said, I would really recommend finding out as much as possible about the actual operation that you will receive.

Not all sleeves are created equal, and definitely, not all post op food plans are the same.  Read as much as you can here.  See who has lost the weight that you hope to shed.  Find out what their post op plan looks like.  Compare it with the plans your local clinics recommend. They vary from low carb to recommending fruit juice post op.  Make careful choices based on the success that you hope for.

Good luck and do stop by the Maintenance group.

HW: 249 in 2009  SW: 229 Maintain < 25 BMI -  Age: 63

Body by Sauceda - 12/9/2011 LBL,Thigh Lift, Breast Lift/Reduction, Arm Lift, Butt Aug, Stomach Muscle Tightening - 12/12 /11- Facelift/NeckLift/Eyelids

inextremis
on 3/12/13 9:25 pm

Preparing for my sleeve on march 25th and for sure I am looking into long term result. Two recent studies seem to indicate that: 

A- Bigger bougie size (above 40 up tp 60) does not reduce weight loss at 3 years but it reduces leaks and GERD http://www.ncbi.nlm.nih.gov/pubmed/23023201

b- Long term side effects reported after 5 years include GERD and regain http://www.ncbi.nlm.nih.gov/pubmed/20622654

 

In light of this I am wondering what the best middle ground might be. I am discussing this with my doctor but would like to hear more about real people with actual life experience. Has anyone here had a large bougie 40 and up ?

    
(deactivated member)
on 3/18/13 10:45 am

Hi,

After a short experience with BPDDS, I''ve started performing sleeve gastrectomies in 2001 . At least at 5 years less than 10% of patients will need a reoperation in my series and the options are an additional DS mainly in super obese patients, or a conversion to a bypass in case of major GERD, or a resleeve for weight regain with enlargement of the gastric pouch some are adding a band on a sleeve. Gastric pouch enlargement is really rare if the stomach calibration has been tight at the time of the surgery. 

The major problem is weight regain after gastric bypass;  its rate is as high as 30% at 10 years in morbidly obese patients and even higher in patients with a BMI>50. So think twice and take the option of a strategic approach: first a SG. So far SG is the best surgical option that not compromise a further surgery.