VSG vs RNY

careuh
on 8/8/11 11:25 am - Warren, OH
Hello everyone.  I have my surgical consult on August 19th and I'm really looking forward to it.  Originally I was hell bent on having the RNY but the more I read about VSG I'm thinking it would be better for me, that whole no malabsorption thing is probably one of my top reasons.  Also I like the idea of not having dumping syndrome so once in a while if I choose to eat "sugars" I can do so without feeling like I'm dying.  Anyone else here that was originally between these 2 surgeries that can offer some insight?  I'd love to know your reasons for choosing VSG over RNY. Even the post-op VSGers I'm interested in your experience with the surgery good and bad :)

Feel free to add me as a friend, I'm looking to make new friends :)
Ron S.
on 8/8/11 11:50 am, edited 8/8/11 11:52 am
I just made that decision. The Dumping and Malabsorption were big deal breakers. Also the rearranging of my insides. I read the RNY board from April to July gathering data on my surgical choice. At a support group meeting I happened to sit next to the only "sleeve" candidate in the room. We talked a little and the next day I started watching this forum. Each day I found more to like about the sleeve and felt better about my decision. It just felt right to do sleeve instead of RNY.

Then last week I talked to my Doc and he agreed it was a good choice for me and we would move forward in preparing for the VSG.

I dont remember all the names, but USAF Wife and Lisa J had a lot of good info. I bookmarked a few threads. I dont really know how to link, but their names were;
Newbies-Questions answered and hopefully some help
Questions about VSG
Newbie looking for any insight and recommendation

Those threads had many links and a lot of info.

Hope that helped.
    
USAF Wife
on 8/8/11 12:43 pm
This is my standard reply when this question pops up every couple of days. I won't try to sway anyone one way or another, but I'll give you my reasons for choosing VSG over RNY for my revision from the band. You can also check out the revision, failure, and food issue forums on here to get an idea of some long term RNY patients. For me, it was never an option. The cons outweighed the pros.

The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.

1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.

2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.

3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.

4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me, check out the revision forum on here. . . Go back several pages and see just how many RNY patients are looking to revise due to weight regain. ERNY and Band over Bypass to get back some malabsorption and/or restriction

5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.

6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,

7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.

8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.

9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.


I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!

Best wishes in your research!


P.S. I wrote this before pregnancy. And, just as an update, I'm almost 28 weeks pregnant and thriving. The baby is weighing a couple of ounces heavier and is measuring right on target for length. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
Band to VSG revision: June 3, 2009
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs


jillybean720
on 8/8/11 12:49 pm - Woodbridge, VA
Personally, malabsorption doesn't scare me (you're oging to be taking vitamins every day for the rest of your life no matter which procedure you have), but I would never get an RNY because of the fully bypassed pyloric valve. Bypassing the pylorus (and the entire length of duodenum) is risky business, IMO, and is essentially why RNYers experience dumping and other issues, like reactive hypoglycemia, at much higher rates than folks with other, pylorus-preserving procedures.

I technically have a DS, but with way LESS malabsorption than a normal DS...kind of a VSG plus only proximal RNY amount of intestinal bypass (but still with a short bit of duodenum intact due to having the VSG stomach instead of RNY pouch). I've often wished to be able to get a revision for more malabsorption, but I can tell you if I were offered a distal RNY revision for free, I would turn it down immediately because I would never trade in my sleeve for an RNY pouch.
*Jill*...not quite a DS, not just a VSG - stuck somewhere in my own little hybrid world... 
www.dsfacts.com

Check out my profile for info on WLS for Type 2 Diabetes.
Highest Known Weight: 324  -  Weight on Morning of Surgery: 308.5
Lowest Post-op Weight: 180 (currently working on losing baby weight!)

Post-WLS baby Benjamin David born 3/24/2012, 7 pounds 11 ounces, 19 inches!
 
P_B
on 8/8/11 12:59 pm - Norfolk, VA
I choose the vsg over rny because my anemia is pretty bad and rny makes it worse
        
SleeveRockn Chic
on 8/8/11 2:02 pm
 P_B did u have surgery already??? Who did you go through for surgery??? I just noticed u are in Norfolk, Va same area as me.  I hope to have VSG on Aug. 22.  Kerry 
P_B
on 8/8/11 6:18 pm - Norfolk, VA
Nope I'm trying for a late September date.
Dr Mann at portsmouth naval.

We should keep in touch there's not many people on this area on OH
        
borntobethin35
on 8/9/11 5:29 am - VA
Love Dr. Mann, he is a great Doctor!
SleeveRockn Chic
on 8/10/11 2:47 pm
 Yes, def. not very many. I looked on the Virginia Forum but it's not very active plus I think more folks over there had te RNY done.  I saw my dr. today last appt. b4 surgery now I feel like  I'm super nervous and freaking out like omg am I doing the right thing, maybe I could lose it on my own do I really need to do this will I make it through surgery, will I get all my water in after surgery, will i have complications yeah my minds racing and I think I'm going crazy  Got a support group meeting tomorrow night in VB hopefully atleast 1 person will be there that had the VSG it's slim pickings right now since my surgeons office has only done 9 VSG's so far. Wonder if I the 10th lol  Kerry 
careuh
on 8/8/11 5:02 pm - Warren, OH
Thank you everyone you have proved very helpful thusfar :)  I really enjoyed reading USAF's post because it was very detailed and had alot of helpful info for me!
(deactivated member)
on 8/8/11 8:10 pm - TX
Follow the links in my signature for some side by side comparisons of the four major weight loss surgeries. 

In my opinion if you want restrictive only you should go with the sleeve, if you want the malabsorbtion you should go with the Duodenal Switch.

I worked at a bariatric clinic and would never recommend the RNY.   Also had the lapband, and would not recommend that one either.

Be careful of what people say about the DS though, even doctors will lie to you about that one (had it happen to me).  Make sure you research the lifestyle you have to lead after the surgery and choose the surgery that fits you... then choose your surgeon.   Or, better yet choose a surgeon that does all four surgeries and he/she can help you decide which is best for you.

Good luck!