Who do I listen to about WLS?

About which weight loss surgery is right for me?

Over about 10 years I've been looking into WLS and for 1 reason or another, my insurance wouldn't pay for it or something else in my life was going on.

My BMI is 47 without any co-morbidities.

i do have Gerd but it is treated with medication. I do have a hiatal hernia that will need to be fixed.

im not excited about the more invasive surgery gastric bypass but I've been told I most likely with my BMI, won't lose all the weight I need with only the sleeve. But I do like that the sleeve is my minimally invasive.

My insurance will not cover the DS. Only Gastric bypass or sleeve. I know enough about the band to not consider it.

I'm not sure that RNY and VSG differ in terms of invasiveness. One involves cutting your stomach and intestines, but leaves everything in place. The other only cuts the stomach, but then removes it entirely. Both of those things seem pretty invasive to me!

With a history of GERD, there is no way I could go with the VSG. In some cases repairing the hernia fixes the GERD entirely, but I wouldn't risk it. Being on PPIs long term is proven to be unhealthy and RNY would give the best chance of not needing to be on PPIs. Boyle's Law, in a nutshell, states that lower volume = higher pressure. VSG = lower volume which then increases the pressure in the system and this is what raises the chances of GERD/reflux being problematic for sleevers.

Who do you listen to? Just like when it comes to the news you've got to do your own research, figure out the sources that are trustworthy, and make your own decision ultimately.

RNY may seem invasive, but the VSG literally removes a portion of your stomach from your body, never to return. That's a pretty big deal; an RNY can (hypothetically) be reversed, but a VSG cannot.

See, this is what I don't understand when people paint the RNY as more invasive than VSG. Maybe folks don't understand that part of their stomach is physically being removed? I can see where the gut rearranging could be viewed as extreme, but it's still there. :D

Jen

I think it has to do with the complexity of the surgery. As I understand it, there are more steps involved in the RNY operation, it's more time-consuming, and there's a (somewhat) greater possibility of things going wrong during the procedure itself.

It can also be a bit confusing to understand how RNY works-- tab A, slot B, what gets reconnected where now? It's a bit difficult to picture. Whereas VSG is just "we take this piece out and then we're done" and it mentally SEEMS a lot simpler.

It seems that people are afraid of having the plumbing rearranged, but it all comes out in the end, right.

I am glad you said it too Julie, I never understood how throwing out part of your stomach was less invasive...

There is some kind of myth that goes around citing the rny as being more invasive than the vsg. Surgery is invasive. I don't think you can get anymore invasive than that.

However you can find read and research as much as possible with both surgeries & talk it over with your Dr to discuss how each one would would affect you with your medical history.

The gerd & vsg is definitely a possibility & can get worse since you already have it.

I also had gerd, but it was very,very mild & likely caused by the hiatal hernia that was repaired at surgery. I was very fortunate, others aren't so lucky.

I had the VSG & it was the best decision for me.

I wouldn't touch a VSG with a barge pole with ANY history of gerd. Most of the revisions we are seeing lately are VSG to RNY for that reason.

Gerd is not something to be messed with and prolonged use of PPIs come with their own possible bad outlook.

I had very infrequent acid reflux (a day or two every month or two) and had a hiatal hernia fixed at the time of my VSG. The repair didn't hold and I'm having surgery in about a month to try to repair it again because the GERD is terrible if I don't take a PPI. So I would also be very wary of relying on a hiatal hernia fix to eliminate the possibilty of GERD or future surgeries.