Your opinion please!

I also posted this on the VSG board, but thought I would post here to for some of you lightweights that have had VSG.
I have completed all of my pre-op requirements and am now waiting on insurance approval.  (Leaning on the RYN)  I have been checking on OH for about 5 months now and am seeing alot of posts on the VSG.  I have about 90lbs to lose.  I developed diabetes 2 years ago and have been on insulin for over a year now.  I also have hypertension, high cholesterol and high blood pressure and Im on medication for all of them.  Ive been overweight almost 20 years and the scale only seems to go in the wrong direction. 

OK, here is my question.  Because I know so little about the VSG, can you tell me why you believe one would be better for me than the other (RYN vs. VSG).  I have learned so much from the people on OH and I look forward to your responses.   

If you need to take NSAIDs the sleeve would be better..with that said, why not consider the DS, you get the best of two worlds, restriction and malasborption..I had the RNY and have done wonderful with it, but for a lifetime tool I wish I could have qualified for the DS..also RNY can greatly reduce the amount and types of food you can eat where you have a little more variability with the sleeve and DS..I have also read that some people with Diabetes have it return after a couple of years with RNY and not with DS..Like you are doing though the best thing is to research and know all your options.

Thanks aspan for your reply. Ive been doing more research now and really want to know ALL of my options. My opinion really seems to be changing

I think Aspan is right about doing some research on the DS. There are several surgeons who will do the DS on LWs due to diabetes and they will consider adjusting the common channel length so you don't have so much malabsorption. You can start to do some research on www.dsfacts.com .

--gina

RnY and VSG are about as effective as each other in terms of weight loss and co-morbidity resolution.  However, VSG cost less (important for s, has less complications, particularly long-term, and is more versatile when it comes to the food you can eat and the meds you can take.

My surgeon (and others) thinks VSG is the operation of the future and RnY is on its way out. However, at this time, more insurance companies cover RnY than VSG and there is more long term research on it as well. It's definitely the #1 performed operation in the US at this time (about 70% of all bariatric surgeries are RnY). Often, when people talk about WLS, they really mean "bypass" in fact.

Plus, some people like the idea of dumping when you eat "bad" food. Personally, I don't believe in "good" vs. "bad" food and I hate the idea of not being able to predict how I'm going to react to my food. So that made dumping a deal-breaker for me. Not to mention, not everyone with RnY dumps so if you get RnY because you "need" dumping to stay in line and then you don't dump, where does that leave you exactly? I figure, if you have a 60-70 % chance of not dumping long-term, you might as well learn to make good food choices without this threat. But, obviously, that's an individual thing and not a fact like percentage of EWL or diabetes resolution.

Finally, I personally feel like the long-term satiety with a sleeve is better than with RnY. This is just based on anecdotal evidence mostly from posts on OH but it seems like I constantly here long-term RnYers say things like "your hunger WILL come back" and "I can eat almost as much as I could pre-op!" once they are greater than 3 years out. But with VSG, you hear "I can eat more than in the first year" and "I'm hungrier than I was". IOW, we don't perceive our  hunger as coming totally back or that we can eat as much as normal people. Typical VSG servings even years out are 4-6 oz (by volume) vs. RnYers who typically can eat a cup of food. But again this is just anecdotal so take it with a grain of salt. 

I have some links about VSG on my blog including links to studies about VSG and Type II Diabetes, if you want to learn more:

http://fattyfightsback.blogspot.com/p/links-for-people-researching-vsg.html

I recommend that you find a doc who does multiple surgeries, and discuss all of the surgery types.  I had severe reflux, and with the VSG restriction, that can make reflux worse.  My doc recommeded RnY for me - he also does a lot of VSG and DS.  It seems to be working now.  And my reflux doesn't bother me at this point in time.

When it comes to WL, we all want the weight gone. Being a LW almost gives an added advantage because we don't have too much to go. I choose VSG because I didn't want anything re-routed or the issues of having certain med's not work in the future.

The VSG has been a dream with no complication to date and I feel like I was born this way. I hit goal quickly and by month 9 had exceeded my goal by 20 pounds. In total I've lost 106 pounds.

In the end you have to choose for you and No One else. Life's too short but researching and asking often leads us down the right road.

I wish you the best and hope you find yourself happy no matter what surgery type you choose.