Question:
What is your input VBG vs. Gastric Bypass
I went for my second Drs. visit today. They scheduled my surgery but I still don't know if my insurance is going to cover it or not. Anyway he seems to think that I will benefit from having VBG. I was wondering if someone wil let me know if they had this done and if your happy with it or would you have done Gastric Bypass instead! Any input would help at this point. — Terri S. (posted on May 14, 2003)
May 14, 2003
The VBG failurew rate is 80% over 5 years. With the tite band its hard to
eat goiod food but junk goes down grat:( Get the rny. If you really want
the VBG get the adjusatable band. The VBG is obsolete and being replaced by
the adjustable band.
— Sam J.
May 14, 2003
I agree with the first post. The failure rate for the VBG is very high.
Also, it truly is becoming the "old school" surgery. Many
younger docs simply will not perform it.
The RNY is a more modern approach - either open or laparoscopic. The
success rates are much higher in the long term.
There are also the options of the duodenal switch (don't know much about
that) and the new lap-band.
Personally I'm very happy with the RNY I had done. After all the reasearch
I did, I felt this was the choice for me to help with long term weight
reduction.
Definately look into all the choices and make sure you understand fully
what the differences in are.
Best of luck.
5 years. With the tite band its hard to eat goiod food but junk goes down
grat:( Get the rny. If you really want the VBG get the adjusatable band.
The VBG is obsolete and being replaced by the adjustable band.
— Anne R.
May 14, 2003
I had a VBG in 1983 and a revision to RNY in 2002. Believe me, you don't
want to have the revision - very hard surgery. I only lost 35 pounds total
with the VBG and 85 so far with the RNY. Also, revisions tend to have a
slower weight loss rate than newbies. My weight loss is extremely slow -
well at a total stand still now - and I still have at least 80 more pounds
to go. It's a very personal decision, but I just wanted to give you a
little info to chew on. Good Luck.
— Vicki H.
May 14, 2003
I had VBG in 1995, was revised to RNY last July due to staple line
disruption. I don't know how accurate the 80% thing is, but I can vouch
that with the ring, sometimes dense meats would get stuck and I would throw
up. I have only thrown up two or three times with the RNY. I had pretty
good success with the VBG until the SLD, lost 130 lbs. After SLD I gained
90 back. So far I've lost 80. My opinion would be to have the RNY, that way
you have a good weight loss, and if the dr. does it right and you are
transected, you won't be facing a second surgery several years down the
line.
— Ali M
May 15, 2003
A - the VBG is not obsolete, B - the failure rate is high for the RNY too
if you don't 'follow the program', C - there are a lot of Dr's still
preforming the VBG.
The decision to have either surgery is yours. Percentages and statistics
are sometimes quoted as opinions. I still have yet for someone to show me
a long term study on VBG that shows every participant compliant with the
'rules' of their vbg and the study and still have such a high failure rate.
If RNY is the so called 'gold standard' why is there revisions to a DS?
And why are there so many different lengths of intestines removed? There
is no 'gold standard'. With any surgery there is still a failure rate and
there is still a risk. Tell me that people who don't dump with an RNY
don't ever challenge their new system and never gain weight back.
I choose VBG, because i want to be able to live a normal life. I don't
want to have to take supplements and vitamins or take the risk of
developing some disorder because of it. I don't want to get so sick from
dumping that 'i wish i would just die' as i heard someone tell me before.
I don't want to have to watch every little gram of sugar/carbs/protein/etc.
because then i would just feel like i was on another diet. Forget it. If
I had to do it all over I would do it just the same.
Everyone has their own opinions about every surgery. Do your own research
and choose what you believe would be right for you.
I am almost 9 months out and down 118 pounds and still going.
— salymsmommy
May 15, 2003
It's not just about failure to "follow the program", surgical
failure DOES happen
<p>
Results of the surgical treatment of obesity.
<p>
MacLean LD, Rhode BM, Sampalis J, Forse RA.
<p>
Department of Surgery, McGill University, Montreal, Canada.
