My 600 lb. Life

on 2/24/20 7:16 pm

I have watched my "600 lb. Life" since its inception and have found it to be both inspirational and educational. I have also found it reassuring that I am not alone in the struggles I face, or have faced during the early part of my journey (I am nearing the 10 year mark since my RNY).

I do have a question. It seems that most of the patients featured on the earlier seasons of "My 600 lb. Life" had been getting RNY procedures. Then a few seasons back, I noticed Dr. Now started performing Gastric Sleeves on the patients featured on the show; any idea why he switched surgery types?

on 2/25/20 4:43 am, edited 2/24/20 8:45 pm
RNY on 06/03/15

VSG has really grown in popularity and seems to have taken over RNY in terms of numbers. I've presented to pre-op groups every month for the last three years, and I often ask for a show of hands of who's getting which surgery. Over that time, it's gradually gone from way more RNY - to slightly more RNY - to half & half - to slightly more VSG - to way more VSG. I know more patients request it because they think it's less "invasive", although the surgeons at my clinic have been at this for many years and are skilled at both. Why Dr. Now is doing more of them, I'm not sure. I don't know if those patients are requesting it, or if they're just doing more of them because that's the more popular of the two surgeries now. Surely he's very skilled at both. Anyway, I know that didn't answer your question - but I'm honestly not sure why he's switched.

Edited to add that now that VSG has been around for awhile and has "proven itself" (i.e., that it's not "Lapband II"), that may have something to do with it's surge in popularity, too. Less complicated surgery, and comparable as far as effectiveness and safety goes (???)

on 2/25/20 4:59 am - WI

VSG is the first part of the DS surgery.

The second part of the DS procedure reroutes food away from the upper part of the small intestine. The small intestine is divided and a connection is made near the end of the small intestine.

The third part of the DS procedure changes the normal way that bile and digestive juices break down food. One end of the small intestine is connected to the duodenum, near the bottom of the stomach.

If the patient does not lose enough weight with the VSG, then it is easier to revise to the DS since the first part of the surgery is already done.

Many super morbidly obese patients don't get to goal with only the VSG surgery. They are revised to DS. RNY to DS is a very complicated surgery and there are very few surgeons qualified to do it.

DR. Now is making his job easier and ensuring his patients have a successful outcome by making a revision surgery possible.

HW 270 SW 236 GW 160 CW 145 (15 pounds below goal!)

VBG Aug. 7, 1986, Revised to RNY Nov. 18, 2010

on 2/25/20 9:59 am

Hi Rocky513,

*******Ignorance Waiver on My Behalf! What follows may sound like stupid questions; I actually know nothing about the DS or VSG Procedures so please forgive my uneducated queries!********

Do all DS patients start out by first having the sleeve procedure? Do a good portion of VSG patients go on to have the DS? I had once heard that the sleeve was a 2 part procedure but until now, never knew what that 2nd part was.

on 2/25/20 3:52 pm

Same question from me too! (We can wave that waiver flag together)

on 2/25/20 7:39 pm
RNY on 06/03/15

I know this was directed at Rocky, but I can speak to it as well. They usually do the DS in one surgery nowadays, but traditionally (I think...) it was done in two, and it can still be done in two. It's a pretty straightforward revision if someone has a VSG and doesn't lose enough weight from that.

and no - most VSG patients don't go on to get a DS. Many do fine with just the VSG - which is why it's been offered as a standalone surgery for several years.

on 2/25/20 3:53 pm
VSG on 06/11/18

Also, the VSG takes less time than the RNY (20 minutes vs 45 minutes, if I recall correctly what my surgeon told me). For someone who's super morbidly obese, every extra minute that they spend under anaesthesia adds to the risk. On several shows, Dr. Now planned to do an RNY, but during surgery he found that the patient's body was under stress, so he decided to do VSG instead.

on 2/26/20 5:35 pm
VSG on 02/13/19

On the topic of DS.. my WLS program never even gave me the option to have the DS. I went to two programs in my area (Rochester General, and Highland Hospital) and both did not offer it. Kind of wish they did.



Day of Surgery-347