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Gastric bypass vs gastric sleeve??

(deactivated member)
on 6/2/08 3:46 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 6/2/08 10:09 pm - 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 2:36 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 6:16 am - 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 6:36 am - 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 6:45 am - 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 2:19 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 2:41 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 3:12 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 3:33 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