Sleeve vs Roux en Y
I'm looking at the different surgeries. The bariatric clinics push the Roux en Y, but I would like to know what your choice was and why.
Referral July 3, 2013 * Orientation October 16, 2013 * Nurse Practitioner November 6, 2013 * Ultrasound December 9, 2013 * Nutritionist & Social Worker December 12, 2013 * 2nd Nutritionist January 27, 2014 *Pulmonary Functions Test Feb 6, 2014* Endoscopy Feb 14, 2014* 2nd Nurse Practitioner March 3, 2014* Pre-Surgical Class April 16, 2014* Surgeon Dr. Neville May 20, 2014* Surgery October 2, 2014
on 11/6/13 8:03 pm - Canada
As far as I understand, you don't actually have a choice. RNY is the gold standard in Ontario and is performed much more frequently then the Vertical Sleeve. RNY and the Vertical Sleeve are the two operations which are covered by OHIP. The duodenal switch as well as lap band surgeries are not. I am going to be having the Vertical Sleeve because I have other health issues which negate me as a candidate for RNY such as frequent use of Prednisone and NSAIDs.
I am a rookie too, but I hope this helps :)
In Ontario the gold standard is Roux en Y to be eligible for sleeve you have to have certain medical conditions. However, you can speak to the doctor about why you would want a sleeve and if he feels it is necessary he may agree to do it.
I actually was going for Roux en Y but because I have crohns disease the surgeon fely the sleeve was better choice for me. I would have been happy with either one just to help with the weight loss, getting healthier and rid of the pain I was in.
Referral- March 2012, Letter April 19, Orientation TWH- June 6, NP - July 3, Sleep Apena test July 16, Internist and SW - July 17, Nutritional class - July 23, Dietician appt. July 30th, Psych-Social appt - Aug 20th. Follow up with doctor sleep apena Aug. 28th Surgeons appt. - Dec. 14th Dr. Jackson. Surgery date - Feb 12 2013 - VSG
Do you know what the medical conditions are, that allow you to qualify for the sleeve?
Referral July 3, 2013 * Orientation October 16, 2013 * Nurse Practitioner November 6, 2013 * Ultrasound December 9, 2013 * Nutritionist & Social Worker December 12, 2013 * 2nd Nutritionist January 27, 2014 *Pulmonary Functions Test Feb 6, 2014* Endoscopy Feb 14, 2014* 2nd Nurse Practitioner March 3, 2014* Pre-Surgical Class April 16, 2014* Surgeon Dr. Neville May 20, 2014* Surgery October 2, 2014
This will provide you with some information on the sleeve however, always talk tothe surgeon as he makes the decision on the surgery will perform.
http://www.ontariobariatricnetwork.ca/sleeve-gastrectomy.asp x
Referral- March 2012, Letter April 19, Orientation TWH- June 6, NP - July 3, Sleep Apena test July 16, Internist and SW - July 17, Nutritional class - July 23, Dietician appt. July 30th, Psych-Social appt - Aug 20th. Follow up with doctor sleep apena Aug. 28th Surgeons appt. - Dec. 14th Dr. Jackson. Surgery date - Feb 12 2013 - VSG
As the others said, OHIP covers only two procedures at the moment: RNY and VSG. The RNY is the usual surgery for Ontario patients. To be eligible for the VSG, there are a variety of factors that need to be considered. Previous surgeries (i.e., the presence of scar tissue), some medical conditions, etc. can rule out RNY for some people.
In my case, I have psoriatic arthritis that is extremely well controlled with NSAIDs. My rheumatologist was consulted, as was my family doctor, and both indicated that VSG (the Sleeve) is a better surgery for me because of this and wrote letters to the centre/surgeon in my electronic file to voice their preferences and reasoning.
I have yet to meet with the surgeon, but at the moment, it looks like it'll be VSG for me as well because of the psoriatic arthritis, because this type of arthritis will likely not change post-surgery.
Good luck!
OTTAWA -- 2011 - Contemplated WLS Feb. 15, 2013 - GP Feb. 20 - lung functioning Feb. 22 - blood work Feb. 27 - Referral April 19 - orientation, bloodwork July 10 - nurse July 23 - rheumatologist (VSG) Sept. 12 - Behaviourist & Dietician Oct. 23 - Echocardiogram Nov. 6 - Pre-surgery Class Nov. 12 - Surgeon Jan 13, 2014 - Optifast (3 wks) Jan. 27 - PATTS Feb. 3, 2014 - Surgery (VSG)
HEIGHT: 5'5" HW 303 Pre-Opti 297 SW 271 GW 170 CW 200 (Feb. 8, 2018 - damn the regain!) VSG with Dr. Yelle
~Danielle 
GP Referral: Summer 2012 Orientation: December 17 th, 2012 Dietitian/Social worker and Nurse Clinician January 31, 2013 Post OP: September 19th 2013 Surgery: October 21st, Dr.Smith (VGS)
on 11/7/13 7:30 am
I'm right at the beginning of the process, waiting for them to schedule an orientation, but am also in the same boat (colon cancer also in 2010, plus a large incisional hernia repair in 2012.) Will they do the Sleeve surgery laproscopically? The open surgeries take so much longer to recover from.
~Danielle
GP Referral: Summer 2012 Orientation: December 17 th, 2012 Dietitian/Social worker and Nurse Clinician January 31, 2013 Post OP: September 19th 2013 Surgery: October 21st, Dr.Smith (VGS)
Hi,
Great topic for discussion. More and more people seem to be asking about the Vertical Sleeve Gastrectomy vs. RNY. It may be starting to be the more popular and requested surgery. While the RNY may be an effective surgery for some, I believe it shouldn't be called the Gold Standard for everyone. This phrase is very misleading and may cause some people to not do the necessary research to find what is best for them.
There is some new research that shows that people who have had the sleeve have less regain after several years. Also, the pyloric valve is still intact. The study group with RNY has some issues with Reactive hypoglycemia which may lead to long term weight gain.
http://www.ncbi.nlm.nih.gov/pubmed/21184112
