Why did you choose VSG over RNY?

Hi,

 

I am in the process of making an appointment for surgery and I was all set to have VSG, but now I am reconsidering RNY. Can someone help me think through this and tell me why you chose VSG? II might also post this on the RNY forum to get the other side) I appreciate hearing any stories or comments. Here is a little about me- I am 25, weigh 293 lbs but otherwise healthy except bad heartburn/reflux and some jooint pain, but I am anticipating health problems which is why I want to do this now. My biggest concern about RNY was not being able to absorb all the nutrients, and I already have a tendency to be anemic. I like the VSG because it seems like a less complicated procedure and I also like that the levels of the hormone (not even gonna try to spell it but the one that makes you hungry) go way down. Any thoughts? What made you chose one or the other? Thanks!

Congrats on starting this life changing journey. I'm less than a week post op but I was just in your same shoes about 3 months ago. I had my mind set on the sleeve for the same reasons you listed. I didn't want the risk of malnutrition, and the thought of having my appetite reduced so much sounded great. when talking to my surgeon he was pushing more towards RYN because it produced more wait lost. Ultimately, I did what I felt was best fit for me. Weigh the risks and benefits of both, pray about it, and let your Heart lead you.

1.  Didn't want my innards rerouted.

2.  Didn't want malabsorption.

3.  Didn't want my pyloric valve taken out. 

4.  Didn't want dumping, even though for a lot of RNY folks this does diminish over time.

And while yes, ghrelin (one of the hunger hormones; there are others) levels go down, your body still produces it, just in other places.  Don't think it will go away forever, because it doesn't, and besides...there are lots of other hormonal interactions that drive the impulse to eat.  Ghrelin is just one of the components of the complex hormonal interaction that produces hunger.

^^Ditto! My reasons verbatim!

All of the above. I knew I didn't want RNY because i have severe arthritis in my hands, knees, and feet and i will be taking an NSAID for the rest of my life. I wanted a sleeve, but my surgeon kinda talked me into the DS due to all my co-morbidities.  I went along with it, but I have to admit, I had some reservations. i tried to put on a brave face, figuring he knew more than i do. But I worried about what might happen if for some reason I could no longer afford all the supplements or i got Alzheimers and couldn't take care of myself. 

In the end, my insurance refused the DS but they approved the sleeve. I was actually relieved!  I am GREAT with it now and i'm looking forward to the sleeve in 8 days.

I realized that i need to advocate for myself and not let myself cave in to someone else's ideas of what i should do with my life. That's a primary reason that I am 100-lbs overweight.

My reasons for choosing VSG over RNY:

1. Vitamin deficiencies are fewer and less severe with VSG. I am 27, and plan to have more children, and I didn't like the idea of struggling to get in enough vitamins for myself, let alone any potential babies.

2. I know this is a tool. I know this is a forever commitment to healthier choices. I liked that with the VSG, the sleeve is less likely to stretch than any pouch created from RNY. I also liked knowing that as part of my tool, my sleeve will reduce the ghrelin hormone in my body. 

3. While I am morbidly obese and my health was starting to suffer, I do not yet have a problem with diabetes. If I had diabetes or was prediabetic, I would probably have considered the RNY my best option. While most people are able to change their consumption enough to reverse type 2 diabetes with the VSG, the RNY in most cases provides a nearly immediate stabilization in blood sugar post op, which would be a huge draw for anyone with T2D. I didn't require that feature.

4. The idea of a blind stomach freaks me out. 

5. I like that my anatomy is still in place - connected the same way, just one organ is a lot smaller. 

6. As this procedure becomes more and more common, the statistics are showing weight loss numbers coming in closer and closer to equal with RNY. If the results are so similar, why subject my body to additional and potentially more dangerous side effects from RNY?

Thanks for all the replies! This has been very helpful and you are all confirming my reasons for wanting VSG! Annie, I do not have kids yet but hubby and I want to start trying in a few years, so getting the correct nutrients is one of my main concerns as well.

I'm also fairly young (23), and my main reason for getting the sleeve over RNY is the malabsorption since I plan on having more children in the future. A gastrectomy just seems more natural than having everything re-routed down there. I guess maybe it just seems less drastic, but from following these forums I know what I need to do to get the same (if not better) results than RNY patients. 

My reasons are the same as others are listing, except for the children part.  Been there, done that, got the dirty diaper to prove it (I didn't keep it though!) lol

You know your body, stick to what is important to you.  The VSG is part body, part head for it to be a success.  Work on why you over eat and you will lose 100% of your weight and be happier for dealing with your problems.  It is too easy to transfer addictions unless our food triggers are eliminated.

God bless,

There were two major factors I considered, and 1 minor factor.  

1. Acid reflux - my surgeon told me that some patients with acid reflux tend to get WORSE with VSG, and then RNY is the only cure.  While I did have reflux very badly, I felt certain that it was due to the fact that my lap band had slipped and caused a hernia, and so I took the chance on VSG.  So far, so good.  I was on a PPI for 6 months to aid in healing.  While my reflux is still there, it's definitely controllable with one Prilosec a day now.

2. Dumping from sugar.  If my food addiction was to sweets, I would have strongly considered RNY, since dumping is one way to keep you away from eating sugar!  Sweets are not usually an issue for me, so I chose VSG.

The minor factor?  Both my brother and a work colleague had RNY done several years ago.  They both lost weight frighteningly fast to the point they looked ill while vomiting up their meals at least once a day.  Neither one changed their eating habits and relied solely on the surgery to change their life.  They have both now gained back at least half of the weight they lost, and show every indication of gaining it all back.  Now, I know logically that if they had followed the RNY program they'd be healthy today, but it's still a built-in prejudice in my head.  The lesson is that regardless of which surgery you choose, you must put the effort into working the program.  Surgery is about 5% of the equation - the rest is exercise, the right foods, and therapy if you need it.

Good luck - you'll make the right decision for you, I have no doubt!