Question:
Which is better between the RNY and VBG (both open surgeries)?

I have the choice between an open RNY or an open VBG and I have no idea which is better. I am 303 pounds and have a pretty big sweet tooth and am a binge eater. I am curious which is better and why. I've read that the RNY is a bit better for people with big sweet tooths, but I also want to take into consideration the surgery risks (especially the risk of major complications and death!), scaring (is the incision length the same for both?), success rates, etc. I'm a bit more scared of the RNY since it's so drastic but I also don't want to waste my time with the VBG if the success rate is far less successful. Any insight, suggestions, comments, etc. would be greatly appreciated. Also if anyone knows of some good websites/urls that can tell me the specific differences between the two surgeries, I'd appreciate that very much too! Thank you!    — PamG (posted on July 22, 2005)

July 21, 2005
My surgeon says the VBGs 5 year failure rate is 85% and I believe it. Our support group is filled with VBG to RNY revisions. The tight VBG band allows high calorie liquids that are easy to eat. While good food like steak arent band friendly and hard to get down:( Get the RNY, its much more effective.<P> Lap vs open is only a matter of access, the actual surgery is the same. But do know about 1/3 of opens get incisional hernias, Lap the rate is near zero. This according to my doc. Both of these reports are backed up by posters here.<P> One last consideration, does this surgeon transect? Thats important to avoid a future surgery for a SLD, that causes ulcers and regain.
   — bob-haller

July 22, 2005
I agree with Bob. My VBG failed around the 5 year mark from a staple line disruption. I started to regain the weight. I decided to have a revision to RNY and that was done in 2002. I lost the weight I had regained plus a little more. I have had a successul pregnancy post RNY and I'm working on my second, due in October. You can get a good explanation with pics here at OH.com:<p> http://www.obesityhelp.com/morbidobesity/m-surgerytypes.phtml <p> Good Luck in your decision.
   — Ali M

July 22, 2005
From what I have read the VBG has a very high failure rate. I would not have had that surgery. However, just because the RNy is touted to be good for sweets eaters, let me tell you, it still comes down to choices. I didn't touch sweets for most of the 1st year. I ate almost all protein for the first 4 months to maximize ketosis and the weight loss. I then ate some veggies and fruit, but did not each much other sugar. Well at 2-1/2 yrs PO I can eat just about any amount of candy I want. I used to dump once I did start eating sweets but over time I have built up a tolerance to it. Occassionally I will dump on some small amount of something I normally tolerate and it just reminds me my anatomy is no longer normal. It will slow me down for a little while, but then I tend to float back. While I still stay away from certain sweets and I am afraid of them, the licorice and gummie life savers are my downfall. Those and Recess Peanut Butter Cups. I do fairly well in keeping it reasonable, but the bottom line is I am able to eat the sweets and unfortunately I chose to do it. My reason for going into this is do not choose the type of surgery based solely on planning to dump. You could be one who never dumps no matter how much sugar you eat. <p>I still know that the RNY was right for me. I have made a lot of changes in how I eat and I certainly cannot begin to eat the quantities I did pre-op. I'm still down about 235 lbs, but my highest loss was 252. So the sugar has caught up with me, but I seem to be able to hold things steady with what I am doing now, so I am comfortable with that. <p>Pick a good surgeon you trust and go forward with the RNY. JMO Chris D.
   — zoedogcbr

July 23, 2005
In the RNY section here. A woman from my surgery date forum has not lost much at all with her VBG and I have heard that it is common to have a high failure rate. I'm not sure of the statistics for risk between the two surgeries, but I would think both carry similar risks. There might be a small percentage difference but for me personally, it is not worth it to take a fraction of a decimal point less risk (when there is still risk involved) and have less of a chance of succeeding. Sugar - yes, you can acclimate over time. I can eat it in certain quantities depending on the type. I still will say RNY is best because it gives you that deterrent when you need it most - while in active weight loss phase. Good luck! Dina
   — Dinka Doo

July 23, 2005
The VBG has a HUGE failure rate!!!!!! My aunt had it 11 years ago and did OK and my mom had it in 2001 (same surgery and same DR)however, my mom failed. The band grew into the stomach and she wanted to have a revision to the RNY however her insurance has denied it 3 times. I had the RNY and have lost 200 lbs. I would have my surgery again if I had to. I love my DR and he is AWESOME!!!!!! What state are you from???? Hope
   — Hope Netterville

July 24, 2005
I had RNY and have had great success. Mother-in-law had VBG 12 years ago and started gaining back weight at about 5 yrs. post-op. Still throws up everything, but gain most of weight back. Sister-in-law had Adjustable band done about 1 1/2 yrs ago and has lost a most of weight, but she can't eat anything except ice cream, sweets that slide down easily. She is a diabetic on insulin pump. Not a good combination. Personally if you like lots of sweets he RNY will train you to not eat many. I can tolerate a few bites of dessert after a meal, but can't just eat sweets. If I do I will have dumping syndrome and trust me it is not fun. Good luck on your decision.
   — Melinda A.

July 26, 2005
Pam: Where I live in Nebraska, they do not do the VBG any longer. It has a high complication rate post surgery with leaks and staple line problems. Revisions are done more often than with the RNY because the RNY severs the stomach whereas, to my understanding, the VBG does not. The problems you have with sweets and binging has to be dealt with now before surgery to prepare you for the surgery. Don't expect surgery to solve your problems. You may get dumping, you may not. You may feel nausia with sweets you may not. This surgery is just a tool, and you have to learn to work your tool, or you won't have success. Many obese people can and will trick themselves into regaining their weight. We have lied to ourselves for years about our habits and had our excuses as to why we eat. I am glad you understand that you have binging and sweet problems, but you need concrete ways to deal with them now prior to surgery to get you started. I have lost about 110 pounds altogether, and I understand the desire for sweets. I am about 16 months since surgery, and am very thankful to The Lord for my success. But make no mistake, I can trick myself into eating too much and doing away with the success I have. It is a huge head game, and if you aren't willing to beat the head game, you should consider not playing the game at all. This is serious surgery, but there is serious success for those who put their tool to work and do what their doctor says. I have exercised hard for most of the last 16 months, and keep on top of my diet for the most part. I am at the phase when I can eat small amounts of most anything and am thankful, but diet and exercise will be part of my life for the rest of my life if I expect to maintain the weight I have lost, and I do. I have never been this healthy as an adult and am so thankful for what I have. I don't want to go backwards. For me that means no soda (only sips on occasion), as soda expands the stomach, even when it is flat, it means watching the candy and sugar intake, it means fighting the protein and water battle daily, along with vitamins and calcium every day. For me is means exercise on a daily basis as possible (I have travelled alot this summer :)). It is a real blessing this surgery, and the more research you do, the more you will be come aware. If you go to Google and type in weight loss surgery there are a good group of websites that will pop up, or type in the kind of surgery and see what pops up. What people say is important, but not as important as medical research. Be sure your information is accurate and that you have an advocate to bounce your answers off to (like your spouse or a good friend) to get objective opinions. Sorry to be so direct, but I hope it helps in some way. Take care. I kept a pretty good log of my journey on the site if you want to read it. Patricia P
   — Patricia P

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