VSG vs RNY ???
A different perspective on why I chose the sleeve. My brother in law did the RNY and hit goal in 9 months, put on about 10 since then... but doing great. When it was time for me to decide here was what I weighed:
Pro sleeve:
- I have cancer, asthma, and allergies and need full access to medications. Steroids in particular are a regular occurring thing for me, and I did not want to have some meds not be an option.
-I cringe at the thought of the intestines being rerouted. I get intellectually that it is proven and reasonably safe, but on an emotional level tough to swallow. My mom died from colon cancer and i just don't like the idea of messing around with that area. Entirely irrational as there is no link to colon cancer that I am aware of, but an issue for me anyhow.
-I am not the best at remebering to take vitamins. Less of an issue with the sleeve, a huge issue with RNY.
- stretchy part of stomach is left with rny
- dumping- this was huge for me. I teach and cannot just suddenly leave to use the bathroom. Sleevers also may exprience dumping, but not many. I have had no problems with it.
-malabsoprtion of caloires with rny would be a boon- at first. But I know I would get used to eating those calories, and eventually they will start to count against you.
- easier recovery and less risk
- weightloss numbers for sleeve is comparable to rny. I was willing to risk not taking off the last 20 or 30 pounds and avoid rerouting intestines if it came to that. You can see by my ticker that I don't think it will be a problem.
-my brother in law cannot eat bread, pasta, or sugar. Sometimes food gets stuck on him and it is a very unpleasant experience. I get that it helps one to avoid these calories, but I did not want that for the rest of my life. At about a year out he was very tired of this restriction.
-cancer patients have had partial gastrectomies for a long time and data is good on them. I know, not the same but comparable a bit at least.
- my surgeon said if it didn't work as effectively as I needed I could revise to RNY if need be. Not a selling point in my opinion! It did help reassure me though that if it didn't work I still had an option. It worked though... my point is only that you can revise to rny or ds if it comes to that. I had a l of weight to take off... a little more than a typical sleever, but certainly far less then some sleevers. Jimbo on this board lost over 350 pounds and several lost over 200. I need to lose at least 140.
Pro rny
-my brother in law looks awesome and he hit goal in 9 months. He never revealed how much he lost, but for sure it was more then what I needed to take off. Will I hit goal in 9 months? Probably not, but I will be very close.
-he would do it again given the choice. His wife did share with me that he would do the sleeve now though- but at the time of his surgery it was not an option back then. He is jealous that I can eat bread and pasta in particular and food does not get stuck.
-the sleeve is a newer procedure so less long term data
-doctors tend to be less experienced in the procedure. My sugeon is a big RNY guy and tried to get me to consider it. I made the right choice, but it was a little disconcerting.
-procedure is more common so it is easier to find like minded folks. I should throw in here though that at support group there are many sleevers, so this might not be an issue in your area.
I love my sleeve and it was absolutely the right choice for me. Educate yourself and figure out what your best fit is.
Pro sleeve:
- I have cancer, asthma, and allergies and need full access to medications. Steroids in particular are a regular occurring thing for me, and I did not want to have some meds not be an option.
-I cringe at the thought of the intestines being rerouted. I get intellectually that it is proven and reasonably safe, but on an emotional level tough to swallow. My mom died from colon cancer and i just don't like the idea of messing around with that area. Entirely irrational as there is no link to colon cancer that I am aware of, but an issue for me anyhow.
-I am not the best at remebering to take vitamins. Less of an issue with the sleeve, a huge issue with RNY.
- stretchy part of stomach is left with rny
- dumping- this was huge for me. I teach and cannot just suddenly leave to use the bathroom. Sleevers also may exprience dumping, but not many. I have had no problems with it.
-malabsoprtion of caloires with rny would be a boon- at first. But I know I would get used to eating those calories, and eventually they will start to count against you.
- easier recovery and less risk
- weightloss numbers for sleeve is comparable to rny. I was willing to risk not taking off the last 20 or 30 pounds and avoid rerouting intestines if it came to that. You can see by my ticker that I don't think it will be a problem.
-my brother in law cannot eat bread, pasta, or sugar. Sometimes food gets stuck on him and it is a very unpleasant experience. I get that it helps one to avoid these calories, but I did not want that for the rest of my life. At about a year out he was very tired of this restriction.
-cancer patients have had partial gastrectomies for a long time and data is good on them. I know, not the same but comparable a bit at least.
- my surgeon said if it didn't work as effectively as I needed I could revise to RNY if need be. Not a selling point in my opinion! It did help reassure me though that if it didn't work I still had an option. It worked though... my point is only that you can revise to rny or ds if it comes to that. I had a l of weight to take off... a little more than a typical sleever, but certainly far less then some sleevers. Jimbo on this board lost over 350 pounds and several lost over 200. I need to lose at least 140.
Pro rny
-my brother in law looks awesome and he hit goal in 9 months. He never revealed how much he lost, but for sure it was more then what I needed to take off. Will I hit goal in 9 months? Probably not, but I will be very close.
