Bypass or Gastric Sleeve...which to have?

healthybabs

I saw my surgeon today for my first visit. I thought going in I was leaning toward the Bypass (RNY) but the more we talked about my options, I think I am leaning toward the gastric sleeve. I don't really have any other issues besides HBP and high triglycerides so I only have to see the NUT (2 visits pre-op and 1 post-op), Psyche eval, get bloods done, get a letter from my cardiologist that I am OK for surgery (she already told me verbally that she approves), and attend one group session pre-op and then one post-op. GS is an approved procedure here in CT and he said my BCBS approves in 2-4 wks. He sees no need for sleep apnea test or a pre surgical endoscopy. Since I am not diabetic and do not have acid reflux he thinks the sleeve would be best for me but really said it is up to me since both would suit my needs. I think the one huge benefit to the sleeve is that you don't have dumping because there is no rearranging of the intestines. He said pre-op and post-op process is the same as is the diet once post op. The only draw back is the rate of loss may be a little slower with the sleeve. He did recommend that I attend a group session and talk to people that have had both before I make up my mind. If all goes according to plan I could be looking at a surgery date late Feb to early March.

For those who have had either one is there anything you can share that may help me make up my mind. Did you have the sleeve and now wish you had the bypass? or vice versa?

tbahmanz

I had the gastric bypass but I sorta wish I had had the sleeve. Not sure if I would have done as well as I have with the sleeve but the long term effects are lessened with the sleeve. I had a friend who had the sleeve 10 months after I had the gastric bypass and she has lost way more weight than I have altogether. In the end, it is an individual decision between yourself and your doctor.

hmboucher

I had gastric sleeve on february 7th 2012 and i have lost 154 lbs so for me the weight loss was not slow at all, no matter which you choose just listen to what the doctor says, eating wise and exercise! I chose sleeve because i was not comfortable with the rerouting.
Good luck to you in whatever one you choose!

cakelady69

I have not had surgery yet, but one thing I liked about the bypass vs. the sleeve was that I could dump. It will hold me accountable and help keep me away from the foods I should not be having. (I hope that makes sense, its kind of a false safe) My doctor said that if you like sweets, then the sleeve is not the best choice. For me the sleeve would not be an option since I have had reflux issues for a while. Good luck with which ever you decide on. I look forward to watching your journey.

smokeywolf57

the only bad thing I heard about the sleeve is that it stretches and does not hold it in as it were. so if you over eat it will stretch to accommodation and wont go back into shape.

the nurse said she didn't think that they would do the sleeve up here at all

sapl31

My RNY was Feb 7, 2012. One thing I heard was the sleeve does not have as much research and time behind it, so they don't know as much about long term success. Dumping can be uncomfortable but can be an incentive to be careful what you eat. The only downside to my surgery has been an ulcer at the incision where they reconnected the intestine. I think there are probably good and bad both ways.

grim_traveller

When I first started looking into surgery about five or six years ago, the sleeve was fairly new, and had little track record. My hospital did not even offer it then. I was uncomfortable with the lack of track record, so I chose RNY rather than the sleeve when I went ahead with the surgery this past summer. Others have also made some good points here. I think dumping can be a good thing to keep me honest.

I assert nothing, just my own experience, but it seemed to me the sleeve had too much in common with the band, and for someone my size, RNY had a much higher success rate than banding.

VaingloriousVictoria

I chose the sleeve. For me, it was between the same two that you are looking at. I like the idea that the portion of my stomach that makes me hungry is gone. Plus, my pouch is small; I only eat 5-6 ounces in a sitting. I feel like I've been pretty successful up to this point. I had surgery on June 14th, and I've lost 74 pounds.

The rate of weight loss is faster with the RNY - according to what I've read online, but I was drawn to the idea that I would not have this overwhelming sense of hunger.

I don't have dumping syndrome. I can eat all foods, but I've completely changed my mind set and approach to eating. That's what needs to change. If I want a bite of cake, I might have it. 98% of the time, I don't eat what I used to eat. I am making more informed decisions. I highly recommend you do the meetings with the NUT before your surgery. They helped me out a lot.

