Gastric Sleeve vs Gastric Bypass

I am trying to decide between gastric sleeve vs gastric bypass. Here is a little background on me I'm 5'6 and 315lbs I have type 2 diabetes, PCOS, hypothyroid, acid reflux and just found out I have a very large fatty liver. I am just starting the pre op work up and it will be 6-8 months before I can have the surgery. Any help would be greatly appreciated.


  • khontz
    khontz Posts: 31 Member
    I chose the sleeve because it was the least evasive. Wasn't too keen on the remove, disconnect and reconnect. More chance for something to go wrong I felt.

    Was sleeved on February 25, 2013. Like all the first few weeks were a monster. I unlike a lot of people didn't have so much pain but just gas pain. Walking was my friend for sure. My doctor had me on semi soft food in 5 days. He told me to CHEW you don't need chopped food or baby food you have the best chopper in the world, your teeth!!!

    SO I managed through and dropped almost 200 lbs by November of last year and have been maintaining at 220. It has been a very rewarding experience and I can say I am not going back to where I was.

    I maintain on about 1200 -1800 calories a day striving for 100-120 grams of protein a day. Going to the gym three days a week now since last September and doing great with it. Having more energy than I ever did.
    Down from a size 54 waist to a 36~~~~@!!!!!!
    Feel free to ask me anything. If I can help or assist in any way just ask!!!
  • stroynaya
    stroynaya Posts: 326 Member
    I think either is good. I had RNY myself and have had no issues. The acid reflux might predispose you to one or the other. I remember when I did the classes, the doc said something about one being better for that, but since it wasn't an issue for me, I didn't really pay attention.
  • DJRonnieLINY
    DJRonnieLINY Posts: 475 Member
    Attend a support group and gather as much information about the two procedures as you can. There are posters in this group who have had great success with both VSG and RNY. More than likely your surgeon will reccomend which one he thinks is best for your situation but ultimately it's your choice.

    Fatty liver: You will more than likely be placed on a very strict pre-op diet (2 weeks liquid only) to shrink and de-fat the liver. SInce you have a known issues please take this seriously!

    I had the VSG (a good friend had the RNY) we both have great success though we have some different restrictions.

    *RNY primarily works through the malabsorbstion of food. You get a "plumbing" re-route which moves more partially digested food through the system. RNY requires lifetime supplimnets and many experience "dumping syndrome". RNY is reviersible.

    *VSG is not reversible. 75% of the stomach is removed leaving a small, non-elestic, pouch or sleeve. For most the final size of the pouch is approx 8 oz. (after many months of healing). Digestion takes place, no malabsorbstion and, for most, no dumping. The plumbing is not rerouted so food follows a normal digestive tract.

    At 9 months out I have lost 125 pounds, am keeping it off on maintenance and have no food rejections. I never had dumping, gradually worked up from 2oz liquids to 8 oz full meals. I never feel hungry, have great energy and am so glad I chose the VSG.
  • madmags
    madmags Posts: 1,340 Member
    I would do some research into which would help you more with the diabetes and PCOS. I know PCOS can cause insulin resistance and lead to diabetes. I know someone who had PCOS and a lot of the symptoms associated with it went away after the RNY procedure. The sleeve might do this as well, but not sure, so I would do some research and ask the surgeon directly how this will affect your medical conditions other than your weight.
  • april731
    april731 Posts: 122 Member
    I'm loving my sleeve and wouldn't change a thing about it, but I don't have type 2 diabetes. When I was discussing surgery options with my doc he said that it was up to me, but I remember him saying that RNY was best for diabetics. Also, I know that the sleeve can exacerbate acid reflux - although I haven't had this issue and mine is easily controlled with Prilosec OTC once a day.

    I chose the sleeve because I was wary of rearranging my guts, long term malabsorption of nutrients and medications, and having an inaccessible remnant stomach that can't be easily scoped in the event of an ulcer or cancer. I agree with the other posters to research as much as you can before making your decision. Good luck!!
  • murphyraven
    murphyraven Posts: 163 Member
    I also have PCOS although I have not yet developed diabetes. I have 100-120lbs to lose. I was very interested in the sleeve due to studies regarding hormone changes, resolving diabetes and helping with insulin resistance (which is mainly what pcos is caused by).

