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VSG or RNY

sandra5292
on 5/26/09 10:12 pm - Fresno, CA

When I started looking into WLS I had no idea there was a few options out there for me. I thought well I will just tell Dr. Higa (who I haven't met yet) I want the RNY. But after some research on the OH forum and a few tips from friends that have responded gracefuly to my blogs I find that I would like to look into VSG. I think that may be a safer and better choice for me. But of course I am not sure what the Surgeon will tell me when I meet with him in a month or two. I am very anxious and can't wait to start on my journey. Is anyone out there going thru the same thing I am going thru? I know that with all WLS there are risks and complications but does anyone think VSG is the best choice? I want to hear from people that have had the VSG and have had success with it or have had a bad experience and complications from having the VSG. Please help me as I try to sort all this out! thanks  

corky1057
on 5/26/09 11:01 pm - Holland, TX
VSG on 03/31/08 with
Sandra, when I started out researching, I had also never heard of the VSG. After much reading and asking questions, it quickly became apparent that this was the WLS for me. No long term issues, safer surgery, nearly identical weight loss to a bypass, eating normal foods, just much less off it, less chance of regain. I can take any medications I need, no worried about getting stuck or dumping.

I have had a wonderful experience and great success. I have NO regrets.


(((HUGS))) Mary      Pink RibbonSurvivor 
 
Handle every stressful situation like a dog.
If you can't eat it or play with it,
Just pee on it and walk away.










 

SmyleyFace
on 5/26/09 11:02 pm - Phoenix, AZ
RNY on 12/21/09 with
I have not had the surgery, but I have already learned alot from the forum. I have arthritis so the sleeve is better for me because the risk for ulcers is less. Also I like the idea that the part of the stomach that is left is not the part that stretches easily. I am not always compliant with calories or food choices so I need extra support there, the grehlin reduction from the sleeve.. many have said they actually forget to eat!!! I could use  that kind of help too. I have had nothing but trouble with the band and I like the fact that the lbs lost with the sleeve are comparable to the RNY without the rearranging of parts. Digestion still flows naturally. Keep asking questions.  Everybody here is really willing to help.  Thanks all of you!!!  Keep in touch, SmyleyFace , Maureen
 
                  NEVER TOO LATE TO BEE HAPPY!!!!            
        
GoingMobile
on 5/26/09 11:14 pm - San Dimas, CA
I think we all go through the same emotions and indecisions. When you find the right WLS procedure for you, you will know.

I would look at all 4 options talk to your A Dr that performs ALL 4 options and not just the LapBand adn RNY and go form there. read the forums and talk to people, go to a few support groups as well.

I chose the VSG becasue I am ahorrible pill taker, I know I would not take my vitamins like I NEED to with the DS or RNY. I laso have a need for nsaids so the RNY was a bad choice for me. 

Here is a link that explains all 4 choices ......

http://www.obesityaction.org/weightlossoptions/bariatricsurg ery.php

 I am also going to go out on limb adn say your Dr doesn't offer the BSG, as I have not heard of him before mso he/his office will say its new experimental adn no insurance will cover it. All not true but thats the sales pitch from Drs who do not perform the VSG. I hope you have a better experience but remeber this when you talk to him about it.

 
~~Sami~~ *.
on 5/26/09 11:16 pm - Jacksonville, FL
Revision on 07/07/08 with
I think it would help to know more about you... BMI, diet history (successful ever? never?), comorbidities, etc.

For example, if your BMI is 50+, skip the RNY and VSG, and go for the DS.  It's your best chance of long-term success.

I'd also go for a DS if you have had really bad Type 2... as it's your best chance at a cure.


However...if you're a relatively "normal" OH person... BMI in the low 40s, then I think you could do quite well with the VSG.  I've been on OH since 1998....and I've seen way too many Lap-Banders and RNYers have revisions.  I think, sadly, that there will probably be a good  portion of VSGers seeking revisions long-term... perhaps not as high as Lap-Band... but the advantage is that your stomach having been sleeved makes a revision quite easy.

From the numerous studies  out there, you're looking at on-average of 60% EWL with a Sleeve.  Plenty of people here reach goal... but plenty do not.  The good thing is that you will have less hunger due to the removal of the fundus of your stomach that produces ghrelin.  For some it's dramatic and lasts a long time.. for others, less so. 

You will have a normally functioning stomach.... which means no dumping.  Some potential RNYers view the no-dumping as a negative.. but it's important to note that roughly 25% of RNYers never dump... and a good portion of them stop dumping long-term.

You can eat pretty much anything with a VSG..which is both good and bad. :)  Grazing can be a problem for some... as although your stomach is small, you can refill it quite often. 

Also... just because your surgeon does the Sleeve doesn't mean he's an experienced Sleeve surgeon.  It's not a technically difficult operation... but technique can make a load of difference in terms of long-term satiety and success.  If you are seriously cconsidering the VSG (or the RNY or the DS), I really think you should seek out a surgeon that does all three operations (and frequently).  That way he can give you an unbiased opinion on which might be best for you.  You also have to deal with the very real insurance issues.  Not all insurance covers the Sleeve, but most cover the RNY(If they cover bariatric surgery, they'll cover it.)

Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008 by Dr. Roslin.  I've had three happy healthy Lap-Band babies.... and one VSG baby.  5 years out from revision to VSG.  Gained 55 pounds in past 5 months, now considering DS. :(

 

Jen C.
on 5/27/09 6:37 am
I agree with everything Corky said, except that there is "less chance of regain with the sleeve." There is no long term data on the sleeve so the chance of regain may be less, or it may actually be more. We don't know yet. The 5 year studies do show sleeve patients beginning to regain their weight, we'll have to see what happens.

Dr. Higa is one of the best bariatric surgeons in the country, he's a very skilled and respected surgeon with tons of experience and low complication rates. I don't know if he does the sleeve yet or not. I know he does not do the DS.

I couldn't have the RNY because I have arthritis, I need to take Motrin. So I was deciding between the sleeve or DS. and since my BMI is on the lower side I chose the sleeve.

Good luck with your decision!
 
Height: 5'7"     Join US On The VSG Maintenance Group Forum!!  
                          http://www.obesityhelp.com/group/VSGM/discussion/

liveinphx
on 5/27/09 7:01 am - Phoenix, AZ
On May 26, 2009 at 10:12 PM Pacific Time, sandra5292 wrote:

When I started looking into WLS I had no idea there was a few options out there for me. I thought well I will just tell Dr. Higa (who I haven't met yet) I want the RNY. But after some research on the OH forum and a few tips from friends that have responded gracefuly to my blogs I find that I would like to look into VSG. I think that may be a safer and better choice for me. But of course I am not sure what the Surgeon will tell me when I meet with him in a month or two. I am very anxious and can't wait to start on my journey. Is anyone out there going thru the same thing I am going thru? I know that with all WLS there are risks and complications but does anyone think VSG is the best choice? I want to hear from people that have had the VSG and have had success with it or have had a bad experience and complications from having the VSG. Please help me as I try to sort all this out! thanks  

I understand how hard making this decision is, been there and done that.
Most everyone, naturally, thinks that "their" choice is the best surgery method. I can only tell you what my experience has been and why I chose the sleeve.
I am 53 (52 at surgery). My BMI was over 51 and I weighed 263 before my pre-op liquid diet for 2 weeks. I am also just 5 ft tall so 263 was alot of weight on such a short person. I also had high blood pressure and sleep apnea.
I was self pay so I could have opted or any procedure and I researched all of them extensively both on and off the OH boards. I also got info from folks that had actually had the procedurces so I could get info "from the horses both" so to speak.
After gathering info I knew that I did not want any procedure that involved malabsorbtion. Many folks go that route and have great success but for me the potential risks outweighed the potential benefits.  I had a good friend that had the RNY procedure and despite having done everything "by the book" still experienced major medical issues directly attributable to malabsortion. I also did not want to risk any medication issues related to malabsrobtion and worrying about what meds I could or could not take or if they would be absorbed correctly and so on.
For some medical issues the lap band procedures were not an option for me and I also did not want to have to sorry about slippage, erosion, flipped ports or not being able to find that "sweet spot" where I would have enuogh restriction but still be able to eat.
For me the sleeve was the best of all worlds. I liked that there was no rerouting of my innards, I liked that the time on the table was shorter than with the bypass procedures as well. I was looking for a procedure that I thought gave me the greatest opportunity to learn how to eat like a normal person.
The sleeve allows me to feel full faster and stay feeling full longer. I still get hungry but again I am satisfied with normal portions of food.
That having been said, I also did a ton of work on me and my relationship with food, emotional issues around food and so on.
Since Jun 08 I have lost about 120 lbs, have gone from size 28 to 6 petite, I no longer take BP meds and no longer use CPAP machine.
I was blessed and did not have any complications. I was pretty much able to drink and eat with no problems pretty much from day one.
Feel free to PM . I too live in the Phx area and though I did not use her Blackstone is a great surgeon and I am thrilled for the Phoenix area that she is doing the sleeve procedure.
Whatever you do is it truthful, necessary and kind?
dw45
on 5/27/09 8:34 am - Hartford, AR
VSG on 03/23/09 with

I chose the VSG because I didn't want anything re-routed or any foreign object placed in me.
After researching the VSG...it was the perfect procedure for me.

I have no regrets and LOVE my SLEEVE!!!!


DW



                                                   10 lb lost pre-op       5'10
Plastic Surgery completed 12/17/09 with Dr. Sauceda (Anchor Cut Tummy Tuck, Medial Thigh Lift & Eyelid Surgery)


OldMedic
on 5/27/09 9:20 am - Alvaton, KY
I began researching weight loss surgery in 2003.  I spent many, many hours at medical libraries, University libraries, etc. looking into the various types of weight loss surgery.

I doscovered that the RnY is considered "the Gold Standard" when it comes to weight loss.  BUT, it also comes with a LOT of significant complications, and it requires that you never again take NSAIDS (which I have to have for my arthritis).  Long term, it is associated with a very high rate of ulceration of the intestines, severe vitamin deficiencies (even for people that regularly take vitamins) and malnutrition.  This is a problem with ANY of the types of wls that involve rerouting the intestines.