Good luck to you!

healthybabs

Thanks for all the great input. I know the decision is ultimately mine to make and I will make a thoughtful one.

13turtles

My mom had the sleeve instead of RNY because of the absorbation levels. You absorb nutrients much better with the sleeve than with bypass. She has had wonderful success and would do it all over again! If you don't have reflux or diabetes, the sleeve is really a good choice, but ultimately it's up to you!

spfldpam

The decsion is up to you. I had sleeve surgery 6/11/12. I lost 47 pre op and have lost 51 post op. I wasn't for sure which to have either but was leaning towards the sleeve. After talking to my surgeon I decided on the sleeve. Less connecting and re connecting your guts with the sleeve.
Actually, you can stretch out your pouch from RNY too so with both you could "stretch out you sleeve or pouch". Like my surgeon said, in order to be succesful you have to follow the program, eat small amounts, 80 oz of liquids, exercise and make sure to get in 80 oz of protein. Don't eat till 15 minutes after liquids and no liquids 30 minutes after a meal.
Alot depends on how much you have to loose and how fast you loose it. The bigger you are the faster you will loose it. I am 172 today and wearing size large in pants and tops. My surgeon's goal weight for me is 156 pounds since that would be loosing 55% of my excess weight on surgery day. My personal goal weight is 130-140 pounds.
The sleeve has been done for years as part of a two part surgery. People who were super obese had the sleeve done first and then when they had lost some weight would go in for the RNY but many of those people were doing good with their sleeve and loosing and decided not to do the 2nd part surgery of the RNY so that is why there isn't as much stats on it since they have just been doing the sleeve only procedure and tracking it for 5 or 7 years.
I do think the complication rate is less with the sleeve. You don't have absorption issues either with the sleeve but I still have to take special bariatric vitamins.
Good luck!

mandyabraio

I was just approved for my VSG Monday! When I went to see my doctor the firs time, he highly recommended the sleeve over the bypass...said that it gives the same results but without all the bypassing etc...To be honest with you the bypass really scares me. I am currently waiting on a return call from my doctors office to set a surgery date...I would recommend the sleeve over the bypass just because I trust my surgeon 110% because he has done several of my surgeries for me in the past.

Wellypeep

I just had my surgery last week and was meant to have the bypass but ended up having the sleeve due to my intestines being a bit stuck together from previous operations. I am actually quite delighted so far though. I have had minimal pain, was up and walking within hours of my op and am managing really well on the liquid diet. I have no hunger which is a fairly startling thing to experience after a life of always wondering what I was going to eat next. Whatever you decide, I wish you all the best!

Tinalu69

I did lapband a few years ago and have had problems since. I am going forward and have decided to opt for sleeve when I have my band removed in the spring. I have to go through the pre-op requirements again, but hopefully it'll all be worth it! Looking forward to it!

grim_traveller

I did lapband a few years ago and have had problems since. I am going forward and have decided to opt for sleeve when I have my band removed in the spring. I have to go through the pre-op requirements again, but hopefully it'll all be worth it! Looking forward to it!

I'm sorry to hear you have to go through surgery again, and the problems you have had with the band. I'm two months postop RNY, and went to my first support group at the hospiral last week. I think about a third of the patients in the group had originally had the band, and for various reasons had revision surgery done, so you aren't alone. Good luck.

don666car

BY PASS ALMOST 1 YR AGO 196 DONE CANT SAY ANYTHING BAD ABOUT IT

healthybabs

My doc won't even recommend the lap band anymore and prefers patients opt for the bypass or sleeve. I have come to the decision of having the sleeve. Blood work on Monday, I have to see my cardiologist on Wed even though I just had my annual visit with her in July she wants to repeat the EKG and then she will write the letter to my doc clearing me for surgery, first NUT visit on Thursday. Boy, I have a busy week ahead!!

amyk0202

I think you'll be happy with the sleeve. I had my sleeve on 4/4/12 & have lost 73 lbs. I decided to have the sleeve rather than the bypass because I was uncomfortable with not absorbing all the nutrients in the foods I do get to eat. I did think about the dumping as being a pretty powerful motivator for the bypass, but I just couldn't get past the malabsorbtion.

