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Gastric bypass vs gastric sleeve??

(deactivated member)
on 6/2/08 10:46 pm - CA
Is there anyone out there that decided on the gastric bypass over the sleeve?  The choice of which one I choose is up to me.  I don't want to make the wrong choice again.  I had a lapband placed almost a year ago and it is not working out for me at all.  Its time to change and I'm not sure which way to go.  I would appreciate any input any of you have.  Thank You!  Joanne
Andrea U.
on 6/3/08 5:09 am - Wilson, NC
You simply need to decide if you need the malabsorption that comes along with RNY.  If restriction alone is good for you, then go with the VSG.  If you need the malabsorption, RNY or DS. I guess I'm a bit surprised it's a choice between RNY and VSG.. I would have though DS would have been the other choice in regards to the VSG.
(deactivated member)
on 6/3/08 9:36 am - CA
See, I know too little about this.  What do you mean about if I need the malabsorption?  Maybe I am also confused by his terms too.  RNY is the gastric bypass correct?  Isn't DS another type of surgery that is not called a bypass.  I am sooo confused I can hardly stand it.  Thanks for the info.
Andrea U.
on 6/3/08 1:16 pm - Wilson, NC
OK.. RNY, or Roux-en-Y is commonly known as Gastric Bypass.  There is a school of thought that the Duodenal Switch (DS) can also be referred as gastric bypass.. but I've not seen anything 100% concrete on this. The RNY creates a small pouch from your old stomach.  The old stomach remains in the body to produce the gastric juices needed to digest food.  It is considered a "blind" stomach because there is no way, other than surgery, to really see inside the stomach. The VSG cuts away part of the stoma*****luding the area where tha majority of the hormone that makes you feel hungry is produced.  In essence, it will look like a banana.  The rest of the stomach is removed completely. The RNY then adds what is known as a malabsoprtive element to the smaller pouch.  Part of the intestines are bypassed, which means some of the food that goes through will not be absorbed (thus adding to the weight loss). The VSG does not have any malabsorption.  The DS is a VSG with a different malasorptive element than the RNY.. the areas of the inestines bypassed is different, which changes what is absorbed and what is not absorbed. RNY'ers cannot take certain medications for life.. specifically time-release or NSAIDs (aspirin, naproxen, ibuprofin) due to the possibility of ulcers.  VSG and DS do not have this issue. DS and RNY'ers both have to supplement daily.. depending on which surgery depends on which supplements.  For example, RNY'ers typically have to add iron and b-12.. while DS'ers have to supplement ADEK more than most.  Both might have to supplement the other.. these are just typical. Diet after RNY changes dramatically.. pure, simple sugar and fat can put someone into dumping syndrome.. a very unplesant effect.  DS'ers do not have this problem.  VSG does not either. Does this help some?  I try to be completely open as to surgery choice.. and I recommend you also go to the ds and vsg forums to ask any questions you might have.  I know the RNY and a bit about the other two (but not nearly enough..).  I also will be sending this link to a DS'er in hopes to verify all info that I've given to be correct.  I just feel that you should have all the answers to determine the surgery best for you.
(deactivated member)
on 6/3/08 1:36 pm - CA
Thank You so much.  That really helped but one more question.  What do you take in place of the asprin, naproxin, ibuprofin if need be?  I have had quite alot of problem with diahrea in the past due to an allergy in  my colon that I think was caused by oral diabetic medications I was taking.  If the dumping syndrome is anything close to that I'm sure that might be something I would be against with the RNY.  This is such a large decission and I am a little upset with my doctor for letting me make this decission on my own without much information.  You have been such a great help.  I at least know the gastric bypass he has been refering to is the RNY now or at least I think I know.  Thank You!
Andrea U.
on 6/3/08 1:45 pm - Wilson, NC
Tylenol is the basic pain-reliever of choice.  Then you can move onto the narc-tylenol combos for severe pain (vicodin, perccocet, tylenol 3, etc.).  I also use Tramadol for pain relief, but it doesn't work for everything. Now, just to be fair, not everyone dumps.  Some do, some don't.  I don't.  Never have.  I can eat a candy bar without any issues.  However, some people would be on the floor writhing.  It just depends.  And there's no prediction as to who will dump and who won't. Some choose the RNY specifically for the dumping.. knowing there was a serious consequence for eating bad food.  That's a personal choice you need to make. I will let you know that a surgeon will not recommend a surgery they don't perform.  So if you surgeon doesn't do the DS, you won't hear about it from them.  Also, they will most likely tell you that it's bad for x or y reason, when they are just trying to sell you on something they do.  It's a sales presentation.  I wouldn't rely on your surgeon to make your choice for you.. *you* need to do the research, figure out the questions to ask, maybe see a 2nd surgeon, etc.  It's your health, and you need to take charge of it *now*. If you have any additional questions, just PM me.  I don't mind helping out.
on 6/3/08 9:19 am - big pine key, FL
My friend chose the sleeve because she had a family history of osteoporosis. She didn't want to have to worry about getting her calcium in. I believe she made a really smart decision and she is doing great now. She had her surgery at the same time I did and we so far are loosing just about the same amount of weight, and our recovery time was the same as well.


