New here and cannot decide which surgery to choose.

 Hello everyone :)
 
So I have done a lot of research on the available surgeries and I honestly cannot decide which one to have. I think I have ruled out the lapband and now I am mostly torn between having a DS and a Gastric Bypass. Here are my pros and cons: 

DS
Pros
-better chances for long term maintainence of weight loss
-no dumping syndrome
-larger stomach for larger portion size and more "normal" diet
-potential for more weight loss
Cons
- Surgery is more complex which equals greater risk
- Less common surgery so may have problems down the road with doctors not knowing how to treat you. 
-Vitamin Deficiency- I'm terrified of this one. I want to get pregnant again after the surgery (which is part of the reason I want surgery) and I am scared of not getting enough nutrition.
-Have to take a LOT more supplements. I am nervous about my ability to be consistent with the high number of supplements.  

Gastic Bypass
Pros
-Very common Bariatric surgery
-Will lose a great deal of weight and can potentially keep it off
-Surgery has been performed on a number of people and there is a lot more research available.
-Less supplements
Cons
-Potential for dumping syndrome
-Very small stomach, food can get stuck.
-Some people gain weight back over time. 

Gastic Sleeve
Pros
-Small intestine remains intact
-No dumping syndrome
-Reduction of hunger hormone
-Larger size stomach than GB
-Less risk of Vitamin Deficiency 
-Could convert to DS if I have trouble losing.
Cons
- Stomach could grow larger if I don't keep myself in check
- Requires a lot more discipline to maintain weightloss (which obviously I have problems with now)
-May not lose as much weight as with other surgeries.

So I have my seminar tonight, and I will probably learn even more. The good news is that they perform all of these surgeries so I can choose the one I want. The downside is that I don't know which to choose. How did you decide? What should I do? I don't know.. feeling a little stressed and like this is such a big decision. 

 I chose the sleeve.  I looked at a couple of options, starting with the band.  With the band the odds were stacked against me for losing the weight I needed t as quickly as I needed to.  The average numbers on the sleeve put me where I needed to be.  Plus, I could always revise to one of the other procedures if I needed to.

When I started I was at 343 lbs with Diabetes, High Blood pressure, Hyperlipidemia.  I also have cataracts from the diabetes and some limb issues.  A week after surgery I stopped all blodd sugar meds.  3 MOnths after my A1C was down to 5.4.  3 months after I stopped all BP meds.  I am now healthier than I have ever been.  I am even incorporating running into my exercise program and - gasp - looking forward to it.

For me the sleeve seemed to be the happy middle ground.  I have an emotional aversion to rerouting all of the plumbing - so I held those options in reserve.  I do worry about stretchng the sleeve, but thats not as common as it sounds.  You have to be a chronic overeater to make that happen.  The rule there really is stop when you feel full.

Best of luck to you on your journey!

For me, the biggest pro to the sleeve is no malabsorption* of nutrition (and therefore, only minor supplementation is needed).

The converse, for DS and RNY is that the body is limited in its absorption of nutrients from food and therefore heavy supplementation is needed. But, of course, the calorie absorption is restricted, too, so it's a double edged sword.

I don't mean that as a slam against those two surgeries. I view both as legitimate choices for WLS. I just wanted to offer my perspective.

*Edited to add that with the sleeve, there is malabsorption of B vitamins.  So there is some malabsorption, just not much. 

 
Well between DS and Gastric Bypass the DS has the best stats. Glad to hear you've ruled out the band. I wouldn't miss that on my worst enemy.

You're missing a couple of big cons on the RNY: loss of pyloric valve and reactive hypoglycemia. Both were deal breakers for me. I never seriously considered RNY. You'll have to make the lifestyle changes for any surgery to work, JMHO.

Hi...I am going to make this short and sweet and to the point.

I chose the sleeve because not one single person I know, or have read about, has had long term results with anything but the g.b. or the sleeve.

And the sleeve patients, all I have seen, never look sickly like the g.b. patients do because of the mal-absorption problem you have when you have the g.b.

You just look like you are losing weight with the sleeve.  And that is one of the main reasons I chose it.

On your pros and cons list...from my research and my information given to me by the doctors, the sleeve stomach is about the same size as the g.b. stomach, just shaped a little differently...and my food has gotten stuck so that kind of gets rid of that con on the g.b. since it happens with both.

I have also known people that have eaten around the g.b. so that also eliminates that issue.  Anyone can eat around either surgery if they want to.

Best of luck to you.

I had my surgery August 8, 2011 and to date have lost 82-85 lbs...i am plateauing right now so it keeps going back and forth...but to tell you, unless I tell someone I had the surgery, they don't know it as you don't look sickly...that to me was a huge  pro.

I don't think it's accurate to say gastric bypass patients look sickly.  I don't think I look sickly.  I know a lot of RNY patients that don't look sickly.

Now, I'm sure some gastric bypass patients do look sickly, but I'm pretty sure some VSG patients look sickly too.  I've even seen people that have not had any WLS that look sickly!  I don't think WLS of any kind makes people look sickly, though.  Not taking the proper vitamins might make people look sickly, though.

oh i agree with you and was just saying that those that i know personally have looked very sickly and it helped me to make my decision. 

i guess i should have expanded on that....didn't mean to offend if i did.

was just sharing from my own experience....and i will add that those that i know that did have b.p. adjusted to the weight loss anywhere from a year to a 1 1/2 years and looked just fine...this is again, as i have said, just my experience with those i know personally.

Good Luck with your decision, it sounds like your doing all your research and after tonight I'm sure with the help of your surgeon you can make a good decision. 

I originally had the lap-band so restrictive only.  It took me 2 yrs to lose the weight it was a lot of work-because with restriction only if you want to eat cookies and drink milkshakes-you can.  I did reach goal and maintained for over 5 yrs.  When my band malfunctioned and I regained some of my weight,  I revised to the RNY because I needed to lose the weight quickly and honestly I really needed the malabsorption piece.  No sugar and carbs and I am losing nicely. 

I think it's such a personal choice and you need to think about your own eating habits/issues or addictions.  If it's just portion sizes than restrictive only maybe a good choice.  If you're addicted to sugar, carbs etc than perhaps having malabsorption will be your answer!  I've had both types so I definitely know what it takes.  Good luck! Kari

If you are addicted to sugar, carbs etc then you are at a disadvantage with all the surgeries because no surgery will cause you to malabsorb those.  Malabsorption is mainly for fats with some malabsorption of complex carbs but none of simple carbs.  Those are absorbed 100% no matter which surgery you choose so if that is your issue it is best to address that along with WLS in order to have the best success.