    Here's a interesting article regarding hormone impact from the sleeve.

    As always, your surgeon will be the best person to discuss the pros and cons of each surgery with and make an informed decision.
  • SimplySusan63
    SimplySusan63 Posts: 88 Member
    I had the sleeve done 5/5/14. I was 284, PCOS, pre-diabetic, hypothyroidism, high cholesterol. I did a lot of research and attended a local support group for weight loss surgery. My doctor gave me the choice and left that decision up to me. Bypass will provide better overall weight loss, and has more possible complications. Sleeve is still great weight loss with fewer possible complications. While I want all the help I can get, I was more comfortable with taking fewer risks. The sleeve is less 'body modification.'

    I am very happy with the choice I made, and I have no regrets!

    It is really between you and your doctor. Get all the accurate information you can and make sure it's a decision you can live with. Good luck and enjoy the whole process. It's well worth the effort.
  • Dannadl
    Dannadl Posts: 120 Member
    I had RNY 2 years ago. When I had my surgery, my Dr. went over the sleeve, the band and RNY and pulled out the statistics and studies. At the time of my surgery there had been more long term studies on RNY than the other 2 procedures. At the time, RNY had the lowest rate of complications and mortality of the three surgeries and had the highest long term success rate (maintaining weight loss 5+ years post op) and had the highest rate of percentage of excess weight lost. So I opted with RNY. I've had no complications and have lost 180lbs. Prior to surgery I had no co-morbidities except high cholesterol. My surgery was laparoscopic and easy. I had surgery on Friday afternoon and came home on Sunday morning. I never took a pain killer after release from the hospital and felt about 90% after a week.
  • pawoodhull
    pawoodhull Posts: 1,759 Member
    My personal preference was for the sleeve, which I had done July 2011. Both are effective, just in different ways and I've met lots of people on here who have been successful with either. Personally I chose the sleeve because I feel the sleeve is more "natural" as it simply reduces the size of the stomach by removing the stretchy part of the stomach. No disconnecting and rerouting at all like you have with bypass. Also, bypass has lifetime restrictions on certain over the counter meds and some stomach tests that the sleeve doesn't. I didn't want to deal with those restrictions either. That said, either way you go, weight loss surgery is a tool. Use it well and you will get the weight off. Keep using it and you will keep the weight off. Truth is, you can outeat any of the weight loss surgeries and regain. After a point, losing and maintaining is all on you.

    You mentioned heartburn/acid reflux. I have acid reflux and my doctor told me depending on how well controled it is with medication and if there was damage to my stomach lining and my esophagus, the sleeve might not be available to me. RNY is better for patients who have reflux issues. Turns out I didn't have any damage from my reflux and it is well controlled with my daily Omaprozole, so I was able to get the surgery I wanted.

    Hope this helps, but as others have said, attend the seminars for both, educate yourself, talk with your doctor and then make your decision. My sleeve was the best thing I've ever done for myself. Surgery and recovery were relatively easy as I had no complications and I am very happy with my decision.
  • katematt313
    katematt313 Posts: 624 Member
    I had the sleeve. I found some information online that said that people with type II diabetes and PCOS (which I also had) had better resolution of their symptoms with VSG, because the part of the stomach that is removed has something to do with the production of ghrelin and other hormones, and both type II diabetes and PCOS are hormonal diseases.

    I came home from the hospital post op with no diabetes meds. My diabetes was completely resolved. My MD said that is quite common following WLS.

    I wouldn't get RNY. Don't mess with your intestines, is my philosophy. The sleeve is less invasive. Actually, there are a number of people who are exceptionally obese, and they have VSG first, then get RNY later when it is safer to do so.

