THINKING ABOUT HAVING THE SLEEVE INSTEAD OF THE RNY??

I did the same thing----I had a surgery date for the RNY of January 9th and something just didn't feel right. I looked at these forums and did even more research and called my surgeon's office to swith to the sleeve. Now I am having surgery on Nov 30th. My patient advocate thinks I will be successful with this as well.
I am a very picky eater and moreof a volume eater as opposed to a 'wrong choices' eater. I think that is why the sleeve will be perfect me.

And I will even add that even though I have chosen the sleeve and am currently on my liquid diet for it, I still wonder if I shold have the RNY (silly right?)
I just worry that I won't loose ENOUGH weight with my sleeve but I guess that is really up to me.

Good luck!

Thanks Latoya I think me and you are in the same boat, and I feel the same way worried that I won't loose that much weight, and the chance of me regaining the weight, but you can do the same thing with the RNY! From what I read on these forums---some people have the same problems with both surgeries, so I guess it is up to what I want to deal with! Well I wish you well and I will keep you posted!

What many others before me have said, very well. I need to be able to take NSAIDs. I worried that I might not lose enough with the sleeve. I started out for the DS and was too scared of the postop vitamin regimen. At 29 lbs in six weeks Monday, I might not be the fastest loser, but I'll take it.

And congrats on your preop weight loss! It will only help.

Hi BethR311 while I don't have any major health concerns now, you never no what the future can hold or what could happen. Thanks for your comment it really means alot.

It's hard to beat USAFWife's treatise on the subject, so I will only add comments as I see fit -

My surgeon doesn't even give the RNY credit for two years' worth of caloric malabsorption, but irrespective the effective time for it, long term it will continue to malabsorb minerals, but not calories to any significant degree. This is why my doc doesn't offer it anymore.

Looking at the overall average performance of the RNY, the general population of studies indicate that average weight loss is in the 70-75% excess weight loss range, the same range as the VSG, while the bands tend to be down in the 45-55% EWL range and the DS in the 85-90% range. So, statistically, it offers very similar performance to the VSG, but at a much higher cost in lifestyle and medical treatment restrictions. On the regain front the RNY is not overly impressive as there is no real structural or metabolic changes made the significantly influence weight regain as there is with the DS; there is the premise held by some surgeons that the pyloric valve, which is bypassed along the rest of the stomach in the RNY, is one of the factors that helps the DS resist regain along with its' fat malabsorption, and that maintaining the pyloris in the VSG will likewise give it some regain advantage over the RNY. This is something that is still not well established due to the minimal long term data available so far on the VSG.

I never seriously considered the RNY for these reasons, and as my weight was already fairly stable for some years after losing quite a bit the old fashioned way I didn't feel that I needed the bigger hammer offered by the DS, which was my main alternative, either on the overall weight loss need or on the regain front. YMMV.

Since the RNY bypasses the duodenum, that part of the small intestines immediately below the stomach, along with the stomach, and the duodenum is where the bulk of our mineral absorption occurs, RNY patients have much more significant needs to supplement minerals; the DS only bypasses a portion of the duodenum, so it does not malabsorb minerals as completely as the RNY does. This is particularly an issue with post menapausal women who are already prone to problems with iron intake and osteoporosus. On the other hand, the DS does malabsorb fat soluble vitamins (A,E,D & K) along with the fats, but those are fairly easily supplemented with water soluble versions. My wife is about six years out with a DS, and at 60 doesn't have any particular iron issues (does not replenish well from any major blood loss, but doesn't need routine infusions, either, as some do,) though does have to supplement potassium; the other vitamin and mineral areas are not a particular supplementation issue for her.

Compounding the iron issue is that RNY patients often have minor but continuous blood loss from the suture line between the stomach pouch and the intestine - this is because, unlike the duodenum that the stomach normally empties into (even with the VSG and DS) the part of intestine that they join to the stomach pouch is not resistant to stomach acid, so that suture line is continually being irritated by the acid and has a hard time completely healing.

The final nail in the RNY's coffin in my mind is that of revision - what if we choose the wrong surgery, or it just isn't the one that works for us? The RNY is a very difficult surgery to revise - usually to a DS if regain was the problem - and there are only about a half dozen surgeons in North America who are really qualified to do such revisions. On the other hand, the VSG is the basis of the DS, so revising that, if it is needed, is a fairly straightforward completion of the DS - indeed, the VSG really got its' start as a weight loss procedure as the first phase of the DS done to those patients who were too weak or ill to subject to the longer surgery; many found that they lost enough weight with just the VSG that they didn't need the second part done.

In short, the RNY offers similar performance to the VSG, but at a cost in downsides similar to, if not greater than, the DS. So, that's my view, only slightly biased by a doc who no longer does RNYs, but is one of the few who you want to see to revise one.

 Wow I love it this was very educational! I really got alot of feedback, and  your research is Great! I think I have enough ino to make my decision! Thanks fro everything!

Either way, you are going to lose most of your stomach. So, I figured, if I can get the results that I want without messing with my colon too, why not? More organs cut meant more opportunity for complications. That was my logic. And keep in mind that this surgery has been going on for years for cancer.

In 5 months:
100 pounds down
size 11 shoe from size 11W
size 18 jeans (today) from size 28
on and on and on.

For me, the restriction is awesome. The progress keeps me motivated to workout and focus on protein and water intake.


I prayed and confidently made my decision with no doubts at all. I hope you experience that. Good luck.

Thanks I pray I will make the right decision also!