On the band wagon for sleeve I think!

Hello everyone, i've been on the roux-en-Y site for a while now.  That is the surgery my husband had.  He has lost 160 pounds.  So, after a year of seeing how this man would do with everything, I decided I was ready.  My first choice was the lap band only because we have a surgeon (who is very nice by the way) that does this procedure only in my area.  Then, after going through 4 months of nutrition meetings for my insurance to do the lap band, I decided since my husband had such good results, I should travel and do the roux-en-y.  Well when I talked to his surgeon he showed me internal diagrams of where they do the surgery in roux-en-y and sleeve.  My eyes were immediately directed to the sleeve because it doesn't mess with the intestines.  I was just drawn in to that, and in my mind, it was a no brainer.  My surgeon said he would do either, but I had to decide this month.  So I've been back and forth ONLY because the surgeon said he would do either, but the sleeve does have more of a chance of leaking.   SO to me that is the only worrying factor from one to the other.  Thanks for any comments or advice that you may have.  I appreciate this board so much and everyone on the other sites were so nice and informative.  

Not messing with my intestines and less of an issue with mal absorption are the primary reason that made me decide on VSG.  As far as leakage goes, my surgeon said he performs a leak check while your are still under anesthesia, before he finishes up the surgery.  That made me feel a lot more comfortable with the procedure.

I didn't realize this, I will have more to ask him when I see him for the last meeting on the 18th.  Thank you for responding, I appreciate it.

Actually this is usually the case.  The surgeon will either do one of three things.  Perform a leak test while in surgery.  Perform a leak test after surgery ... like the day after to let things settle down so to speak.  Or do both.  I know that there are even some surgeons like those in Mexico that figure since you are traveling some distance and out of country they actually will do two or three prior to sending you on your way.

In my case I did have at least the one test that was about 18 hours post op and on the next day.  They did this before allowing my to drink anything.  Once I passed that test I could drink.  They kept me there for a couple hours after giving me a "lunch" of sorts to make sure things were going well.  Then I was discharged.  

I have not had my surgery yet, but Like you, I was originally leaning toward the lap band.  After speaking to my surgeon, we decided I should go with the sleeve or gastric bypass.  I was turned off by the bypass because of I didn't want my intestines messed with.  I had several heart to hearts with family and close friends on my decision, but knew I was the only one that could make the choice for myself.  I decided to go for the sleeve because after really thinking about it, I didn't want to put myself through all that i've done for surgery to have the lap band and not reach my full potential.  I also learned from my surgeons office that if the lap band failed (ie; i didn't lose enough weight) most insurances will not pay for a revision to another surgery unless....the band slipped, or eroded. 

Just remember.....With any surgery, there's always risks. They do several tests to make sure the sleeve doesn't leak after being stapled.  Good luck with your decision!

Thank you Krys!  Do you know how much longer it will be for you?  We could keep each other posted on our progress if you'd like.  Thanks for responding!

Yep you are right that you could have a leak.  Statistically that is unlikely though (even more unlikely if your surgeon has done a number of the VSGs ... you could ask for a rough guess on how many or how long he has been doing them).  Even if you were in the small number of people that had this issue it can be fixed.

The RNY has dumping syndrome as you are undoubtedly aware.  This doesn't sound like too much fun to me and this is an issue that can only be fixed by changing what or how you are eating.  Plus there is far more cutting involved.  In my opinion there are more possibilities for issues to occur with this more complicated surgery and reworking of your insides.  You could have a leak where the intestines are re-attached.  

Of course the VSG provides restriction while the RNY adds malabsorption to the mix.  The malabsorption thing can be a tough issue as you also already know.  

The only other thought I might have to help you choose is that if you had the VSG and for some reason it didn't work for you ... you may always have it revised to the RNY later on.  The reverse isn't true.  

There are so many people that have been very successful with both surgeries.  It seems like the VSG being less drastic and less complicated it would be the better choice.  Why do a more complicated and more restrictive surgery when you could opt for a easier path at least surgically speaking and from what I have seen also in general.

Thank you Calking!  I will as how many again, as I think he said he has done many?  You made a couple of points I hadn't thought about and I so appreciate you taking the time to post to me.  Thank you so much!

Well I know that you likely don't know my story but the VSG literally saved my life.  I didn't have even one complication and am extremely biased towards this surgery.  I so strongly believe that this is the way to go.  You can always use the RNY as a back up plan for a revision if absolutely necessary.  

I firmly believe that there isn't one person you could find in this forum that would trade their sleeve for the RNY ... and that is even including the ones that did have an issue or two pop up.  I am just about 10 months post op and doing great.  I have been on this forum for over a year now and I have read posts on a daily basis every day for this past year.  As I said there are people that have had an issue or two but then they got them taken care of and got back on track and are extremely satisfied with their choice.  Even read where some posted that they would go through the surgery and complication all over again to be where they are at this point in time.

I really think that the other point is that the sleeve is very forgiving.  There are people that have screwed up and started to gain some weight back.  They quickly go back to their post op plan that they started from day 1 post op and restarted from scratch and have become once again successful.  It does take work but the key to this is following your surgeon's and nutritionist's plan both pre op and post op to the letter.  If there is an issue with that plan then talk with either the surgeon or nutritionist and they can help you get past the issue and keep moving forward.  The second thing that is the most important thing is to log every bite and every slip into something like myfitnesspal.com.  You can get many people on here that will friend you and keep an eye on your progress.  Also you will be able to see what they are eating currently or in the past.  For me I started logging within the first week post op and I have with only two days of exceptions logged every bite since I started and even today.  I have a 10 month history of every bite along with a 10 month history of my weight.  I can see the positive correlation with my plan and what I have chosen to eat each and every day and the weight loss I have accomplished.  It is my plan to use myfitnesspal.com for the rest of my life.  It really helps to keep you honest. Plus if you come to a point where you aren't loosing any weight you can show this information with your nutritionist and together you can see where you may have strayed.

I would caution you as well that if you choose to do the VSG your plan may be slightly different than the plan your husband received.  Do not modify yours to look like his and don't let him change what he does to look like what you do.  He likely will have to have higher doses of vitamins and minerals do to the mal absorption issues than you will.  He will likely not be able to eat some of the sweeter things that you can eat.  

I am very pro VSG and if nothing else since it could later be revised to the RNY I figure you should go with the least invasive surgery and also more straight forward surgery at the same time.  On another note I think that the average surgery time for the VSG is between 1 and 1 1/2 hours whereas the RNY is closer to 2 hours or more.  You will be under for a longer period of time which could be an issue if you have an issue with the anesthesia.  I would think that the longer you are in surgery the more likely some issue might pop up.  You were thinking only of the leaks as an issue with surgery.  I counter that with a longer surgery time that would be the case with the RNY.  Now I don't expect either surgery to become an issue as the surgeon has also very likely done more RNY than VSG as it is a procedure that has been around longer.  A lot longer.  So you have a couple things like a longer time but perhaps more experience with that type of surgery would make the risks about equal.  

When I researched the VSG I found a local surgeon that told me that a laparoscopic gall bladder removal was slightly more risky than the VSG and slightly less risky than the RNY.  Overall there wasn't much risk in any of the three surgeries.

Awesome information!!  I appreciate knowing your background.  I will have to work at the logging of food as I'm not too organized in my personal life, but it's time for some big changes, I can see where this would be VERY beneficial to you if you would run into problems with stalls in the future.  A great big thank you to you for taking such time with me.  THANK YOU!!!!!!