Pros and Cons on Rny/Sleeve??

I'm trying to decide which surgery to have any thoughts, comments from those of you that have had the surgery??

I haven't had either surgery, so take this as coming from someone with only theoretical knowledge of either.

I had been leaning towards the sleeve, as it seems much less invasive than the RNY, without the dumping, and still great results.  However, the Registered Nurse I met with in December, explained that the RNY can prevent Type 2 Diabetes.  This is a condition that both of my parents have, and while I don't have it yet, I'm fairly resigned to the idea that I will develop it at some point.  If a the RNY can prevent this, I'm happy to get a RNY. 

I'm meeting with my surgeon this week, and will discuss the issue further, I'm sure. 

I haven't heard of any wls that prevents diabetes. Usually once you've had type 2 diabetes losing the weight & changing your lifestyle is what either keeps it in check or puts it in remission. Change your lifestyle now if you want to prevent getting the disease.

I have diabetes & I chose the sleeve, but I had already changed my lifestyle to the point I was off of insulin & was down to the pills, & now with the weight loss I am down to the lowest dose of diabetes medication available. The surgery helped but ultimately it boils down to what you put in your mouth, not what surgery you get.

These are the opinions that factored into my decision:

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.

This question gets asked a couple of times every week, so use the search feature (the small magnifying glass near the top of the page) and search for "RNY vs VSG" or "bypass vs sleeve".  You will find many reponses (some of them quite long that people aren't inclined to repost after about the 6th time).

Personally, I had RNY 8 years ago (when VSG wasn't an option) but if I were making the decision now, I would opt for the sleeve.  I have written lengthy pros and cons in other posts.

What would be (or is) the best surgery for me or someone else doesn't make it the best choice for you, though.

Good luck with your decision.

Lora

I felt the RNY was preferable for me because I needed the advantage of the malabsorption even if it wasn't permanent. I was at a point in my life, even when I following plans perfectly I wasn't losing any significant weight... and I had a lot to lose. I wasn't sure how the restriction only of the sleeve was going to be enough for me.