Hi,

Newbie here, I am scheduled for my surgery on March 22, coming so fast and still I spend the days with racing thoughts about which surgery type to have. First, I told my surgeon I wanted the Sleeve, later changed my mind to the RNY Bypass. Now I am second, or maybe third guessing my decision. Does anyone have any thoughts on how to go about making a final decision? Any help is greatly appreciated!! 

What outcome do you want? Do you need restrictions imposed on you in order to comply? Do you have a large amount of weight to lose? I feel theseare all things to consider. I am choosing RNY because I have a lot of weight to.lose & I'm told it has the fastest rate of loss & malabsorbtion which pushes that along.

Wow, everyone has responded with such a great deal of thoughtfulness. It has been extremely helpful and though I am still not committed to either the sleeve or RNY, thanks to all of the provoking conversations I am closer to making that final decision. So thank you and I wish you the best on your journey!

First, if you aren't ready, mentally, for the surgery, see if you can delay the date until you are.

I'm fairly new at this, have absorbed alot of information, but am by no means an expert.

1) Ask your surgeon what he/she thinks would be the best procedure for you.
2) Have you seen this comparison: http://www.lapsf.com/weight-loss-surgeries.html
2) I'm assuming the duodenal switch (DS) is not an option, so I'll just go with my thoughts on the RNY vs VSG and why I chose a VSG.
3) RNY: Good choice for people who have difficulty losing weight, and clearly assists with weight loss. Possibility of dumping syndrome, if not careful. Malabsorption helps further weight loss for awhile, but vitamins need to be taken forever. Is reversible.
4) VSG: Less rearrangement of digestive system, NOT reversible, but can be converted to DS. Seems to work for those who are conscientious or those who lose more easily. Dumping is rare. Eventually can go back to normal vitamin/supplement routine. No long term restrictions for medications.

I chose VSG because it was more straight forward and as I can't predict what type of medications I may need in the future, I wanted all options available to me.

I have no regrets. I had a problem-free surgical experience and am content with my rate of weight loss.

I view the VSG as a "tool" to ASSIST me with weight loss, not something that will work on its own. I needed that kick in the butt. And believe me, if I overeat (at this point -- try to eat 1/2 cup in volume), I feel stuffed and uncomfortable.

I'm one of the VSGers that never feels hungry, which is an added bonus.

Good luck with your decision. Whatever it is will be the right one for you, so don't get into the "woulda, shoulda, coulda" thinking afterwards.

Maybe ask your surgeon which procedure he/she would choose for himself/herself? (I asked mine.)

HI,

Something to consider...are you diabetic?  I am 1 week post RNY and went with the RNY because it will evidentually clear the diabeties.  I am already off one medication and only take another when blood sugar is over a certain number.  Most days, I'm taking just pill broken in small pieces...the size of a plain m&m.

For me, the sleeve made sense over the RNY, because I was not severely obese (in fact, my insurance may not have covered it if I didn't have two other "co-morbidities" -that is, problems caused or made worse by being overweight that would be resolved or lessened by wt. loss) -I have hypertension (was on 3 meds) and arthritis in my knees. The sleeve was appealing to me because I can still take NSAID's (such as Advil, Motrin, etc.) later on if I need it, which you cannot with RNY. Also, it appealed to me that the normal anatomy was less disrupted this way -no bypass, and also much less dumping syndrome. I am just 7 days out, so we will see in 6-12 months if I made the right decision for me! I have lost almost 7 lbs in 7 days, so I think so far the weight loss couldn't be better! I have read (and have been told) that the weight loss for the sleeve is just about as good as the RNY, but a lot of it has to do with how much one exercise as the weight comes off, so I'm determined to do that too! The other very short-term difference is (at least where I had surgery) the RNY is a 36-hour stay, but the sleeve is about 48 hours, which isn't really that different. I didn't mind the second night in the hospital -I wouldn't have felt ready to go home yet anyway. I liked having the nurses and my surgeon around to make sure everything was OK and to ask questions about things if I needed to. I'm sure no matter which one you choose, it will be right for you and you will do well. The most important thing is to do as they tell you -everything is for a reason and will help you to recover better and faster. I agree that you should also ask your surgeon if he would recommend one over the other for you, given your individual needs. Good luck!!

THINK TWICE CUT ONCE.

Read up on ALL FOUR SURGERIES. Visit all the forums. ds, rny, and sleeve, lapband

 I chose RNY, because I have been diagnosed with insulin resistance, and I have a very bad pool of genetics which suggests that malabsorbtion is a good idea.  Where I had my surgery, RNY hospital stays were 5 nights and VSG hospital stays were 3 nights.  I would have been fine with 3 nights of stay, but it was nice to know that the doctor had a conservative approach to the surgery.  During my surgery, my doctor discovered a large hiatal hernia, which suggests that I had some digestive problems on top of my arthritic knees.

If I were somewhat younger (maybe 35 instead of 45), and there was a possibility that I would have wanted to get pregnant in the future, I would have chosen the sleeve (you can get pregnant with RNY, it's just that vitamin deficiencies are a bigger problem).  But, I am 45 and I don't have my plumbing.  

BTW... one of the great things about the sleeve is that if your tool stops working for whatever reason, you can get the DS.   Revisions for RNY are much more complex.  This was not part of my decision process, but it might be important to you.

There are not too many people who complain about either the RNY or the sleeve, so you will probably not make a bad choice.
  

I never seriously considered the band or RNY. The band is too high maintenance and slow. I wanted to keep my pyloric valve and need NSAIDs, so that ruled out RNY. I thought long and hard about the DS but decided the postop vitamin regimen was too much for me. So that left the sleeve. No regrets, except that I didn't do this many years ago.

 Definitely postpone your surgery date until you are secure with a decision.  Most insurance approvals are good for 3-6 months