(deactivated member)
on 6/3/08 9:41 am - CA
I am guessing that you had the RNY which is the gastric bypass correct?  I'm getting a little overwhelmed here and confused.  The sleeve seens to b easier to deal with than the RNY but maybe I have been mis-informed.  Why did you choose the RNY over the sleeve?  My doctor hasn't given me enogh info and has left it up to me and only needs to know the day of surgery and that is July 7th.  I just want this to all be over because the last year of my life has been awful since I had the lapband placed.  Thanks
on 6/3/08 10:12 am - big pine key, FL
I did have the RNY-gastric bypass. always talk to your doctor about your question regarding the difference of the two, but from my understanding, the Sleeve is a newer procedure and  alot of insurance companies do not cover it---that is why a  lot of people choose the gastric. They also choose the gastric because there is physical reaction to high fatty and high sweet food---some people need that to stay away from those foods. I believe the Sleeve does not get that reaction because really nothing has changed except the stomach has been reduced in size--there is no bypassing the dodeum (higher interstine and I proabably spelled that wrong) which absorbs calcium, b12, and iron an various other vitamins---so supplements aren't as necessary. Like I said, I am only speaking from my own research and understanding, so please talk to your doctor about everything before you make a decision. My insurance did not cover the sleeve, so it was not even an option for me.   


(deactivated member)
on 6/3/08 10:33 am - CA
Thank You for your reply.  Being a diabetic I need to stay away from the sweets and fat but I've only heard horror stories about the bypass.  Have you had any of the dumping syndrome they talk about?  Any other problems you have had?  I have a hard time speaking directly to my doctor.  I did see him last week but I left feeling more confused and I'm part of a large HMO in California with lost of places to get lost.  Thanks again
on 6/3/08 2:18 pm - big pine key, FL
I am only one month out so I haven't tested the waters in that direction yet. I am scared of dumping, so I don't know if I ever will (I'm sure I will though!) But, that is why gastric was a good choice for me anyway, because the fear keeps me from trying it. So far--I'm very happy with my decision and I feel great. Also, you may want to try and find a Dr. that has an insurance specialist working for them if you are using insurance. My Doctor had an insurance specialist who basically got all the paperwork ready and sent---she was great and made it sooo easy for me. I really had a great experience at the hospital/Dr. I chose and they had a really great educational seminars that you have to attend before even getting an apointment with the Doctor. By the time I saw my Doctor, I knew exactly what I wanted.  The office (Cleveland Clinic) was very organized and they had their sh*t together--you know?  Anyway---good luck. I have heard more rave reviews than bad reviews about both the Sleeve and the Gastric--


on 1/28/11 3:12 pm
On June 3, 2008 at 9:19 AM Pacific Time, sarahunt17 wrote:
My friend chose the sleeve because she had a family history of osteoporosis. She didn't want to have to worry about getting her calcium in. I believe she made a really smart decision and she is doing great now. She had her surgery at the same time I did and we so far are loosing just about the same amount of weight, and our recovery time was the same as well.
This post is really helpful to me.  I'm at the point where I have to decide which surgery.  Since I am 53, adding more risk of bone density problems is a big concern.  I am leaning towards the sleeve.
on 6/3/08 10:47 am
I had diabetes since I was a young child of about 5 but never on the insulin.  When I had the RNY done, my blood sugar went down to 87 and has been managable ever since.  I know that in Spain or Italy they are doing the RNY type of surgery as expiermental type of curing diabetes where the intenstine is hooked up to the other end of the stomach.  Sorry don't know the more technical terms.  I also watched a show, I believe it was 60 minutes where they had a group of about 8 people all of which had diabetes and one of the men took 3-4 shots per day and they basically said that once they had RNY the diabetes went away.  So it must have something to do with either malabsorption and/or moving the intenstine.
on 6/3/08 1:54 pm
RNY on 06/23/08 with
I was also given the option of having the RNY or Sleeve.  I did a lot of research, and decided the RNY was best for me.  The Sleeve is relatively new, and my doctor has performed far less of them than he has the RNY, which was one consideration.  The other was the restrictiveness combined with the malabsorption provided by RNY.  Quite frankly, the idea of 'dumping' scares the heck out of me, and I believe, for me personally, will provide a lot of incentive to stay away from sugary foods.  IT is a hard choice, but please, do your research, ask your surgeon lots of questions and then decide what you feel is best for you. Just my two cents. -D
on 5/23/09 8:53 am - Coldspring, TX
Hello Joann

