Why VSG?

I am contemplating RNY or VSG and I would just like to have everyone's opinion why they chose VSG?  I am about 85/15 for VSG because I have asthma and while losing weight will help A LOT I am not sure it will completely take away symptoms and I was told you can't use steroids with an RNY.  I might need steroids if asthma starts kicking my butt - skinny or fat!  LOL

 I chose VSG because I didn't want my intestines re-routed and because I don't have more than 100lbs to lose I felt it was the best option for me and my doctor agree

yep. me too

The decision to have VSG vs RNY is an individual one.  Everyone will have differing reasons why they did the surgery they did.  My reasons for the VSG over any other WLS were as follows:  Malabsorption was not something that I wanted to play the game of Russian Roulette with...you never know how you are going to do with the re-routing of intestines and I was not willing to spin the chamber and see what happened.  As an RN, I have seen my fair share of complications for the malabsorptive procedures and I wanted no part of them.  I researched and chose a surgeon that had data that indicates the VSG is just as effective as the RNY in excess weight loss and it has way less complications.  I also have joint issues and asthma too, and, like you,  may need to take NSAID's and steriods from time to time.  Although, I will say that since I have lost 204+ pounds, that I have not had any joint pains/issues or asthma attacks.  I knew this was a procedure that I could live with and would have to whether I wanted to or not once it was done. 

I have found this journey to be relatively easy to navigate.  There have been forks in the road that had to be studied and decisions made, but I feel that I have done well with those forks and am still on the right highway for a lifetime of maintaining my weight loss and my new found health.

Good luck to you in your decision.

  Thanks for asking the question. I was just about to ask the same thing.

  I am in the same boat. Was looking at RNY, but besides being 100lbs overweight, I have only bad knees (facing replacement) and back. Those "co-morbidity" factors are not in my deck thankfully. I have recently been told that I am B-12 deficient. That concerns me because of the malabsorbtion part of the RNY. I really dont/havent done well taking meds on a schedule. I dont want to have to take supplements to counter the malabsorbtion. The rerouting of my insides always bugged me a little, but if that is what they needed to do, I was working on accepting that. 
  Then at a meeting, someone said they were getting a "sleeve". That looks so much better for me.  Less supplements, no rerouting, etc. I just need to know what to tell the doc.
  My 2nd appt is this Friday. I have everything done to set a surgery date. Just contemplating which surgery.

Any assistance would be appreciated.

I went with the VSG cause I didnt like the idea of malabsorption. Also the thought that Id malabsorb nutrients for life and calories for what 2 or 3 years seemed insane to me. I am very happy with the choice I made and hit goal in under 6 months.

 Same here - I didn't want anyone messing with my intestines.  Now my stomach?  You can have it!   Seriously, I watched my mom's struggles in the years prior to her death, and she had trouble eating enough to keep her alive.  I can't imagine what would have happened had she not been absorbing part of what she ate.   There was no way I was going to set myself up for that.  
-Second, I have never been the best at following a pill schedule.  When I was on meds for diabetes, I would forget them literally about half the time.  I was not someone who would have been good with having to take potfuls of supplements forever.  
-Third, I have always been a bit of a health food, veggie nut, and I think there are a lot of nutrients that we get from food that we don't even know about.  I eat very healthy, and I WANT to absorb what I eat!

You may want to read back a few pages as this question is here a lot, and you will see tons of responses.. mine are likely the same as many others:

I use NSAIDs for back/knee/ankle/migraines.. no NSAIDs with RNY for me would be torture.
I do not like the short and especially long term complications that RNY can have- there are too many to list, some are annoying some are life-threatening, and many are risks for life, not just early out.
I do not want to worry over medication absorption for anything I may need in the future.
I did not think the mild malabsorption is worth it.. when a few years it's gone and you are relying on pouch restriction alone.. but nutrients are still not fully absorbed.. nope.
I didn't like the idea of a pouch/stoma, especially as the stoma sometimes enlarges and food can pass freely without restriction, and no surgery that they have invented to tighten the stoma has proved effective long term.. once it's enlarged, that's it..
Dumping/hypoglycemia is a big no-no for me. Dumping would be horrible, hypoglycemia is dangerous and often leads to regain and revision.
The rates of revision for RNY are high. Not early out, but 5-10years, there are increasing numbers seeking it due to regain or uncontrolled complications.
My family has a long and bad history of serious gut issues, and I have my own that I deal with.. I wasn't going to have anything moved around in there if I could help it.

With all that said, all I will say about the sleeve it that it to me is it preserves the natural function of the stomach, leaves the guts alone and addresses my own person demon- overeating in volume. 
IF I wanted/needed malabsorption, the only one I'd consider would be the DS. If you have not read about it- please do. You would be able to have your steroids and have the additional benefit of life-long significant malabsorption.

Please read this transcript- it covers all the surgeries, and gives some more insight on the suspected why's of surgical failure (regain.)

edit- forgot the link:
http://www.obesityhelp.com/forums/amos/4416773/quotDoes-the- Patient-Fail-the-Procedure-or-Does-the/

The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.

1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.

2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.

3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.

4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me, check out the revision forum on here. . . Go back several pages and see just how many RNY patients are looking to revise due to weight regain. ERNY and Band over Bypass to get back some malabsorption and/or restriction

5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.

6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,

7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.

8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.

9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.

I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!

Best wishes in your research!


P.S. I wrote this before pregnancy. And, just as an update, I'm 26 weeks pregnant and thriving. The baby is weighing around 8oz heavier and is measuring right on target for length. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.

My sister had RNY 6 yrs ago.................. she has regained 50% of her weight loss, has to have blood transfusions every few months because of the malabsorption..................... that is why I chose VSG!!!!!!!!! Love my sleeve!!!!