<p>
A prospective, randomized trial comparing vertical banded gastroplasty
(VBG) and vertical gastric bypass (GB) for obesity was completed in 106
patients who did not differ in baseline body mass index (BMI = kg/m2) or
length of follow-up. The goal of this surgery was to return patients to
within 50% of their ideal weight, i.e., a body mass index less than 35
kg/m2, and to accomplish this while maintaining a low risk for malnutrition
as well as other morbidity and mortality. Success was defined as a BMI less
than 35 kg/m2 because the mortality risk increases rapidly above this
degree of obesity. <b>Surgical failures were encountered in 43% of
the 54 patients in the VBG group, all of whom had division between the
vertical staple lines.</b> The main causes of failure were stenosis
and enlargement of the gastroplasty orifice. Surgery failed in 23% of the
GB-treated patients, due to perforation of the vertical staple line. An
isolated gastric bypass (IGB) not dependent on staples was performed as the
remedial operation for the failures of both VBG and GB. IGB was
significantly better than VBG or GB, with a success rate of 83% compared
with 39% for VBG and 58% for GB. Subsequent experience since completion of
this randomized trial in 54 consecutive patients supports IGB for primary,
as well as remedial, operations for the morbidly obese (BMI = 40 to 50
kg/m2), as well as for patients who are super obese (BMI greater than 50
kg/m2).
<p>
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8418692&dopt=Abstract
— Ali M
May 15, 2003
At the Hospital of the University of Pa, the VBG is typically only
performed in one of two cases - in the very high BMI cases (I'm talking
600-700 lb patients) and when conditions preclude a scheduled RNY to be
completed (such as a fatty liver). I'd say that the great majority of the
WLS performed at HUP is RNY nowadays - no lap bands, no DS and very little
VBG...JR (open RNY 07/17/02 -175 pounds)
— John Rushton
May 20, 2003
Terri, I'm for RNY. I had mine LAP on 9/3/02. I will say a few things and
leave the rest for you to decide. Just wanted to say a little something in
response to something Tabetha mentioned...Tabetha, the failure rate CAN BE
high in ANY surgical procedure with regard to WLS. Yes, RNY does have some
high failure rates. Guess what?? Sometimes these high failure rates can be
attributed to the patient being in non-compliance, other situations that
contribute to it is the patient's condition before AND the expertise of the
surgeon involved. I'm inclined to beleive that some may agree with what I'm
saying here. You asked the question, "then why are RNY revising to
DS"? It is a matter of personal choice often times IF the patient
wants to lose more and oftentimes the previous surgeon does not agree,
anyone can look for another surgeon and get what they want (especially if
their finances are in order and IF their insurance agrees to pay). Many
other things should be taken into consideration as well. Maybe the
person(s) that revised to DS didn't totally do their "homework"
in research of ALL types of WLS. I think to just make a blanket statement
against DS, RNY, VBG, SVB(sp?), micropouch, mini-gastric bypass or whatever
whether it was me or anyone else on this website, would not be the entire
truth. We all have to make up our own mind based on the information
provided (and not what is always given here becuase sometimes we just give
our "opinions"~each of us are entitled to that. It is VERY
important, everyone to understand that the decisions we make can make a
difference in our life...good or bad. It's who you choose to do your
surgery_his or her skill, competence, knowledge, IF they pay attention to
everything in your medical records, also your current medical condition(s).
IMHO, quite frankly, I agree with the rest of the posties here (because my
interest is in medical reseach-I work in it) and the VBG really does have a
high failure rate. My surgeon does, them ONLY at the request of the patient
coming for the consult. He also explains what the consequences COULD be.
Yes, the RNY is the "gold standard", but dig around in your
medical journals, and honestly, you will find why. Idon't feel it wise for
me to go into a lot of detail here, but I'm happy to supply additional info
on the subject. I just want to be able to obtain the help I need as well as
supply useful information that is accurate to the members here; both
pre-ops and post ops. I'm still learning, but since I'm more knowledgable
in some areas than in others, when I know what's what, and maybe it's not
accepted, then all I can do is move on.
Finally, Terri and everyone, this is JMHO, you don't have to agree or like
it, but have the surgery YOU feel is best for you...just, PLEASE do your
research with an open mind and find someone that you really have surgical
confidence in. Check out credentials and ASK questiond of the person who
you choose to do your surgery-the PROS & CONS-the advantages and
disadvantages. I don't know what else to say say about it other than the
fact that I'm glad I made the decision I did~as I'm sure each of us have. I
have no regrets. If anything I've said is offensive, my apologies. It
certainly is not my intent-just to tell the truth of what I know. LAP RNY
9/3/02 265/160/115-126 down -105#...
— yourdivaness
May 20, 2003
OOOps, I forgot, RNY's whether open or LAP, we do live a normal life as
well and thanks Alison for the article on failure-you're right, it does
occur. That's what I meant when I said it's very important to research, do
your homework and not just assume and go on our opinions.
— yourdivaness
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