Which surgery method should I choose, gastric bypass or gastric sleeve?

I am a 58 yr old male, current weight 380 lbs. Would like to loose 200 lbs and
keep it off. Do not have to choose my surgery choice till the day before the operation which is Nov 26.13.

Any and all comments would be greatly appreciated.

hi RH,

No surgery is right for everyone. There are lots of success stories on these boards from folks who have lost  more than 100 pounds with RNY, VSG, and DS. I know why VSG is working well for me but I cannot say what might be best for you.

We all bring different medical histories, comfort levels, and food issues with us on our weight loss journeys. For example folks with diabetes and other serious metabolic problems may find DS most effective and worth the increased nutritional vigilance necessary. On the other hand there are more surgeons around the country who are experienced with RNY.  You might want to post your question on the Surgical Forums which seem to have more activity than this general forum. There is also a forum for starting BMI over 50.

Personally I was not diabetic, was very nervous about having my intestines redone, and had been told that my other medical issues made RNY dangerous.  As soon as my insurance started covering VSG my surgeon recommended it as safer for me than RNY  and more effective than the band. I have been very happy with my results.  Now that more surgeons are doing the VSG regularly there is more evidence that it can be very effective for both heavyweights and lightweights. (Look for the encouraging post & photos from Jimbovsg who wrote earlier this week about keeping off more than 300 pounds for 4 years!)

Keep reading, researching and asking questions. Good luck.

all the best, Katy 

Now that I've been on the other side of this surgery for over six years, I'd recommend that you keep as much of your normal digestive path as possible.  In other words, I'd go with the sleeve.  I didn't lose all I wanted to with the bypass, but that's fairly normal for someone who was a 'lightweight' like me (still makes me laugh to say that - 260 is NOT light).  However, I've ended up with one of the rare complications of gastric bypass.  I have severe reactive hypoglycemia and possible nesidioblastosis.  This means I have developed insulin-producing tumors (non-cancerous) of the pancreas that cause a huge outpouring of insulin when I eat anything even semi-starchy.  Food knocks me out.  With blood sugars as low as 23, this can be life-threatening.  The only thing that can help this is having the pyloric valve and intrinsic factor from the bottom of my stomach put back into my digestive path, e.g., a revision to a sleeve.  If you have any sugar issues at all, I'd recommend the sleeve.  It should give you the restriction you want and not cause the metabolic issues.

Best of luck with our decision.

Id go with DS. Has best long term success rate.  But like what everyone else says it depends on what you want out of It and your personal eating habits. It also depends on what you committed to do afterwards. Take vitamins, blood work frequent, exercise and much more? Find out lifetime requirements of each surgery

I know your surgeon doesn't do the DS, but I still think you should research it as well. You can't really make an informed decision unless you have ALL the information.

There are many things to consider. Do you have any health problems, or do any run in your family? Things like diabetes, high cholesterol, arthritis, GERD, etc? If so, you'll want to think about how each form of WLS with impact/be impacted by these health issues. For instance, if you have diabetes or high cholesterol, the DS has the very best stats for resolving or preventing those co-morbs. Got arthritis? Then you don't want to give up NSAIDs, which you'd need to do if you chose the RNY/gastric bypass.

The Sleeve and the DS preserve the pylorus and all normal stomach function. The RNY does not. The Sleeve and the RNY have about the same long-term success rate, the DS has the very best long-term success rate. With the Sleeve there's no malabsorption, which means fewer vitamins. (Not 'zero' vitamins, just, usually, fewer.) The RNY has permanent malabsorption of certain vitamins and minerals, and temporary malabsorption of a small per centage of calories. The DS has permanent malabsorption of certain vitamins and minerals, and permanent malabsorption of a significant per centage of calories, especially calories from fat. This means that those with the Sleeve and the RNY do a lot more counting of calories, especially long-term. Most long-term DSers I know eat 2500-3000 calories a day, but only absorb about half that many, depending on whether they're calories from protein (about 50% absorbed), complex carbs ( about 60% absorbed), simple carbs (nearly 100% absorbed, alas!), or fat (about 20% absorbed.) This means that on average DSers have an easier time maintaining their weight-loss while still eating tasty food. (*grin*)

I chose the DS for a lot of reasons, and at nearly ten years post-op I've never regretted my decision. If I had to choose between the Sleeve and the RNY, then I'd choose the Sleeve every time. If you do choose the Sleeve and it turns out to be insufficient, adding the Switch to make a complete DS is fairly easy. Revising an RNY to a DS is very complicated, and very few surgeons in the world do it.

Hello,

Here is a link of other members post where they are talking about RNY - VSG.  We hope this helps  

 

http://www.obesityhelp.com/search/action,search_oh/?q=rny+vs +vsg&cx=000946886326336472648%3Ae-vpeg4uyxw&cof=FORID%3A9

I have two family members who have had the gastric bypass. I had the sleeve. The only reason why I choose the sleeve is the recovery time is much faster, the food you eat and when you can start eating is sooner, and I believe the less they mess around with your guts the better. But, it really depends on what your health issues are. And if your doctor recommends a certain surgery due to your own health issues.I am sure you will make the best decision for you.Good luck!