I chose to have sleeve surgery for several common reasons - I didn't want to deal with the malabsorption issues, I didn't want to have my insides rerouted, and I just felt it was a less invasive surgery overall. My surgeon agreed that the sleeve would be best for me, partly because of my weight. He said that for some people if they are too much overweight, it's actually more difficult to perform the gastric bypass or rny. He did say that at some point, if I wanted to I could do a revision to bypass or rny, so that is an option for some people. Just remember, whichever surgery you choose, you have to commit to the process and commit to making long term lifestyle changes. I can say this for sure - having the sleeve surgery was probably the best thing I have ever done for myself.

I did a ton of research about RNY vs. sleeve, both anecdotal evidence from forums like this and reading scientific literature, and, although the sleeve has less long term data, the data for the sleeve vs. RNY is very promising. The biggest selling point of the sleeve, for me, was the ghrelin (hunger hormone) reduction. I knew that it wasn't guaranteed that I wouldn't be hungry, but I thought I would have a better shot at weight loss if I wasn't starving all the time. I'm almost 5 months out and have yet to experience any real hunger (although, head hunger can be a beast).

In addition to the malabsorption and other reasons for getting the sleeve, another issue that hasn't been mentioned yet is that with RNY there is a larger possibility of long-term complications. Where the intestines were re-connected, there is a chance for obstructions due to twisting and a higher likelihood of intestinal ulcers (because of the open stoma at the bottom of the pouch; the intact pyloric sphincter with the sleeve reduces this likelihood to the same as a person that didn't have surgery). In addition, with RNY you are left with a blind, remnant stomach that can't be easily scoped in the event of an ulcer or cancer. Granted, these complications are all rare to very rare.

All that said, almost everyone that has had either surgery is very happy with their choice, so either way I think you will be glad you had WLS. Having the sleeve is, hands down, the best decision I've ever made! Good luck!

I did a ton of research about RNY vs. sleeve, both anecdotal evidence from forums like this and reading scientific literature, and, although the sleeve has less long term data, the data for the sleeve vs. RNY is very promising. The biggest selling point of the sleeve, for me, was the ghrelin (hunger hormone) reduction. I knew that it wasn't guaranteed that I wouldn't be hungry, but I thought I would have a better shot at weight loss if I wasn't starving all the time. I'm almost 5 months out and have yet to experience any real hunger (although, head hunger can be a beast).

In addition to the malabsorption and other reasons for getting the sleeve, another issue that hasn't been mentioned yet is that with RNY there is a larger possibility of long-term complications. Where the intestines were re-connected, there is a chance for obstructions due to twisting and a higher likelihood of intestinal ulcers (because of the open stoma at the bottom of the pouch; the intact pyloric sphincter with the sleeve reduces this likelihood to the same as a person that didn't have surgery). In addition, with RNY you are left with a blind, remnant stomach that can't be easily scoped in the event of an ulcer or cancer. Granted, these complications are all rare to very rare.

All that said, almost everyone that has had either surgery is very happy with their choice, so either way I think you will be glad you had WLS. Having the sleeve is, hands down, the best decision I've ever made! Good luck!

I had the RNY 2 years ago, and did much of the same research. Now that I have a knee injury, my pain is not managed as effectively due to not being able to take NSAIDS due to risk of ulcers. Tylenol sometimes just doesn't cut it. However, I will note that as far as the hunger hormone, the body always finds ways to adjust. Even with the RNY I was not hungry at all the first 6 months. I ate on a schedule. I'm still happy with my decision, however find that in some cases the sleeve is the better option.

You are not supposed to use NSAIDs after sleeve, either.

I was sleeved 3 years ago and I was told by my doctor I could resume NSAIDs after 6 months. With my weight loss I am pain free 95% of the time, but I still have arthritis and for that 5% of the time I have pain, I take Aleve, etc for it without issue.

I chose the sleeve because all it does is surgically reduce the size of the stomach by removing the stretchy part. It's that simple. No reroute, no disconnect, nothing left behind. Like others have said, I didn't want to deal with malabsorbtion issues, not being able to take certain meds for the rest of my life or have certain tests if needed for the rest of my life that go with RNY/bypass/my.

