Why VSG over bypass?

Hi all,

Just wondering if the choice to have VSG was yours? Or medically was it the only option? How do you feel it compares to bypass?

In all my research I feel VSG is helping people achieve the same results, just a bit slower and perhaps without the same nutrition deficiency?

I will be having VSG this month.

I chose the sleeve because the RNY is a lengthier more complex surgery and I didn't like the idea of my guts being artificially rearranged. Just downsizing stomach seemed like a better idea. Its not reversible but who would want to get fat again. Also the ghrelin reduction by removing the greater curvature made most sense. I liked the idea of keeping valves intact and was cautioned about vitamin deficiency by pharmacist on RNY. So that was 7 plus years ago and I am so glad I did this. You will be too. Diane S

I did for the most of same reasons as Diane S, with the addition that I knew that I could eat right, I always just ate too much even when I was eating healthy. It didn't matter if I ate the right things, when I was eating enough for 4 people at a time. I didn't need malabsorption in order to continue to eat carbs and stuff, just the help with reducing how much I could eat. Best decision of my life. I can only eat so much, and I've made permanent changes to my way of eating and lifestyle that I never was able to maintain before.

It was my choice for the same reasons as previously mentioned. In my case, I'm not sure I could have lost weight any more quickly. For long term after much reading and research I felt the odds of maintaining were pretty similar (we have to work at it either way).

According to medical research, VSG and RNY have very similar outcomes. VSG patients tend to lose a bit more slowly, due to the lack of malabsorption, but patients with both surgeries see similar rates of reaching goal and regaining after surgery. VSG, however, does not have the same statistics as RNY in regards to diabetes remission.

Patients of both surgeries can become vitamin deficient, that's why it's important to follow the ASMBS guidelines on supplements.

Personally, I opted for the VSG over RNY because of the malabsorption. I take medication for bipolar disorder, and I did not want ANY chance that malabsorption would mess with my psych meds. I cannot function without them, and I'm not willing to trade "sane" for "skinny."

I too am having VSG surgery this month, on the 28th in fact. I will be having my Band removed during the surgery. Today is day one for my liquid diet. Anyway, my reasons are the same as what Diane S. mentioned. I also made the decision with the advice of my surgeon because the Band was causing some complications and I was never able to achieve the restriction I needed. We both decided that the Band was in long enough and that it needed to go. Because of the complications with the Band, I had no problem with getting my insurance to cover the revision surgery. Good luck with your surgery and I hope everything goes well for you.

I had a slight preference for VSG related to the malabsorption and the loss of the pyloric valve function. I have rheumatoid disease and my rheumatologist also told me that the tissue that is removed with VSG but not with RNY would have a positive impact on my systemic inflammation levels. Add to that the need to take steroids and NSAIDs when needed for my RD and we were pretty firmly pointed at a VSG. (NSAIDs are banned for VSG normally, but the benefits outweigh the risks in my case with a VSG but the risks are higher with a RNY.)

I did have a history of mild reflux, and we (my team and I) were willing to take a chance on it worsening with the VSG given the other factors. Luckily, my reflux was never bad and was likely a result of obesity, as I've had no problems since. (Though I will likely be on a PPI forever because of the meds I have to take with the RD, so I don't know what it would be like without the PPI.)

You can still have nutrient deficiencies with VSG from the reduced volume and variety of foods, but there is no true malabsorption with it. I've had to supplement Vitamin D, B12, and iron, but it's not onerous.

I am hoping for a VSG because I have multiple Sclerosis, which means I currently take and likely in the future will take a lot of medications, and there could be absorption issues.

I also have a hard time keeping vitamin D and iron up, so being able to absorb supplements is a bonus.

Here in Ontario, the surgery tupe is decided by the surgeon. I consulted with a bariatric pharmacist and she recommended VSG; I'm currently in the waiting room of a bariatric internist, waiting to hear what his recommendation will be as well.