4 years after surgery - question for the educated

I had my VSG in 2011 and doing great with it.  Never had complications, awesome journey.

I have a co-worker who is considering bariatric surgery and I'm wondering if VSG is still the best or is there a latest and greatest?

I know I'm asking on a VSG forum so everyone here believes VSG is the best of course, but are there other alternatives out there or have there been any findings of ill effects long term, etc.

The best surgery is the one that is most suited to her needs.  She will need to do some research and then discuss with a surgeon.   VSG is usually not the best surgery for someone suffering from reflux or GERD.  People with high BMI'S might do better with a surgery that includes malabsorption.

I don't personally feel the VSG is the best- it's not, medically and statisically speaking. That's despite the fact it's worked well for me, or more accurately- I've worked well WITH it.

Of all the WLS out there- the DS is the one shown to have the best outcomes over the long-haul. For a restrictive only surgery- VSG is it. For a malabsorptive surgery- DS is it. The RNY & VSG have a bit better than 55% EWL and maintained at 5yrs, the DS is much higher- higher than 80% iirc. This means if you are a lightweight- in 5 years with the VSG you may end up a bit overweight but healthy, if you are SMO, you will likely still be obese, possibly MO in 5 years. It's not about how much you CAN lose, it's about how much weight loss you can maintain. There are outliers, but these are the medical facts of the surgeries if you look up the studies. Be aware- there is an EXPERIMENTAL procedure being done called the loop-DS, SIPS etc.. this is likely going to wind up perhaps a bit better than a RNY, but it's not a DS and it's not got the time behind it to prove itself yet.

ALL surgeries can get some weight off- RNY & VSG are about neck and neck, some studies put the VSG ahead - RNY comes with more long-term side-effects, some of which tend to come up after many years (RH) but overall a very similar outcome of weight loss in the end compared to VSG. The DS has the win heads above for total weight lost and especially weight loss maintained, with the benefit of a much more normal way of eating post-op, with much less to no restriction needed of food, save for avoiding excess carbs.. just have to be willing to be educated and keep up on supplements. 

What is a DS? 

DS is a dueadinal Switch  (I'm sure that is mis-spelled!)

It is a combo of VSG and RNY.  The stomach size is reduced as in the sleeve, and then there is a bypass of part of the intestine to give some mal-absorption to enhance the weight loss process.

It is my understanding that you can have the sleeve first, and then add the intestinal bypass part later, though I don't know if this is the usual way it is done or not. 

Best wishes,

Carol

Duodenal Switch- Sleeved stomach with very significant permanent caloric malabsorption, to the tune of aprox 80% fat malabsorption, and significant protein and carbohydrate malabsorption as well- seems to vary but 30-40% is about right.

It is very unlike the RNY, which is very minor malabsorption, aprox 20% fat, mild protein, and no carb malabsorption and that is somewhat temporary as it lessens after a couple years as the intestines adapt. Two very different surgeries. It is also almost always done together as there is a synergy of the sleeving of the stomach with the gut work.. separating the two does work well though, as many VSGers have been revised after not losing adequately or regaining, and they do very well, just a bit slower loss.

http://www.dsfacts.com/ds-math.php

http://www.mayoclinic.org/tests-procedures/bariatric-surgery /multimedia/biliopancreatic-diversion/vid-20084649

Very timely- this was posted by OH on the DS board, it's a good read:

http://www.obesityhelp.com/articles/what-you-need-to-know-fo r-the-duodenal-switch-ds

I'm sure there are other alternatives, but finding a skilled surgeon who is able to do them is something totally different. The surgery that is best for your friend is the one she'll succeed at & be comfortable with for life. Not to mention some of the alternatives out there might not be covered under her insurance.

I had my VSG in 2013.  I've been active on the forum and haven't heard of any new alternatives. 
I love my VSG.  I lost 225 pounds in 18 months, and I've been maintaining for about 1.5 years.  I highly recommend it even for people who need to lose a lot of weight. 

I understand that if a person has GERD, that VSG can exacerbate it, and RNY might be a better alternative.  But other than that, I think VSG is awesome

best wishes,

Carol