Newbie Q's

 Hi all,
I am really enjoying reading about all of your fantastic progress. I just met with my surgeon and we have decided to do a sleeve when I can get all of my paperwork in to him after my 6 mos. medically supervised weight loss. Hopefully May 2012?!
Anyway, he has only done 15 sleeves and says will probably have done another 30-50 by then. I was suprised that he agreed to sleeve as he is a huge RNY guy having done 1400 of those.
Do any of you ever wish you had gone with RNY or band? Am I at a higher risk of gaining weight back with this procedure? What was your main reason for choosing sleeve? Or what was your main reason for not choosing another type of surgery? Thanks y'all!

My insurance covers the RYN and Lap Band but I was so certain the VSG was the right surgery for me that I self paid for the procedure.

I didn't want the Band because of slippage and constant adjustments at the doctor's office. Also, once the band is removed the weight comes back.

I didn't want the RYN because of the malabsorption issues, rerouting of organs and the number of pills you have to take forever.

I'm more than 2 years post-op and I've lost 100% of my excess weight and have maintained without a lot of effort.

Best of luck,
George

Some say the risk of regaining the weight is actually higher with the bypass surgery because the pouch is created using the upper part of the stomach, which is the stretchiest part. With the sleeve, our new, smaller stomach is the inner curvature of the stomach, which is the least stretchiest part.

My reasons are the same as George's.

I LOVE my sleeve and knock on wood- have had no complications nor problems.

SO far 3 different people in my support group have had major complications with there Lap Band- 2 had to have it removed-one just this week! The more I learn about the Lap Band I am SO HAPPY I chose NOT to have it as it was my first choice.

The only people in my support group who have gained weight back- Bypass patients.

And I truly believe my first major tool to my weight loss-YES-is my sleeve but my second best-my therapist. I really feel WO my therapist and working on my brain I would not be successful with the weight loss.

Good luck on your journey  and no matter what you make the best decision for yourself and no one else!

 Just called insurance. They cover everything exactly the same so if you can jump through their hoops for one you have jumped through the hoops for all. Several websites said that sleeve was for extremely obese (check!) individuals and that there is potential that a second bypass or band surgery would need to be done in the future. It sounds like that is not actually the case from what you are all telling me. I only want to do this once. Well, this and get new boobs at some point. ;-)

Very good questions. Originally the sleeve was designed as a 2-part surgery for morbidly obese people, but after years of documentation, it became obvious that the sleeve was as successful for weight loss as the RNY without the issues that George noted.  The band can be successful but takes so long to lose the weight that many people become frustrated.

All of us can gain the weight back if we choose to fall off 'the plan'. But why would you do that after you've gone through 'jumping hoops' and all? Support groups and this website (VSG forums) are absolutely necessary to stay on track. You can do this, we all have gone through what you are going through now. Keep asking the questions and we'll give you our honest opinions and experiences.

Hi! I am in Alabama too, welcome to the forum. I am very happy with my sleeve thus far and have had no problems or complications. Here is a copy of a response that I posted to someone else asking the same questions about why I had the Sleeve over other procedures and a couple of url's to some recent articles comparing type 2 diabetes resolution with VSG and RNY and also regain with RNY and why they think it's higher with RNY than VSG. Good luck to you on your journey!!


The Sleeve is being covered by a lot of Insurance companies now, but not all of them. It has been performed for years, especially in other countries, but the US is both slow on Drs performing the procedure as well as Insurance coverage. It is equal to RNY on amount of weight loss and also early resolution of Type 2 Diabetes.
The reason I chose VSG over RNY is because I have back/hip problems as well, and wanted to be able to continue taking NSAIDS. You can't take them with RNY. I also had IBS, and it's not recommended to have the malabsorptive type WLS for people with IBS or Crohn's Disease. I also didn't want to have to battle the nutritional deficiencies and was seeing a lot of weight gain with RNY during my research. After 2 yrs with the RNY your body adapts and you no longer malabsorb calories, but the malabsorption of nutrients is forever. Below are a couple of fairly recent articles I found that explains that Pylorus preserving weight loss surgeries might be superior to the RNY on maintaining weight loss. You can just copy/paste them into your browser.


http://www.gastroendonews.com/ViewArticle.aspx?d=DDW&d_id=484&i=August+2011&i_id=755&a_id=18885


http://agajournals.wordpress.com/2011/09/08/bariatric-surgery-more-than-expected/

The characteristics of the sleeve regarding average weight loss and regain is similar to the RNY, with both being better than the bands on both counts. There are some indications that the regain resistence of the sleeve may be somewhat better than the RNY, but both are largely dependent upon us adopting and maintaining a reasonably healthy lifestyle long term post op; the DS is the only mainstream procedure that offers signifacantly better regain resistence than the others which are all considered to be restriction only procedures (the malabsorptive component of the RNY is temporary at best on the calorie front, though unfortunately is not temporary when it comes to malabsorbing minerals.)

The main reason I did not go with the RNY (never seriously considered it, for that matter) is, as noted above, it's performance as a weight loss tool is similar to the VSG, but its cost in lifestyle and medical treatment limitations is substantially higher. The DS was the only other procedure I considered but given the substantial lifestyle changes I had already made, did not feel that I needed that big of a weight loss tool to lose and maintain the remainder of what I had to lose.

I've researched wls for years LITERALLY. Started about 8 years ago researching it for and with my neice. She had the RNY 5 years ago because at the time it was the "gold standard" for wls. 5 years out...her hunger has returned with a vengeance and she frequently says she feels her "inner fat woman" calling to her. I work for one of the best GI docs in this area and he recommends the VSG, and says that his bet is that the VSG will soon replace the RNY as the gold standard for wls, and he has been researching the VSG since Dr. Cirangle started doing it years ago.
There is some recent research on wls patients that shows immediately post op the levels of grehlin drop signifigantly in all groups (except the lap band, it doesn't drop much at all)
by 5 years out...the level of grehlin in VSG and DS patients has risen minimally, but is almost back to normal levels in RNY patients, because that blind stomach is left in place and re-routed back to the intestines, and it eventually cranks back to full production. (i think the last article I read on it was an abstract titled something to the effect of "did the wls patient fail or did we fail the wls patient"
Also, at 5 years out, if my neice WANTED to...she can pack in as much food as she could pre-op because the pouch contains more of the stretchy fundus of the stomach.
That's why I chose VSG, and the fact that if I choose to eat a bite of something sweet, I don't want to have dumping ...and I do not want to deal with malabsorption and mega supplements the rest of my life.
Good luck to you on your decision!
-Pam