Thought about RNY and went with VSG? You dodged a bullet

Saw this article on the Revision forum, thought y'all might find it interesting.  I'm going to add it to the list of research articles to print off for anyone who needs to use my VSG appeal letter:

Gastric bypass surgery has long been considered the gold standard for weight loss. However,. recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital’s Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial – a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.

The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis – there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar – followed by a swift exaggerated plunge – was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine. The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.

Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve – sleeve gastrectomy and duodenal switch – would lead to better glucose regulation, thus suppressing weight regain. The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure. The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.

“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss," said Dr. Roslin.

Thank you for sharing this information.

All i can say is Thank God i found out about the sleeve and didn't go along with my doctor who wanted to do the bypass.   Thanks for sharing,  i did read this on the main board.  :o) jeani

So you got the sleeve as opposed to the DS?

yes, i got the sleeve a year ago and couldn't be happier with my results  :o) jeani

Did they do it lap or open and how long was the surgery?  And how fast have you taken off the weight?

Surgery was about 45 mins, lap lost 80 lbs in a year but i have a bigger sleeve, each doctor makes them different ;o(  i eat more than most but at 162 and still losing quite happy with things  :o)

Do you know of any place that gives statistics on weight gain after RnY and the sleeve?

No sorry, you should maybe ask this on the main board, there is a lot of talk on there these days about the rny, stating that by losing the Pyloris (sp) valve they are seeing that there is a lot of regain with they rny. this thread is about this, you should go re read what sunshine originally posted its about this very subject at the top of this thread

Ok, thanks!