Why VSG? Deciding between RNY

Hey guys!! 

Im fairly new to the VSG forum and my pre-op journey has been over 9months.  I was originially scheduled to have a bypass on Sept 16th but I decided to cancel because I wasn't confident in my decision and the huge lifestyle change.

When I finally got to see my surgeon for a pre-op visit to cover any last questions, he really gave me a good persepctive on the sleeve.  I never even thought I would get any of these proceders when I first went to his seminar (i thought id just get the lapband). 

So I am wondering, why did you choose VSG over RNY?   

But even further, I am kind of freaked out about having a permantely smaler stomach with the procedure being pretty new (only 10 years now).  Did you think about these things in your decision? 

Thank you so much!! i need some support on here and getting pretty nervous for my surgery! 

I chose VSG for several reasons.

One being you have a more normal anatomy. The stomach is made smaller, but all else is normal. Less vitamin deficiency and malabsorption this way.

I am a medical student, so I see what goes wrong when intestines are played with, with a bypass, they reroute your intestines.

Also, they leave a portion of the stomach there, and there is as far as I know, no way to ever scope it if need be, check for cancer, etc.

Bypass is valuable in certain cir****tances, I just felt like it was a "less extreme" option. I also just sat in on a bariatric information seminar with my mother, and it looks like the newest data is showing the VSG rivaling Bypass for weight loss. So if it came down to the same results with each, I would take the one that doesnt mess with the intestines.

Also, the VSG has only been used as a bariatric stand alone for a decade, but its been used in treating cancer patients for decades, also as the first step of the RNY in severely morbidly obese patients who were not stable enough to perform a bypass on until they lost some of the weight.

Food for thought. Hold the cheesecake!

Thanks so much for replying.  I did ask my surgeon if he feels the RNY is reversible and he told me 100% yes and I could go back to normal if I needed to.  The other thing he told me with VSG is the possibility of leaks which only occur within the first month. 

Did you have any complications?  Can you eat any type of food if you really wanted to? (unlike the possibility of dumping like RNY)

Its a very individual choice, and its best to chose right the first time, whatever that may be. 
Some insurance companies are now only covering the first surgery, but NOT revision.

I didnt have any complications, now that I am further out, I can eat anything in moderation. There are the possibilities of leaks, but I haven't seen many in my 3 years on the boards from the VSG.

It was the first stage of the DS not the RNY.

Good to hear you didn't get the Band.  It was not at all what they claimed.  I am loving my Sleeve.

Why would he say you will have more chance of leaks with the sleeve than the RNY?  Is he not comfortable doing the sleeve.  You have a higher risk of leak with the RNY

He didnt say Id have a higher possibility, he said leaks only occur in the first month. After that its clear sailing.  

He also said the possibility of me getting any complications are very low (I am 25 with no medical conditions). 

Hijack - great to see you post.  I miss reading about your new life in vet school and seeing your great pics.  Your postings were really inspiration to me when I was thinking about having the surgery.  Hope all is well!

My reasons were very similar to Sassyitalians.  I was a big meal eater, so I went with VSG as it's restricts how much can eat vs how the RNY works.  I also could not imagine never being able to take NSAIDs again. I don't take them regularly, but use them for the occasional headache, or sometimes if I get bad lady cramps, and nothing else works for me. Plus I have arthritis in my family and if I get it I want to be able to take them for that pain. It was a small part of it, but it was still one of the reason. I am only four weeks out, but very glad I made this decision.

Good luck deciding!

Reasons for sleeve over bypass for me:

No intestinal re-routing and no malabsorption.  Moving my innards around made me nervous and I believed that having a restrictive surgery would be enough.

Keeping a normally functioning stomach/still having a pyloric valve.  Food still enters and exits the way it should.  There just less space to fill up.  And because food still processes normally, you're less likely to have dumping or reactive hypoglycemia.  But keep in mind that dumping only happens for about 1/3 of the rnyers, so there's no certainty that you'd dump.  And you can dump with the sleeve.  You can dump with no surgery at all.

Less of a risk of vitamin/mineral deficiencies.

Ability to take NSAIDs if necessary.

Not having a remnant stomach that can't be scoped or examined except through surgery.  Not having a stoma that seems inclined to stretch over time.

Partial and total gastrectomies (yes, you can live without a stomach) have been done for many, many decades as a treatment for stomach cancer and ulcers.  It's not a new surgery.  The shape of the gastrectomy - the sleeve or banana shape - is relatively new (a few decades).

Both surgeries work.  I know people IRL who have both and have done well, with no complications.  So it all comes down to what you're more comfortable with.