Advice on VSG vs RNY...... trying to decide

Hello

Wondering if I can get some pros and cons to both surgeries and reasons why you chose yours

I am looking at getting a Sleeve or RNY in May 2013.... I meet the surgeon in 2 weeks and need to give him a somewhat decision by then.

The only options I have where I live is Band, Sleeve, RNY...... self pay is not an option for me 

Thanks So Much

Sleeve! easier recovery and waaay less cons than the rny. good luck!

I chose the sleeve for the following reasons:
1. I wanted to have a fully functioning stomach not a manmade pouch/stoma with a hole in it 2. I wanted to preserve my pyloric valve 3. I want to have the option of taking NSAIDS down the road should the need arise 4. I did not want reactive hypoglycemia, dumping syndrome, marginal ulcers, bowel obstruction and the like all of which can occur with the RnY 5. I did not want malabsorption of calories for only two years and malabsorption of vitamins and minerals forever 6. I did not want a blind stomach hanging around in my abdomen which cannot be scoped in case of ulcers and cancer 7. I did not want this blind stomach continuing to produce 100% of ghrelin (hunger hormone) 8. My surgeon tells me that the pouch can stretch given that it is partly made from the fundus while the fundus is completely removed during VSG 9. My surgeon also tells me that vitamin B12 and iron defficiency is more common with RnY patients than the sleeve because my remaining tiny tummy still produces intrinsic factor which will bind to the B12 and help absorb it while the RnY pouch does not 10. If I needed to lose more than the amount of weight I need to lose and if my surgeon would have recommended a malabsorptive surgery then it would have been the DS (duodenal switch) which is the Rolls Royce of WLS. If ever I will need a revision, this is what I would do. No doubt about it.
On the reversibility of a RnY: it is not that easy to take down a RNY and few surgeons are skilled enough to do it. I would not lull myself into thinking that any WLS, even the band, are ever fully reversible without leaving your insides with adhesions and scar tissue.
The RnY may be the gold standard of the past but it is quickly being overtaken by the sleeve. Studies continue to come out and are very encouraging. I recently read in a post here somewhere that someone seeking WLS asked a number of RnYers and thet ALL recommended the sleeve.
I am five weeks post op tomorrow and feel amazing. I had an easy surgery (with a hiatal hernia repair as well) and a painless recovery. I feel no hunger at all and have lost 24 lbs since surgery day. No vomiting, no nausea, no diahrea (a bit of constipation the first four days but awesome since), energy same as ever. Feeling really really great. And I was soooo scared before surgery that I wondered if I would actually have the guts to go theough with it. So glad I did!!!!
Best thing ever is that my blood glucose levels are normal since 3 days post op. i am no longer on metformin. my blood pressure is more or less normal and I am going to discuss scaling back the blood pressure meds with my PCP.
Whatever surgery you choose it has to be right for you, your body and life style and particular metabolic needs. I researched for a long time and spoke to many surgeons and doctors. They will recommend what they know how to do best....you have to take your health matters in your hands and research the heck out of all the options!! Best of luck with your decision and wish you excellent health in whatever path you take.

The sleeve gives you an excellent option to lose the weight and keep it off without as many risks.  I am thrilled with it at 9 months post op, I am BELOW GOAL and living maintenance now. As long as I follow the rules of protein first--no eating and drinking at the same time and not for 30 minutes after--I see myself doing very well in this. I had diabetes before surgery and do not have it now--and the motivation to keep diabetes at bay is MORE than enough to keep the weight off and follow the rules. I am also afraid of gaining the weight back and having diabetes again and perhaps having even more health problems as I age. That is another darn good motivator. I want my health #1, and #2 I am happy being a normal weight and never want to go back.

If you have RNY you may lose weight faster, but you will have more potential risks. Do you want to wear those skinny jeans faster or do you want to have better long term health? Hmmm..easy choice in my opinion.

My sister had RNY. I can tell you that it has worked well for her. She's kept off every ounce she lost for 7 years now. She follows all of the post op rules. Takes all of her vitamins. BUT THERE"S A BIG BUT... she still has to get iron infusions quite a bit. Her vitamin levels are NOT good, despite her best efforts.That is indeed scary because she is not even 30 years old yet.

You do need to take vitamins with the sleeve. It is possible to get defiicient, but it's usually easier to correct with a VSG vs. RNY. We don't malabsorb like RNY post ops do.

The band is definitely a NO GO--it is usually a temporary solution. Many banders end up having theirs taken out for many reasons, and some of those reasons are not their fault. The band itself is the problem a lot of the time. Sometimes, the person simply can't live well with a band. Choking on foods, stuck episodes and etc do not sound pleasant. Neither do expensive fills and unfills.

 

Best wishes!

Everyones wls is like their child... The one they have is perfect. I hope you posted this on the rny forum also. I was a self pay and chose vsg for me. I like the idea of getting rid of my ability to eat massive amounts of food w/out some of the other problem rny has. It seemed less extream and if I needed something more down the road there was always the ds. I've lost 136 lbs in 7 months. I had surgery 6.5 months ago. I have pretty faithfully followed my eating plan and measured and logged every bite on mfp. It has been easy for me and know that vsg was the right choice for me. Good luck with your decision!

Good comparison!

 CHACUN À SON GOÛT.

As Fred said - each to their own taste.  I can give you the reasons I chose the sleeve:

1. No re-routing - my system works as it was designed, 2. No ghost stomach that is there and can develop problems but can not be scoped, 3. No dumping (some can develop it, but far more likely in RNY, 4. No malabsorbtion, 5. Similar results to the RNY, 6. The part of the stomach that produces the hunger hormone is removed - so you are less hungry, 7. The part of the stomach that remains is less stretchy - so you feel full quickly - the pouch is stretch.  A co-worker who had RNY has stretched out her pouch to original size.  While you can stretch out your sleeve - it is harder to do - you would have to work at it.

Good luck making your decision!

Sleeve has far less cons! A girl at work had RNY and I had sleeve...she calls in sick to work 1-3 times a month where I have NEVER been sick! No dumping syndrome and I got to my original goal just as quick as she did. I work in hospital and see a lot more complications with RNY but to each their own. Good luck in whatever you choose!