What made you pick RNY? What made you pick the Sleeve? Made the right choice?

shorty71
on 2/28/14 4:02 am - CT
VSG on 04/01/14 with

Would love to hear what everyone has to say.

What made you pick RNY? or what made you pick the Sleeve?  Do you think you made the right choice? Would you change anything?

White Dove
on 2/28/14 4:55 am - Warren, OH

To be successful, you have to change your eating and your lifestyle.  RNY gives you a head start because what you eat does not get absorbed for the first year or so.  With the sleeve you absorb everything you eat from the beginning.  I liked that head start and did not have to really start worrying about what I ate until about year three.

southernlady5464
on 2/28/14 6:28 am

I picked the DS...it gave me the malabsorption I needed and the advantage of keeping my pyloric valve of the sleeve.

What you chose is up to you but read about all the surgeries.

I know *I* chose the DS because I had to have NSAIDS and wanted the BEST chance of keeping my weight off and resolving my diabetes. You can't take NSAIDS with the RNY....you can with the VSG and the DS.

ONLY thing I would change...I would have it much sooner than I did.

 

Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135






   

MsBatt
on 2/28/14 6:30 am

I didn't choose either of them---I chose the DS instead. It offered me things I really needed and wanted, like a fully-functional stomach, lifetime malabsorption of a significant per centage of calories, the ability to still take NSAIDs, the best chance of treating my high cholesterol and avoiding the diabetes that runs in both sides of my family, and the very best long-term, maintained weight-loss stats, period.

 

Ten years later, I'm still convinced I made absolutely the right choice for me.

cabin111
on 2/28/14 7:17 am

These are in general...Your surgeon may have a good grasp on why he or she would want you to go certain route.  The older you are, and the more comorbidities you have, will help make the big decision.  If you are young (say younger than 40), need to lose 60-100 pound, and have a couple minor things wrong such as high blood pressure, sleep apnea, high cholestrol the sleeve would be good for you.  If you are older or have a large amount to lose, and have many medical issues, then RNY (or in some cases the DS) may be the better way to go.  There are plus and minus for each surgery.  Many doctors will not do the DS, so if you really need (not want) to go that way, you may need to look for another surgeon.  The nice thing about the sleeve is that if you are not successful with it, you can move to the RNY or DS later in life...Or another surgery procedure may be in the offering in a few years (one we don't even know about at this time).  Again, these are general answers...Your specific condition should be considered and your surgeon can give you good input (I would usually go with their recommendation).  Brian

MsBatt
on 2/28/14 10:19 pm

I have to disagree with a few things you've said.

Instead of saying that many doctors WILL not do the DS, I think it's more accurate to say that many doctors haven't bothered to learn HOW to do the DS. There's simply not as much profit in doing the DS, since most insurance companies don't want to pay much more for the DS, and it does take longer to perform, not to mention the time it takes to properly learn to do the DS.

The DS is absolutely THE go-to surgery for high cholesterol, because the DS causes us to only absorb about 20% of the fat/cholesterol we eat. Most DSers eat quite a bit of fat, but have total cholesterol numbers around 100. (Mine dropped for about 220 to 112 at my last checkup.)

 You write"...so if you really need (not want) to go that way, you may need to look for another surgeon. " No no no!!! Each patient should choose the procedure they WANT to live with for the rest of their life, and they should GET that procedure unless there's a compelling medical reason why not. Over the years I've been reading here and on other WLS boards, the most successful patients are the ones who are happy with eating the way their particular surgery requires. For instance, a vegetarian would not be very happy with a DS. (*grin*)

 

hipswishingvinegarball
on 2/28/14 9:46 am

My biggest thing was keeping my pyloric valve, which only left me with DS or sleeve.

The things I wanted to avoid could be avoided by keeping he pyloric valve (dumping, reactive hypoglycemia, regain). The sleeve has about the same weight loss as the RNY, without those drawbacks, or the need for as much vitamin supplementation.

Julia HasHerLifeNow
on 2/28/14 4:03 pm
VSG on 10/09/12

Curious about avoiding regain and how that can be accomplished by keeping the pyloric valve? Lots of sleevers regain quite successfully unfortunately. And we all had our pyloric valve before surgery and gained nicely into obesity. I wanted to keep mine too which is why I had the sleeve but I have no illusions about the possibility of regain. Vigilance and commitment as well as sticking to a clean eating plan are my tools against that. Fingers crossed for the long term!

View more of my photos at ObesityHelp.com 5ft0; highest weight 222; surgery weight 208; current weight 120

     

    

MsBatt
on 2/28/14 10:11 pm

Here's my guess on what she meant: You're more likely to keep good restriction with a fully-functional stomach than with a pouch and stoma. I know that ten+ years after my DS, I still have pretty good restriction.

hipswishingvinegarball
on 3/1/14 1:48 pm

The pyloric valve cannot prevent regain, but the lack of it can certainly contribute to gain.

The pyloric valve helps keep food in the stomach, so if the stoma stretches with RNY, they can lose satiety when food empties too quickly from the stomach, and that does lead to regain, in addition to possible dumping or reactive hypoglycemia. 

I love the sleeve, but KNEW it's restriction alone wasn't enough to lose my excess weight, and keep it off, so I decided the DS was what would work best for me. I'm glad you understood what it would take to make it work with the sleeve and thought honestly about it before going under the knife. Lots of folks don't.

×