For me, I need to lose a lot so it had to be RNY or Sleeve. My insurance doesn't cover the sleeve and my doctor has done lots of RNY so I didn't even look into the cost of the sleeve. I'd rather take the older surgery that has all the kinks worked out of it!!
It's no secret that I think the DS is amazing, but between only those two, I would go with the VSG. No man-made stomas to stretch, preservation of the pylorus (which translates to no dumping or reactive hypoglycemia possibly being caused by the surgery, and allows fluids and foods at the same time when space allows), and no malabsorption (not that I am against malabsorption, but with the typical proximal RNY, there is only malabsorption of calories for maybe 2 years post-op; after that, you'll absorb just about all the calories you eat, but you'll still have to take more supplements than with VSG because you will still malabsorb vitamins and minerals).
Of course, that's all purely technical. They're really two very different procedures and best serve different types of patients. Instead of evaluating procedures, I believe you should evaluate YOURSELF, and THEN choose a procedure. Here's a start:
What is your starting BMI?
What are the eating habits that got you to morbid obesity? Do you binge eat or consume large volumes of food at a time, or are you more of a grazer?
Do you believe (or know, if you've ever had it tested) that your metabolism is "broken" or that you have a metabolic condition (such as metabolic syndrome, insulin resistance PCOS, type 2 diabetes, etc.)?
Do you currently have difficulty losing weight even when sticking to a restricted-calorie diet?
Do you have any weight-related comorbidities that you seek to resolve via WLS (such as high blood pressure, high cholesterol, etc.)?
Do you have severe acid reflux or GERD? If so, do your doctors know what may be causing it (do they suspect a hiatal hernia to be the culprit)?
Are you 110% sure you can commit to taking supplements 3+ times a day for the rest of your life?
I'm a lightweight so I didn't even consider the RNY. But after doing all the research I've done, I'd have done the sleeve no matter what my weight. My issue is that I'm a volume eater -- I don't snack much between meals but I really like to feel full after a meal. So the sleeve was made to order for me. I was sleeved just over a week ago, and I feel beautifully full and satisfied after just a few ounces of food.
It's hard to believe, but it's not only physical, it's mental. I ate about 1/3 of a grilled sandwich the other day. Now, grilled cheese sandwiches are one of my VERY VERY favorite foods, and before surgery I'd eat a whole one and want more, even if I felt physically full. But with the sleeve, I felt physically full AND mentally satified. No more cravings, no more food obsession. The surgery removes the part of the stomach that produces the appetite hormone ghrelin, so maybe that's it, but whatever it is, it's been like a miracle for me.
And although the sleeve is fairly new, it's a very simple surgery and it's been done for years for reasons other than weight loss -- ulcers, cancer, that sort of thing.
I had my sleeve done in December. I would do it again in a heart beat. I am down 78 lbs in just three months. I have no hunger so snacking is never an issue. I eat to keep me healthy, not to fill me up. I also walk a lot now where I couldn't do that before. I love it! My insurance didn't pay for anything so I am a self pay patient.
Last edited by iwillsparkle; 04-18-2010 at 09:14 PM.
Jenn....did you consider RNY with the amount of weight you want to lose?
My husband wanted RNY and was 500, but the surgeon suggested a sleeve route because he didn't think the RNY would be held well in his heavy stomach. My husband is doing well.
I have 185 to lose and am worried the sleeve won't give me that without revision. I am not interested in a 2nd procedure nor DS.
Thanks for the welcome! I'm excited to see this forum.
I actually went to the seminar thinking I would end up doing the band but after speaking with the doctor we decided my goal wouldn't be met with the band. I didn't like the idea of doing the RNY because of the moving of the intestine. I was terrified of surgery anyway and to me the sleeve was the least amount of "surgery" if that makes sense. I also looked at the info on how much weight I could expect to lose and compared that to RNY. They are quite similar in weight loss. I knew going into this procedure that I would get out what I put it. I have made a conscience effort to work out more in the hopes that during this first few months I can lose the maximum amount of weight. My doctor basically told me my choices were RNY or sleeve. But he gave me all the info and left the final decision to me. After a LOT of prayer I did the sleeve. I feel I made the right decision.
I picked RNY. It suited my needs. There are alot of great surgeries to consider. It pays to really DO your research. If people have more than 150 lbs I highly suggest they look into the DS.
Sleeve vs RNY
