ValerieKGorman

Why RNY and not sleeve?

27 posts in this topic

For those who chose gastric bypass over the sleeve, would you mind giving your reasons? After the fact, are you glad you chose RNY or do you wish you would have chosen the sleeve? 

I want RNY but at times wonder if I'm not giving the sleeve option a fair chance. I love the possibility of dumping, I love the necessity to eat protein first because of the stoma, I love the fear of stretching the stoma which will help keep my eating in line, I love the rapid and maximized weight loss. Are these also your reasons? Do you have more or different reasons than this? 

 

tmcgee likes this

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For me, I chose RNY because I wanted to the most restriction and limitation I could, because I know myself and that is what I needed to be successful.  I was also pre-pre-diabetic, and wanted to nip that in the bud.  Lastly, I didn't want any of my stomach removed permanently.

And I wanted to lose as much weight as possible, and quickly.  I was tired of being fat.

I will patiently wait for Geoff to chime in, since he has the best answer for this topic!

tmcgee, Minfit, Raeme and 1 other like this

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for me my doctor would only do the RNY.  I had severe acid reflux (GERD) to the point that my esophagus was shredded and I could no longer talk.  The sleeve often causes reflux and we certainly didn't want that.  I love my bypass - I have a friend who had the sleeve the same day I had my RNY.  She started out fine but stopped losing weight and now 2+ years out I'm down 110 lbs she's down about 50 (we started at almost the same weight) and has started gaining some back - she couldn't afford the RNY but wishes she had pursued payment options.  we were size 24 - I'm now a 4 and she's a 14. I hated me and now I love my life and so I am over the moon that my doctor did the bypass - I wouldn't have it any other way!

Jennyfer Reyes likes this

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I will say I chose sleeve because I didn't want anything moved....I don't mind my stomach (most of it) being removed...please take it!! 

either way....it is just a tool....it is what you do with it that ultimately will keep the weight off.  In the beginning everyone loses weight....

 

I started at 321 and I am 16 months out and have lost 157 pounds.  I was wearing a size 30+ and now am in a size 8-10 depending on the make....actually I was able to get into a 6 in one brand!

The surgeries are tools....not a miracle....WE are the ones that have to do the hard work....watching our diets and exercising etc.   your friend should not blame her surgery....sorry....its her.   IMO

Jabsie and msmarymac like this

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Valerie, trust your gut. You have an affinity toward RNY. You have reasons for your preference. Roll with it. :)

tmcgee, CZJ, JustErica and 1 other like this

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I had uncontrolled diabetes and wasn't given a choice.  I lost quickly, have had no problems and didn't like the idea of a large part of my stomach being removed..

i wish I'd have done it sooner!  Not everyone has dumping... I get sick on grease and alcohol.  I can eat a cookie or sweet but if I eat too much that makes me sick so it's best I don't start.  If I want something sweet I go for a protein drink or protein bar.  

Best thing I ever did.

CZJ and Jennyfer Reyes like this

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No regrets about RNY for me, at all. I did spend quite a bit of time considering all options. I chose RNY primarily for two reasons, first, it is reversible if you get in trouble, and second, theoretically, you will lose more weight. After reading here for almost three years, I know that the second reason is not at all true for everyone.

Now, at almost 40 months out, I weigh a pound less than I did when I got married a year shy of 40'years ago -- what's not to love? Nothing has changed my mind about the procedure I selected, although I did seriously consider VSG until 2 weeks prior to WLS.

dredfern likes this

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18 hours ago, GAviv said:

 I will patiently wait for Geoff to chime in, since he has the best answer for this topic!

Aw shucks and thank you.  

In some ways it is simple - both the vertical sleeve and RNY gastric bypass have their own advantages and disadvantages.  Each of them can help you lose weight and get to your goal weight, and then maintain at your goal weight.  As an informed consumer you need to make the weight loss surgery choice that is best for you and your needs. Note that sometimes this choice is mandated by your health insurance company or by your choice of surgeon (not in my case - BCBS of MA let me chose my surgery type, and my surgeon had lots of experience with both procedures).  Also, some people should only have one of these surgeries due to other medical conditions.

I chose gastric bypass for the following reasons (and have never regretted this choice);

1.  Gastric bypass surgery has a higher success rate than the vertical sleeve.  Quite frankly, if I am going to have weight loss surgery, then I want the most effective surgery.

2.  Gastric bypass has been performed for much longer than the vertical sleeve - so the side effects for gastric bypass are better known.

3.  Gastric bypass combines two separate weight loss methods into one surgery (small stomach pouch and malabsorption of calories), while the vertical sleeve has just one (small stomach pouch).  To me, more is better.

4.  Nothing is taken out of your body with the gastric bypass surgery, so that it can (in theory) be reversed - this is not true for the vertical sleeve.  More importantly, with gastric bypass (unlike with the vertical sleeve) you retain the rest of your stomach (besides your small pouch) in your body, so that in case of an ulcer or some other problem with your small pouch many years from now (which is not unusual) you will have spare and healthy stomach tissue inside you for a surgeon to use to make a new pouch.

5.  The people that I knew who had the gastric bypass lost all the weight that they needed to lose and got to their goal weight - while many of the people that I know that had the sleeve did not make it to their goal weight.