I was banded in 2006 and dbanded in 2007 due to erosion, so much for the band.
I had the "Gastric Sleeve" done two months ago. I haven't lost any weight at all. I now find out that:
1. I can't drink anything for 30 minutes before or after a meal. It's harder than you might think.
2. I have to drink a half gallon of water a day.
3. I have to stay on a 1500 calorie a day diet even though I'm still just as hungry as I ever was.
4. I have to exercise one hour a day.

You might want to ask your doctor about these things first. I wonder daily, "what was this sleeve suppose to do"? If I had it to do over I'd go with the bypass even though I hear it's not a smoking gun either.

So much for WLS.
on 10/24/09 10:43 am - Los Angeles, CA
Just wanted to add to the previous post from Hawk7110 that all of those things you have to do with RNY as well.  Basically, if you are not a diabetic and don't need the "negative feedback" provided by dumping, the sleeve may be a better choice for you.  But, if you are diabetic and have an insatiable sweet tooth, you may want to think about the RNY.

The sleeve, as a stand alone surgery, is newer.  Weisht loss results have genrally been better than the band and a little less than RNY.  Of course, it all depends on you and your compliance.

Good luck
Highest weight: 330 lbs
Day of surgery weight: 305 lbs
Height: 6' 3"        
on 6/18/10 4:53 pm
Jessica S.
on 4/25/12 7:13 pm
VSG on 02/15/13
 CLaRue84: can I ask how you are doing with your weight loss journey almost 2 years later?  I'm currently going through the pre-op procedures to get insurance approval and trying to decide whether the sleeve or bypass is a better option for me.  I'm leaning towards the sleeve due to malabsorption issues with bypass.   The data I've read so far seems to suggest bypass and sleeve patients are very comparable in long term weight loss, further pushing me towards the sleeve.  Any further advice you could provide given your experience would be greatly appreciated!
on 7/2/14 8:00 pm

I have been trying different diets to lose weight. I tried the personaltrainerfoods for 2 months mostly eating only meat n veggies n salads.... The food got OLD FAST! I lost 20 lbs and stopped, but my hair fell out... then I tried cooking my meats n veggies for the week on Saturdays (too much stuff in my tiny fridge)... then I thought I would try a low calorie diet... but I am a habitual grazer... I don't eat meals I eat stuff all day its like I am not satisfied unless I am chewing... I try to chew gum and it helps but I either don't get enough calories maybe 980 per day or I binge and get too many... I don't want to have an extremely restrictive surgery, I don't want dumping or issues with taking over the counter pain meds (I am getting older that would suck to be elderly one day and cant take anything good for pain), so many options ... I love sugar ... chips, or just munch munch munch.. I know surgery is not the complete answer but I am trying to figure out which is the best for me. People I know keep scaring me with stories like "I know someone that had bypass and can't get rid of her nausia" or "I know someone who had bariatric surgery and they can't eat much its made them unable to eat enough food" like there are some drastic dangers Im nervous about it. any suggestions? I thought about trying belviq

Sandie E.
on 7/2/14 10:15 pm - La Grande, OR
RNY on 05/14/14

I chose bypass over sleeve due to health issues with GERD, pre-diabetes, etc... With the sleeve, the possibility of reflux worsening was there and I didn't want anything to do with that. With the bypass you do need to make sure you can follow your plan to the 'T" and get all of your vitamins in everyday so you don't get any deficiencies. This is due to the malabsorption from the procedure. I suggest reading, googling, watching videos, etc... As much as you can. That's what I did and it helped so much! Good luck! It really depends so much on your personal situation and needs. 

 Highest - 281   1st appt - 274   Approval/pre-surgery - 259   Current - 140