    Good luck. Go to support groups and meet others who are post op and get info from them. That is the best way to decide.
  • adiggs2777
    adiggs2777 Posts: 111 Member
    I was not interested in having malabsorption nor a plumbing reroute. So I had the sleeve. Pre-op I was a type II diabetic. Post-op I am no longer on any medications for diabetes.
  • pattycakes726
    pattycakes726 Posts: 348 Member
    I wanted the sleeve because it was the least invasive procedure and I thought it would fit best with my lifestyle. My good friend had RNY and has also been very successful. My doc does feel diabetics should opt for RNY. Good luck!
  • curlideb
    curlideb Posts: 2
    Thank you everyone for your advice, I am still doing research and talking with my doctor regarding my options.
  • Losing_Sarah
    Losing_Sarah Posts: 279 Member
    I am sleeved. I went back and forth between the two during the first 4-5 months of my 6 month pre-op stuff. I just continuously researched both options, made a list of the pros and cons of each that would affect me the most, and eventually it came to me. I started leaning heavily towards the sleeve around 3-4 months in, and then made my final decision. I wanted a less evasive surgery and wanted to be able to take NSAIDs if I needed one. It's the ONLY pain med that works for me, so I factored that in. I liked the idea of just having a smaller stomach vs having the re-routing done.

    We are all different, and should know our needs. I imagine that once you've done some more research on both surgeries, attend some support groups if you can, or even spend some time in this group for support it will just come to you as the best choice for you.

    Good Luck!
  • Vickil57
    Vickil57 Posts: 1,798 Member
    I realize this is not one of the choices, but I had the lap band done in Nov 2012 and have lost 155 pounds so far. I dicided on this after checking out and having two sisters that had by pass. They lost the weight and gained back and not able to have anything else done. Also I know acouple people that had the lap band with good results. The best part for me is it can be ajusted the rest of my life if I need to lose more or gain some. That was the diciding factor for me. Good Luck in whatever you do.
  • grace20072010
    I originally had the lap band and I had to revise to gastric bypass. My surgeon does the sleeve but from the band, I developed severe acid reflux and achalasia and my doctor said the sleeve is so similar to the band mechanism that he couldn't do the sleeve on me. So I avoided it for a long time and just kept the band unfilled, but finally decided I had to get control of my weight so I went with the RNY procedure. It has been a hard 4 weeks since my surgery due to chronic nausea but I do seem to be losing weight. The only thing I will mention is my doctor said that although he does the sleeve, there isn't as much long-term data out there about it so he prefers doing the RNY procedure as there is more research on long term success/complications.

    You mentioned you had reflux - VSG can exacerbate that so you might want to talk to your doctor about that. Anyway, I am sure whatever you choose will be good. Also, bypass seems to work better for diabetics statistically. Had I had the sleeve as a viable option I am not sure what I would have done. Best of luck to you.

    Oh - I have PCOS too. I haven't lost enough weight yet to notice a difference. I think with PCOS the act of simply getting to a healthy weight is what alleviates many of the symptoms, and both procedures allow weigh loss. Everything I have read seems to say that both procedures are good for PCOS.
  • Gingersfit
    Gingersfit Posts: 31
    I had RNY 4 weeks ago. I went with it over the sleeve for a couple of reasons: I had pretty bad reflux and the sleeve will usually exacerbate that. My doctor explained that most of the acid is formed in the lower part of the stomach, if you bypass that, you have less or no reflux. I haven't had any reflux since surgery -- can even lay down after I eat without a problem. I'm not on any reflux meds.

    I also wanted to go for the surgery with the most data and the best weight loss statistics. Reading in forums online, I see so many people with band or sleeve revising to RNY -- I wanted to start with the surgery that offered me the best success rate. With both sleeve and RNY you need to take supplements because of the small amount of food you consume. I think RNY requires B-12 where sleeve doesn't.

    The idea of rerouting my intestines didn't bother me... the idea of having a band implanted did.

    Both RNY and VSG have good success rates regarding diabetes. I have a friend having surgery next week who is having the sleeve because she has irritable bowel syndrome and apparently the sleeve is better for someone with that condition.

    Like everyone else has said -- do your research on reputable sites (like WebMD or the Mayo Clinic sites), talk to the surgeon and see what he is leaning towards (my doctor wouldn't choose for me but talked a lot about reflux) and read online forums for different people's experiences.

    Best wishes for wild success with whatever you choose!