Still trying to decide sleeve vs bypass

First off I want to say thank you for all of your posts and words of encouragement for each other.  It has helped me to make the decision to have WLS.  I've been to see the surgeon and I'm trying to decide which procedure is best for me.  My BMI is 35 but I have health issues and trying to lose the weight I hit a brick wall.   Some feel if I'm going to do this go all the way and I usually live my life that way but after reading the forums it seems as if the sleeve has almost the same results.  Why did some of you chose the sleeve vs by-pass?

From this site...

Alternative to a Roux-en-Y Gastric Bypass
The Vertical Gastrectomy is a reasonable alternative to a Roux en Y Gastric Bypass for a number of reasons

1. Because there is no intestinal bypass, the risk of malabsorptive complications such as vitamin deficiency and protein deficiency is minimal.
2. There is no risk of marginal ulcer which occurs in over 2% of Roux en Y Gastric Bypass patients.
3. The pylorus is preserved so dumping syndrome does not occur or is minimal.
4. There is no intestinal obstruction since there is no intestinal bypass.
5. It is relatively easy to modify to an alternative procedure should weight loss be inadequate or weight regain occur.
6. The limited two year and 6 year weight loss data available to date is superior to current Banding and comparable to  Gastric Bypass weight loss data(see Lee, Jossart, Cirangle Surgical Endoscopy 2007).

Good luck with making a decision that is right for you.  I had the lap band and asked my surgeon if he would do the gastric bypass since I was not successful and he said yes, but he asked if I had considered the Sleeve - I had not heard of it - he explained it and I researched it.  I am so happy I had it - I'm only 5 weeks out - but it has been a wonderful decision. 

This is my standard reply when this question pops up every couple of days. I won't try to sway anyone one way or another, but I'll give you my reasons for choosing VSG over RNY for my revision from the band. You can also check out the revision, failure, and food issue forums on here to get an idea of some long term RNY patients. For me, it was never an option. The cons outweighed the pros.

The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.

1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.

2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.

3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.

4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me

5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.

6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,

7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.

8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.

9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.

I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!

Best wishes in your research!

I had a big old tummy and i ate too much,  now i have a nice small tummy and a normal portion makes me happy.  With the bypass they re arrange your intestines,   mine are fine thank you very much.  The regain that a lot of people i know who had the bypass have is not something i wanted either.  There are a lot less complications because the surgery is pretty simple, I still keep a normally fully functioning tummy.   Still able to take nsaids which is the only thing that has ever helped me with pain.  For me it was a no brainer.  With a low bmi of 35 i think you will do great with a sleeve.   Good luck in whatever you choose.  :o) jeani

Wow that's awesome.  I'm leaning towards the sleeve because I don't like the idea of re-routing my intestines either.  I'm not sure how I feel about the partial stomach removal  It just sounds scarey.  It's not like I'm going to ask for it back. I have to mentally work through that.   I would like to live an "as normal" life as possible and feel the same way.    I appreciate your input. 

My surgeon, who used to do the band, RNY and the sleeve, won't do the bypass anymore. He said he just saw too many complications from it and he feels that over the next ten years the sleeve will be THE way most people will go.

Wow it's funny you would say that.  My boyfriend and I were just talking about that.  Is the by-pass out and the sleeve in.  What confuses me is the sleeve would make more sense why didn't they do this before?  Why is this procedure new?

From what I understand, and people correct me if I am wrong...this procedure has been done for a long time, but it was done on people with stomach cancer to begin with. Only been done for weight loss for a few years now.

Amy P. posted a few times lately, as she is 6 years out from VSG, and has offered to answer questions, and she has posted her success with maintainence for the past 5-6 years. Her sx date
was oct of 05. It is very impressive to have the long term OH members come on to give you positive results first hand.
http://www.obesityhelp.com/forums/vsg/4389329/6-years-out-and-willing-to-help/