VSG or Gastric Bypass?

I am trying to decide which surgery is for me. I was thinking lapband but totally changed my mind after hearing all those negative stories about it. And I wouldnt make it to my goal weight which is to lose over 200 pounds. WHats the differnece in vertical sleeve and bypass? I mean, I know in VSG they cut your stomach out and with bypass they reattach your intestines to another spot and both of them leave you with a small pouch. But as far as weight loss and problems whcih one is better? Or is it diffeerent for each person...probably so... please respond, I need some feedback

You are going to get biased answers from RNYers and VSGers. I think the best thing to do is to research each surgery and see the pros and cons of each and what best suits you. You can also visit the RNY board and the VSG board and ask specific questions you have regarding each surgery.

yeah your right. Thanks for responding.
Priscilla

I had trouble deciding which surgery to chose myself.  At first I was leaning towards VSG since my surgeon told me it was a (somewhat) less difficult surgery than RNY.  BUT after he also said that with the RNY patients typically lose about 30 more lbs than VSG patients I decidied to go with RNY.  I figure if I'm gonna do it then I might as well do the surgery that I feel will give me the best results.  However that being said-you may feel differently and you have to do what you feel is best for YOU!!  I did struggle with the decision for a while.

If you are not sure or are confused about the aspects of the 2 surgeries I would recommend (just my measly opinion) that you talk more to your surgeon.  There is also a lot of good info on this site about WLS.

Good luck to you!

I hope you've found a well expereinced surgeon who does oth surgeries.  Surgeons will usually look at your previous medical records and results of tests wanted prior to surgery. Depending on many details, the surgeon can help you.  Each one requires some behaviour modification for optimum results. The surgery alone will not fix overweight issues forever.  These surgeries are a tool to help you lose appreciable wt in a shorter time, but they cannot fix your eating habits. that's part of the behavior modification. You have to take supplements forever. If you're not one *****members daily items easily, you'll have to devise a method of reminding yourself to take your supplements.  You might stronly consider attending support group meetings for both of these surgeries. Talk to post ops there and ask questions. Take notes.  Problems can occur from any surgery--healing delays, scar tissue issues, etc. No two patients are identical in their wt loss progress either.  DAVE

There is another surgery you didn't list, the DS. All three are different in mechanics and this is a very personal decision only you can make.
The RNY is malabsorbtive in nature and does leave you with a pouch rather than an actual stomach. It does leave the original stomach in there, as a blind organ which can cause some problems of its own.
The VSG is purely restrictive where around 80% of the stomach is removed. The digestive tract is left intact including the pyloric valve (exit of the stomach) so your digestive system behaves as before, just much less volume. Advantage/disadvantage is you don't dump on fat/sugar/alcohol like you do on RNY.
The DS is a sleeve with a malabsorbtive component added to it. This takes religious commitment to taking your suppliments for life and keeping very careful watch on your labs.
You need to decide which surgery will fit best with your goals and life style, what you can live with.

Here's a website that has comparison charts to show the the before and after pics of the FOUR WLS procedures. And here are some pics from Google:

RNY gastric bypass:



VSG:


Duodenal Switch:



The RNY has a mild, temporary malabsorption of calories and permanent malabsorption of certain vitamins and minerals. The VSG is restriction-only---no malabsorption. The DS is the VSG PLUS permanent malabsorption of both vitamins AND calories---and has the very best long-term, maintained weight loss. It also has the best stats for resolving or preventing co-morbs like diabetes and high cholesterol.

Given that you need to lose 200 pounds, your best bet is the DS. The VSG and the RNY have about the same long-term results, but those results are NOT as good as the DS, especially for those of us with a starting BMI greater than 50.

This is a MAJOR decision, so study carefully ALL your options. You'll regret it later if you don't. Check out the Revision forum if you doubt me:www.obesityhelp.com/forums/revision/

Do you have comorbitities?  With 200 lbs. to lose I strongly suggest you check into the DS.  Ask your surgeon fror his suggestions.  I don't know of your surgeon performs the DS but his partner (Dr. Chasen) does.  The practice performs all 4 surgeries and can give you an honest opinion based on what your needs are.

My surgeon finds his bypass and sleeve patients lose about the same and have similar co-morbidity reduction. He also says the VSG is more metabolically "active" than bypass (but the DS is the most metabolically active) and has better hunger control.

There are surgeons out there whose VSG patients don't do quite as well as their RnY patients. But why use them when plenty of surgeons are getting better results than that?

Unless you intend to research and pay out of pocket, the first thing you may want to do is check with your insurance carrier to:

1.  See if WLS is covered.
2.  See what types are covered.


Good luck on your search!

Sandie