The band can work very well, for some people.  BUT, it trequires almost monthly doctor visits to adjust it properly, it is associated with a high rate of erosion, slippage, and other problems, and it does not work for abiout 40% of the people that have it because the pouch stretches.

The VSG has been done for over 60 years, but under the name Partial Gastrectomy.  It was originally done to treat stomach cancer and serverely belleding ulcers.  People that had it went to a normal weight leve and stayed there.  They did not tend to gain weight over time, unless they ate all of the wrong things.

It was initially done for weight loss as a part of the Duodenal Swith (and it still is).  They would do a VSG first, and then the relocation of the intestines later.  But, once again, it was discovered that for a LOT of people, the VSG alone worked.  The weight loss rate is very similar to that with the RnY.  There are no known long term complications.  

If you are going to have complications, they usually consists of either a leak, or a stricture of the stomach.  Both show up very early, and can be dealty with somewhat easily. (If you do not have followup with your surgeon however, your primary care doctor may not recognize the symptoms of a lea****il you are in serious trouble.  That is the one drawback to going to a foreign country to have your surgery.)

I have had zero complications, and I love my sleeve.  I have lost 124 pounds in 8 months, which isn't bad for a 65 year old.

I strongly recommend the VSG.  The ONLY people that I have heard of that had significant problems with it all went to foreign doctors, and had no real followup.  There are some things that just can not be handled over the phone.

A former Army Medic (1959-1969), Registered Nurse (1969-2000), College Instructor (1984-1989) and a retired Rehabilitation Counselor.  I am also a dual citizen of the USA and Canada.

High Weight 412 lbs.                    Date of Surgery 360.5                                 Present  170 lbs   

        
Julie S.
on 5/27/09 9:27 am - Laredo, TX
Hi Sandra,

I'm going through the same thing.  I'm going to see my Dr. next month to set pre op tests and I'm still nervous about the sleeve.  My doc thinks it's the best option for me since I'm paying out of pocket.  (my insurance does not covet WLS ) I guess what I really need to hear is what complications are most common and how do patients recover.  What if it fails?  What if you need your stomach back? lol sounds crazy but I can't help wondering.  Please keep in contact I invite you to share this experience with me. 
With God All things are possible!  
OldMedic
on 5/28/09 8:04 am - Alvaton, KY
The ONLY way it can fail is iof YOU do not do your part.

There are people that have this surgery and simply refuse to follow their diet plan.  They eat all of the wrong foods, force themselves to overeat, and sabotage their sleeve, big time.  Of course, they should never have been approved for surgery in the first place, but ????

There are essentially two significant possible complications.  A leak, which means that the stomach contents are leaking into the abdomwn, and strictures.

A leak is a very serious complication, and it must be dealt with immediately.  Depending on where it is and how big it is, it may be dealt with through running an instrument down your throat to your stomach, or surgery may be required.  Competent surgeons have a leak rate of well below 1%.

Strictures are where the sides of the stomach (or intestine, but that is VERY rare with a sleeve) sticjk together.  this is dealth with by running a tube down your throat to the stomach, and pushing the walls apart again.  Strictures of the intestines would have happened, whether or not you had the sleeve, but of course most patients don't see it that way.  In VERY severe cases, strictures may require urgery.  Once again, these happen in much less than 1% of the patients.

The biggest danger is if you have your surgery in a foreign country, and develop a problem after you return home.  Many regular doctors are not familiar with the symptoms of a leak, and you can get into serious trouble before they realize what is going on.  That's what happened to one woman on these boards.  She spent months in the hospital, and came close to dying.

The final complication that people have to worry about is death.  Death can happen with ANY surgery, even tonsilectomies.  The death rate for the VSG is comparable to that with any other major surgery.  it is generally less than 1% of patients, and with experienced surgeons, much less than 1%.  In my program, as an example, it is 1 tenth of one percent!

The higher your weight, and the more co-morbidities you have (such as sleep apnea, diabetes, hypertensions, etc.) the greater the risk of death.  BUT, if you don't have the weight loss surgery, your probability of death is MUCH, MUCH higher.

I have never read anything (and I have read literally thousands of pages of medical journals on weight loss surgery) about any patient that ever needed their removed portion of their stomach back.  In any case, it is gone, permanently, and it can't be restored.  If absolutely necessary, surgeons can fashion a "substitute stomach" out of intestine, which they do in advanced cancer patients, etc.

You can make yourself crazy with the what ifs.  I researched all forms of weight loss surgery for over 5 years before I had it done.  I used university libraries, medical libraries, spoke with many surgeons, did a ton of research on the net, etc.  The vertical sleeve gastrectomy is safe, and it works.

What more could you ask?

A former Army Medic (1959-1969), Registered Nurse (1969-2000), College Instructor (1984-1989) and a retired Rehabilitation Counselor.  I am also a dual citizen of the USA and Canada.

High Weight 412 lbs.                    Date of Surgery 360.5                                 Present  170 lbs