VSG VS Roux-en-Y

Hi there,
I'm curious why some people would choose the Roux-en-Y over the sleeve? The doctor recommends the sleeve for me. He feels it's best because of my previous issues with cancer and the possible scar tissue and damage to my colon, from the chemo and radiation. I tend to agree with him. I have read a few posts here that they feel disapointed that the sleeve was suggested?

I did research, the sleeve and it seems less invasive?

I would say ... it's propaganda! LOL.

Usually WLS centers in Ontario say to patients that RnY is better and it is a golden standard. Lots of people build their opinion based on this information and therefore "feel disappointed" when they don't get what's "better".

 

Is RnY really better? Define "better", LOL.

Some people consider malabsorption to be a pro, others see it as a con. Same with dumping, pyloric valve, permanent tissue removal versus blind stomach and reversibility, etc., etc.

In your particular case, the doctor explained very well what's better for you. See, you consider the "less invasive" to be an advantage, because it's relevant for your case (medical history). For me it wasn't something I would even consider - my arguments were in the area of cure for diabetes and therefore I only looked at "invasive" bypassing options, like RnY and DS (the bypass of duodenum resolves diabetes).

We all have different medical needs and the surgery choice should be based on these needs.

Good luck!

 

 

 

lol I like that it's "propoganda"

RNY is the gold standard and covered by OHIP.

VSG is covered by OHIP if medically necessary and deemed so by your surgeon (some people may fight for this)

DS is also covered by OHIP if medically necessary and deemed so by surgeon (a lot of fighting usually required for this)

LAPBAND is not covered by OHIP

So I think its less of a choice than it is if you medically cannot/should not have RNY.

I am having RnY which I personally think is  better alternative....IMO

My opinion on MY OWN surgery is that if I fight for VSG/DS etc... whats the point...because its less invasive and I can eat more?  I got this big by eating more so a permanent tool to aid in my WL is what is required for ME for lifelong success.

**PLEASE NOTE: I am not passing judgement on anyone else or their choices....this is my opinion on MY OWN surgery.

Sparky,

I like your well thought out posts and responses!  I do have a question though on the following statement

My opinion on MY OWN surgery is that if I fight for VSG/DS etc... whats the point...because its less invasive and I can eat more?  I got this big by eating more so a permanent tool to aid in my WL is what is required for ME for lifelong success.

The VSG is not be more invasive than the RNY, but the DS is (I think that in terms of simplicity of surgery it would be VSG, RNY then DS). My VSG took 45 minutes and I was back to work in exactly 1 week. I'm not positive but I think that the amount you can eat with a VSG and RNY are similar, if anything a bit less with the VSG.  With the DS some surgeons make your sleeve a little larger than the sleeve for a VSG, so you can eat a little more but you malabsorb a lot (permanently, unlike the RNY) therefore making it necessary to eat a little more.

I know that you are not passing judgement, I just wanted clarify a couple of things.

All the best! 

Nobody fights for the DS so they can eat more... to say so is really very insulting. The DS surgery requires that the stomach be made larger than the pouch in RNY or the sleeve in VSG, so the result is that DSers can eat small but normal sized meals. This is often cited as a benefit of surgery, but never a reason why it is done. The DS has the best long term statistics for weight loss and comorbidity resolution, especially diabetes. A person with diabetes who gets the RNY has a 50/50 chance of it coming back within 10 years. A person with diabetes who get the DS has a 98% of the diabetes going away permanently. The DS also does not cause reactive hypoglycaemia as it keeps a fully functioning stomach intact with its pyloric valve, whereas almost 80% of people with the RNY develop RH in the long-term. The DS also does not have late regain as is often seen with RNY and people with the DS tend to keep off about 20% more weight in the long-run than RNYers. The DS also allows the patient to take NSAID medications, which is critical for people with arthritis, tissue injuries, migraines and other conditions.

These are all the reasons I chose the DS. I had to fight for 14 months, undergo rigorous pre-op testing and preparation, have 3 surgeons appointments and prove to every single professional along the way that I fully understood the DS, its risks and complications, the strenuous post-op eating and supplementation plan, as well as its benefits,  plus I had to battle misinformation about the DS as well, from professionals as well as fellow WLS people. I was finally approved despite having a relatively low BMI of 43 at my highest (41 on the day of surgery), due to my very young diagnosis of diabetes and need for NSAIDs and my ability to demonstrate that the DS is unequivocally the best surgery for me. But silly me, I should have just told the surgeon I wanted to eat bigger meals and he would have just handed one to me!

 

It is not that people choose the RNY over VSG it is that OHIP's gold standard is RNY and VSG or DS is paid for by OHIP only because of medical reasons.

I wanted the VSG because of medical issue's or I would have been fine with the RNY but in the end I never had to ask for the VSG as the doctor told me that was my only choice. 

Right now there is not enough research done on the VSG to say if it is better it has been thought with a VSG you will not loose as much as you will with a RNY but that is not true as my daughter had to have a VSG when she was actually booked for a RNY and has lost over 220 pounds in less than a year.

I also seen a comment about you can eat more with a VSG  I do not know how true that is because I have seen what my daughter can eat and seen what others who have had RNY can eat and I see no difference the only difference in eating is what you yourself choose to eat. With RNY some people have dumping and some people don't.

Is it less invasive depends with the VSG they remove 80 percent or more of your stomach and it gets pulled out through a small hole in your belly. Surgery can never be reversed unless you eat too much and stretch your stomach but with a RNY you can also stretch your pouch by eating too much as well.

Both surgery's are a tool and what you do with your tool will depend how success you will be.

 

Right. I assumed I would have the RNY. Honestly, I didn't research the difference until the doctor mentioned that it was a better option for my case. Obviously, I agree it's a personnal decsion. I just want the weight to be gone.If it does that, perfect.

Having a VSG is the doctors decision most of the time yes there are lots of people that would like the VSG and have been turned down because they do not have any medical reason to have it done.

Dani for you and I the best choice is VSG because we have medical issues with our colon and/or intestines. I have crohns and for them to go and reroute anything can be problems for me down the road because if my crohns was to act  up and I had to have a surgery it would be a major operation with them reversing the RNY. 

Read below what my daughter pink jellybean wrote she is a great poster child for the VSG and how well it can work.

I had the full intention of getting the RNY and never once considered that the VSG was an acceptable form of surgery for me.  I went to the orientation and pretty much became "convinced" (interpret brain washed) that the RNY was the gold standard and that it was the only way that I with a BMI of 59 could lose an acceptable amount of weight.  I became convinced that the rerouting of my intestines was the only way that I could be successful.  I still believed that I would have been successful had I been given the RNY surgery....I believe both the RNY and the VSG are awesome weight loss tools and without a doubt I would have been successful had I gotten the RNY too. 

I was given a VSG in the operating room once they discovered that I had non-rotated intestines.  I am nearly one year out and 8 pounds away from 100% EWL (healthy BMI)...I have lost 218 pounds to date.  I feel blessed and fortunate to have had my surprise VSG - I feel less at risk for long term complications because of it and I have been able to be and feel very successful with my tool as I am sure you will too!