-he would do it again given the choice. His wife did share with me that he would do the sleeve now though- but at the time of his surgery it was not an option back then. He is jealous that I can eat bread and pasta in particular and food does not get stuck.
-the sleeve is a newer procedure so less long term data
-doctors tend to be less experienced in the procedure. My sugeon is a big RNY guy and tried to get me to consider it. I made the right choice, but it was a little disconcerting.
-procedure is more common so it is easier to find like minded folks. I should throw in here though that at support group there are many sleevers, so this might not be an issue in your area.
I love my sleeve and it was absolutely the right choice for me. Educate yourself and figure out what your best fit is.
Surgeon: Chengelis Surgery on 12/19/2011 A little less carb eating compared to my weight loss phase loose sleever here!
1Mo: -21 2Mo: -16 3Mo: -12 4MO - 13 5MO: -11 6MO: -10 7MO: -10.3 8MO: -6 Goal in 8 months 4 days!! 6' 2'' EWL 103% Starting size 28 or 4x (tight) now size 12 or large, shoe size 12 w to 10.5 150+ pounds lost
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You've had a number of good responses so far. If you scroll back through this forum, you will see that this question is asked regularly and there may be additional responses in previous posts. Also, maybe do a search (in the box at the top right of page) for RNY vs VSG or visa versa). Good luck with your decision.
1) VSG, by removing the fundus of the stomach, removes 70% of the body's capacity for producing the hormone Ghrelin. Long term, serum ghrelin reduction in VSG patients is more than 50% as compared to pre-op levels. Ghrelin is a hormone that controls hunger. RNY, by contrast, does not remove the fundus, and long-term serum ghrelin levels are actually higher than pre-op. RNY increases rather than decreases hunger long-term while VSG decreases or in some cases eliminates it.
2) Mal-absorption of calories with RNY ends after 2 years or so leaving you with more hunger than you started with and but not the mal-absorption to deal with extra calories
3) Mal-absorption of vitamins and minerals with RNY is for life. While we do have to take supplements with VSG, generally, we don't have the intestinal mal-absorption component to deal with.
4) RNY - no NSAIDS and a blind stomach that can't be imaged properly or scoped.
5) While some VSG patients dump, it's not nearly at the same rate as RNY patients
6) Long-term weight gain is possible with both.
If you have long-standing Type II diabetes (particularly more than 10 years in duration), Duodenal Switch may be your best bet. DS is a VSG stomach plus some intestinal redirection to create permanent mal-absorption of calories, particularly fats. It requires a far stricter vitamin/supplement regimin, but it does a better job of handling long-standing Type 2 Diabetes than the sleeve alone. DS tends to have the best statistics in terms of long-term overall loss and maintenance, as well, but it's not for everyone. VSG patients tend to remain very happy with their surgery choice even if they have some weight gain.
2) Mal-absorption of calories with RNY ends after 2 years or so leaving you with more hunger than you started with and but not the mal-absorption to deal with extra calories
3) Mal-absorption of vitamins and minerals with RNY is for life. While we do have to take supplements with VSG, generally, we don't have the intestinal mal-absorption component to deal with.
4) RNY - no NSAIDS and a blind stomach that can't be imaged properly or scoped.
5) While some VSG patients dump, it's not nearly at the same rate as RNY patients
6) Long-term weight gain is possible with both.
If you have long-standing Type II diabetes (particularly more than 10 years in duration), Duodenal Switch may be your best bet. DS is a VSG stomach plus some intestinal redirection to create permanent mal-absorption of calories, particularly fats. It requires a far stricter vitamin/supplement regimin, but it does a better job of handling long-standing Type 2 Diabetes than the sleeve alone. DS tends to have the best statistics in terms of long-term overall loss and maintenance, as well, but it's not for everyone. VSG patients tend to remain very happy with their surgery choice even if they have some weight gain.
Carolyn (32 lbs lost Pre-op) HW: 291, SW: 259, GW: 129.5, CW: 126.4
Age: 45, Height: 5'2 1/4" , Stretch Goal: 122 
http://www.lenoxhillhospital.org/press_releases.aspx?id=2106
My standard reply is in this topic, it's several months old and I'm too lazy to update all the specifics, but for the cliffnote version, my daughter is now 8 months old, and I'm 6 months pregnant again.
http://www.obesityhelp.com/forums/vsg/4497254/Why-VSG-and-on-Roux-en-Y/
My standard reply is in this topic, it's several months old and I'm too lazy to update all the specifics, but for the cliffnote version, my daughter is now 8 months old, and I'm 6 months pregnant again.
http://www.obesityhelp.com/forums/vsg/4497254/Why-VSG-and-on-Roux-en-Y/
Band to VSG revision: June 3, 2009
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
I would talk to your doctor to see which one they think is best for you. I started out wanting the RNY, however, after I met with my surgeon the first time, I turned out to be a very poor candidate for the RNY. My doctor told me that he felt the RNY was too dangerous for me due to other health problems I've had my entire life (iron and vitamin b-12 deficiency anemia) and basicially, if I wanted to get a RNY, then find another doctor because he would not do it... and I outright refused to get a band... so, there came in the sleeve.
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