Roux en Y vs. Sleeve

What are the main advantages of the bypass as opposed to the gastric sleeve ?  can I loose and/or keep off weight more with one over the other ?

Here's what I've posted in my blog about why I chose the sleeve.  

The four WLS are - sleeve, gastric bypass (RNY), lapband, and duodenal switch. My insurance covers the first three, but not the DS.

I ruled out the lapband immediately because the only people I know who have had it are miserable or have needed it removed. The complication rate is atrocious and it only lasts for 10 years or so. It's billed as being a "reversible" surgery, but the damage it can cause, like from erosion into your esophagus, is permanent. So no lapband for me. Here's an article on that topic.

The choice really boiled down to RNY or VSG and I chose the sleeve for a number of reasons. (Even if DS had been an option, I would not have chosen it.)

1. I really like the simplicity of the sleeve. All it does is remove 85% of your stomach. That's it.
2. I dislike the idea of having my intestines rerouted.
3. The "good" malabsorption that the bypass gives (of fats) is a temporary thing that only lasts for a few years whereas the "bad" malabsorption (of vitamins and minerals) lasts for forever. That's not worth it to me.
4. The sleeve is restriction only, no malabsorption. This also means that I CAN eat anything at all. Fats and sugars won't screw up my bowels the way they can for the bypass. (Of course I still need to make healthy choices, but that's a choice, not something that my surgery requires.)
5. With the bypass, you're left with a remnant stomach that can't be scoped. That scares the crap out of me. First, the idea that I have this weirdly connected non-stomach but then to not be able to get it checked out with an endoscopy if there's a problem? Eek. Do not want.
6. My understanding is that complication rates with the bypass are significantly greater, especially longterm due to malabsorption. While I will be taking vitamins for the rest of my life, chances are that I won't end up in the hospital if I stop because the sleeve has no malabsorption involved.
7. For the most part (and there are exceptions) the people I know with the sleeve look and seem healthier than the people I know with the bypass. That's nothing scientific though.. just a gut feeling.
8. The sleeve leaves you with a fully functional pyloric valve at the bottom of your stomach whereas the bypass gives you a stoma which can stretch over time.

But can I lose the amount of weight and as quickly with the sleeve as opposed to the bypass ? I have a BMI of 50. Is it easier to keep the weight off with one over the other ?

The answer to both questions is "it depends."

No one can tell you how much weight YOU will lose with any form of WLS. All we can do is point you toward the stats about 'average' weight loss. Most people can lose an amazing amount of weight with the Sleeve, the RNY, or the DS. Some people are very good at maintaining that loss long-term, no matter which form of WLS they chose.

Statistically, the DS has the best long-term, maintained weight-loss stats, especially for folks with a BMI great than 50. It also has the best stats for treating or preventing things like diabetes and high cholesterol. that does not, however, mean it's the best surgery for everyone.

You need to research them ALL. Look at the pros and cons, and decide which one is most likely to give YOU long-term success and a lifestyle you can be happy with.

Can u stretch the sleeve out and thus make the area of stomach large as it was before the sleeve by over eating ?

The sleeve will stretch, but never as large as the original size.

The sleeve will "mature" over time, but it will never stretch to the way it was before - especially if you take care of it.  

I put RNY vs VSG in the search function (little magnifying glass on the blue bar) and got this:

About 5,740 results (0.42 seconds)

Someone claimed that I was exaggerating when I said that this question (as well as the one about the week 3 stall) is literally asked several times a week every single week... But given the newness of VSG, that statistic would seem to indicate that she owes me an apology!