It can be difficult because the surgery does not address the reasons why you are obese to begin with & without the threat of violently expelling things you shouldn't eat, it's only your decisions that will help you succeed. I still struggle with portion size--I can only eat 8 ounces of food at a sitting, but that doesn't stop me from putting too much food on my plate unless I measure everything out. I have to be very aware of my personal food issues & guard against them constantly. Sometimes I catch myself thinking that I can have this, that, or the other once I reach goal weight--another 43 lbs for me, but that will never be true. I will never be able to just eat without carefully considering my foods. I was morbidly obese because I do not make good choices about food without serious consideration (and recognizing my ability to rationalize many things) & that will never change for me. So, if you know what your personal demons are & think you can defeat them without the threat of dumping, I would definitely recommend the sleeve. It was the best decision I have ever made.

My dr. doesn't recommend the lap band either.

Wellypeep

I think amyk0202 has written really well about the key issues with any kind of surgery - it's about the changes we need to make in our minds as much as the physical changes to our digestive tracts. This is what I am really trying to press home to myself. My whole life has been about food as a comfort or a reward - a bad day or a good day generally had the same outcome. I lost 50lbs before my surgery and feel like I have made a good start to addressing my issues and finding other ways to feel better or reward myself. Like amyk, I am working on this being the start of lifelong better habits!!

ldturner

I've had my sleeve for 5 years now, and have kept the weight off, although I only lost about 80% of what I had hoped. It still boils down to making good food choices and getting some exercise in. As for the dumping, I have found that there is still a form of dumping with the sleeve, or a distinct feeling of being sick with stuff that digests fast, like ice cream. It's enough to make me avoid large portions, that is for sure! The sleeve does its job - restricting how much you can eat. That has never changed in all these years.

mistydk

Hello, I see you chose the sleeve. If you look at the stats that are out right now, RNY people typically lose more weight in the first year but then it's pretty close to the same in years 2 and 3. As far as long term studies, I haven't paid much attention to the studies coming out now about sleeves done in the early 2000's. The sleeve stomachs were done larger back then and surgeons did older techniques. Some surgeons figured out that the larger sleeves were experiencing weight regain after several years and they started making it smaller over the years. I'd say since about 2009 the surgeries have mostly been done with the smaller stomachs. Doctors have also found out that going closer to the pylorus helps too. So the technique has gotten better over time, including some surgeons "oversewing" the staple line to make the sleeve "tighter". Not all surgeons do that though. I honestly don't think the studies showing the newer techniques with the smaller stomachs will come out until at least 2018-2020 in my opinion.

I think the bypass is a good surgery for some, but I just wasn't willing to live with the risks of dumping and vitamin deficiency. I also didn't want to think about what would happen if I lost a job or insurance and couldn't afford the vitamin regimen that bypass patients require or what if I needed to go for frequent iron or b-12 injections and couldn't afford those? I know that some sleeve patients can end up having vitamin deficiency but it's much rarer and usually easier to correct than with a gastric bypass. So far, with a daily multivitamin and paying close attention to my diet needs, my vitamin labs have been great. I only spend about 10$ a month on my vitamins lol.

I am very happy about my surgery. I had it in February of 2012 and I've lost almost all my excess weight so far, over 90% excess weight loss. I am happy with the lifestyle that is required. Protein first--then complex carbs/veggies. I don't drink when I eat and wait 30 minutes after. I can live with these rules easily. Did I mention that I had type 2 diabetes when I had surgery? It's gone now. Of course, I'm sure much of that is due to the fact that I eat the high protein diet that is recommended for both sleeve patients and diabetics. Best of luck and if you need a friend, I'm here!