6.  The major downsides of gastric bypass - having to take vitamins the rest of my life, a longer surgical procedure, and facing the possibility of dumping - were acceptable risks to me.  Taking vitamins is no big deal (and since I buy them at CVS on sale, it is not a major expense), since I was knocked out for my surgery I did not care that it took longer to perform the surgery, and I only dump about once every six months (any only after I do something "stupid" like eating a big bowl of ice cream).

I fully respect people who get the vertical sleeve, but I love my life with gastric bypass :)).

Minfit, Raeme, Trish13 and 3 others like this

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My doctor said that RNY was the best option for me, and I went with his recommendation. So far, so good. :)

Minfit likes this

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Thanks all!

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Of course, remember that a lot of people who had the VSG are happy with their decision to have that surgery instead of the RNY gastric bypass.

mburnsb1, tmcgee and Raeme like this

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My surgeon strongly suggested RNY due to uncontrolled diabetes and several other co-morbidities.  I went with his suggestion, I'm down 80 lbs and my health is steadily improving.  I wouldn't change a thing :D

GAviv likes this

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4 hours ago, Res Ipsa said:

Of course, remember that a lot of people who had the VSG are happy with their decision to have that surgery instead of the RNY gastric bypass.

Yes of course. Just wanted to pick the brains of the RNYers to hear their whys and any regrets. 

Jabsie likes this

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VSG....because of the beauty of a functional pyloric valve!!!  No remnant stomach remains to develop ulcers or multiple anastomoses.

mburnsb1 likes this

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I was scared of having my stomach removed. That makes no sense when you really think about what they do to your insides with RNY, but it was my hangup. I also liked that RNY has faster results and could be reversed if necessary. I have no regrets. None. Not one. 

tmcgee likes this

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48 minutes ago, Dunndeal said:

I was scared of having my stomach removed. That makes no sense when you really think about what they do to your insides with RNY, but it was my hangup. I also liked that RNY has faster results and could be reversed if necessary. I have no regrets. None. Not one. 

I had the same thoughts, so it makes perfect sense.  :)

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46 minutes ago, Res Ipsa said:

I had the same thoughts, so it makes perfect sense.  :)

Thanks Res Ipsa. You get me. ;)

Res Ipsa and tmcgee like this

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I had a VSG and am thrilled with it, however; I know that RYN is the preferred procedure for folks with uncontrolled diabetes and GERD. As others pointed out, there are pros and cons with both procedures and the decision you make is based on which procedure best addresses your needs and goals.

Not to contradict other posts here but I want to make a couple of important points. 1) Although you statistically stand to lose the greatest percentage of your excess weight with the RNY, this does not mean that your chances of success are any better. The true measure of success is a patient's ability to keep weight off long term (5+ years is the medical benchmark). As it turns out, patients are just as likely to regain all of their weight with the RNY as they are with a VSG. 2) The RNY has been performed for weight loss longer than the VSG, however, Gastrectomies have been performed for over 135 years to treat stomach cancer, ulcers, and other injuries and diseases of the stomach and pyloris. Although not performed for the purpose of weight loss, the safety and long term health affects/complications/etc... of Gastrectomies are very well documented and far and away exceeds the data available for RNY.

In the end, your willingness and commitment to the process will play a much larger role in your success than what type of procedure you have. Best of luck to you!

Edited by Jabsie
mburnsb1, WendyH and ValerieKGorman like this

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YES!!!!!!!!!   Jabsie you are right on!!!!!

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Thanks to all for your insights. I appreciate it! There is not ONE best way to be sure...except our commitment to lifelong change as we partner with our procedure. 

Edited by ValerieKGorman
Jabsie, Res Ipsa and tmcgee like this

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This thread was super helpful. Thanks to all who answered. 

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I have thought hard about both. I'm about halfway through my 6-month insurance required supervised diet. At this point, I'm about 95% sure that I'll get a gastric bypass. I don't have diabetes, I'm young (39), my BMI is 40, and I actually really love to exercise. Those are all great reasons to go with a sleeve.

However, we have decades of research that show the long-term results of the RNY. I remember a decade plus ago when everyone was going for the lap band. It didn't take too many years to see the problems start showing up with the band.

Now, I do believe that the sleeve is a much better option than the band, but we don't have decades of research to show the long term outcomes. It's entirely likely that the sleeve will be as effective long term as it is in the shorter term. But, I feel more comfortable going with the medical gold standard for obesity. I don't want to risk a second surgery down the line if I can avoid it.

That said, I've had several friends get the sleeve and they are doing well. They haven't had the weight loss that I've seen with RNY, but they have lost a lot of their excess weight. Talk about it with your surgeon and go with the procedure that causes you the least amount of stress. 

Res Ipsa, GAviv and Jabsie like this

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Valerie I see you chose the sleeve...Are you glad with that choice you made at this point and what made you chose it..I ask because I am meeting with my surgeon next week to pick and I am still undecided

 

 

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@ValerieKGorman - I too would be interested in hearing your results on this thread.

You started out looking at having the RNY... what changed your mind?

Now that you have had the surgery, what are your thoughts?

Like Tracyringo, I am struggling to make a decision... every time I think I know which way to go I get a new piece of information and start having second thoughts! :unsure:

tracyringo likes this

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I posted a few days ago that I had decided on the sleeve. And once again I am thinking about the bypass. It's hard to really decide which one is best for me. I've decided that I'm going to talk with my surgeon and see what he recommends. I meet with him in the next month or so.

tracyringo likes this

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