I went into the decision making process convinced that the sleeve was the better surgery because all but one person I personally know who had bypass regained most if not all their weight. BUT, what I've learned here is that no matter what the surgery, success is really up to the person not the surgery. All of the WLSs will cause you to lose and lose fast initially. But there comes a point when to keep losing and to keep it off once you hit goal, is really all up to you. These surgeries are tools. Use the tool and you lose your excess weight. Keep using the tool and you keep the weight off.

As for hunger, I was told no matter which surgery most people lose their hunger for the first year, then the body adjusts, finds a way to send out that hunger hormone and most of us get our hunger back. Not everyone gets it back though. For me, it's head hunger I battle. I'm rarely ever "hungry" but I frequently "want to eat". Huge difference. But again, this happens with all the surgeries. I don't think there's anything out there that guarantees no more hunger ever.

Pat

I'm a sleever. I chose it because I liked the idea of not having to reroute all the business down there. I also wasn't cool with malabsorption. And if I ever need to be scoped again, the path is clear. Unfortunately for me I have had hunger since about a month after my surgery, though, not the ravenous hunger I had before it. I used my pre-op program to work on my brain mentally to just suck it up and deal with it. Ultimately go with your gut. Each surgery has its pros and cons. And for every person like myself who had no issues post surgery, there is someone else who had all kinds of complications - for both surgeries.

Pat - Thank you for your insight - it is very helpful. Diane

You are not supposed to use NSAIDs after sleeve, either.

Good to know! I assumed you could since the GI tract was still intact. Must be because of the staple lines then.

Never heard that about the NSAIDS. That is one of the main reasons why I got the sleeve so that I could continue to use my NSAIDS because I have severe arthritis. The sleeve was relatively new and not performed often when I had mine done.

You are not supposed to use NSAIDs after sleeve, either.

Good to know! I assumed you could since the GI tract was still intact. Must be because of the staple lines then.

Never heard that about the NSAIDS. That is one of the main reasons why I got the sleeve so that I could continue to use my NSAIDS because I have severe arthritis. The sleeve was relatively new and not performed often when I had mine done.

My surgeon allows NSAIDS after surgery, but it depends on why you need them. Severe arthritis? He will allow it.
Most of the people in my program chose sleeve because of this.

I take naproxen for severe menstrual cramps. My surgeon first told me he would prefer I didn't take it, but when I explained I take maybe 1 or 2 per month, he was fine with it.

I can only report what I was instructed to avoid.

That being said, I am only 10 weeks out, so the restrictions may change in the future.

You are not supposed to use NSAIDs after sleeve, either.

Good to know! I assumed you could since the GI tract was still intact. Must be because of the staple lines then.

Never heard that about the NSAIDS. That is one of the main reasons why I got the sleeve so that I could continue to use my NSAIDS because I have severe arthritis. The sleeve was relatively new and not performed often when I had mine done.

My surgeon allows NSAIDS after surgery, but it depends on why you need them. Severe arthritis? He will allow it.
Most of the people in my program chose sleeve because of this.

I take naproxen for severe menstrual cramps. My surgeon first told me he would prefer I didn't take it, but when I explained I take maybe 1 or 2 per month, he was fine with it.

I can only report what I was instructed to avoid.

That being said, I am only 10 weeks out, so the restrictions may change in the future.

NSAIDS were a big deal to me too so I chose the sleeve.

6mo out it's great, but as others have said, it's up to you. I have an ex who had the RNY and lost a significant amount of weight initially but never exercised and continually ate past the point of pain and discomfort most meals. Slowly but surely it all came back 1oz at a time. None are a magic bullet, but the consensus seems to be "anything but the lap-band".

I chose the sleeve for these reasons: no dumping, better absorption of nutrients, no rerouting of guts, and the gherelin producing part is gone, so hopefully no hunger. I am 5 days out, and still happy with my choice. The downside of 5-10% less weight loss is there, but I believe these are just averages, which tells me I can work hard and still lose tremendous weight.