Gastric bypass versus gastric sleeve

Hello everyone my name is Matt and I'm new to this form. I have the opportunity possibly be able to have gastric bypass or gastric sleeve. It would be done through the VA administration. I I am having a hard time trying to decide which one would be best for me gastric bypass for gastric sleeve. 

I am 42 years old 5'11" tall Amway 430 pounds. I have never had any luck with guidance been able to stay on them being able to use portion control or being able to keep weight off it seems that when I lose some weight I get to a point to where I plateau and want to hook up plateau I can't seem to get past it and that's when I get to Stearns in working the diet. Due to my work I cannot eat at work I have a large amount of stress work is a stopping go drown which is filled with hours and hours of doing nothing but sitting in around and then only an hour or two I shear madness. 

I'm scared about having to use one of the surgeries I have not been able to consult with any physician yet I just got the call yesterday about being able to start the process. I have so many questions like what's the downtime how long to recover from the surgery what's the present time getting ready for the surgery once you have surgery is a reversible and many many more questions. 

At 430lbs, I suggest you look into the DS. It has the same stomach as the sleeve, but you malabsorb calories like gastric bypass. The sleeve and DS both keep your own pyloric valve intact, which can save you issues in the long run.

The DS has the best stats for weight loss, maintenance, and resolution of co-morbs. The one thing that you must comply with is taking supplements (same with gastric bypass) and they can be a lot. You need to look at what surgery will work best for you before picking a surgeon, otherwise they will only recommend the ones they do, and often bad talk any they don't.

The only option that is open to me is doing it thru the VA. They only offer the GBP and the Gastric Sleeve. I am very new to this and have not even had any interviews with any of the doctors and diet personal yet. I am still setting that up and from what I hear it takes a while thru the VA. I think the soonest that I can even start with the per diet program is Nov 2014.

In that case, go with the VSG. The long-term results of the VSG/Gastric Sleeve and the RNY/gastric bypass are about the same, but the Sleeve leaves you with a fully-functional stomach. Plus, it's fairly easy to add the intestinal portion to make it into a complete Duodenal Switch at a later date, if you fail to lose enough weight or experience significant regain. (Which can happen with any form of WLS.)

Oh, and let me point out that the DS has the very best long-term, maintained weight-loss stats, especially for those of us with a BMI greater than 50. It might be worth going outside the US and self-paying in order to get the best surgery for your needs.

I too would then go for the sleeve, because the results are about the same between bypass or sleeve, but the sleeve is easier to live with as it retrains your pyloric valve at base of your stomach, and avoids the possibility of dumping or reactive hypoglycemia that gastric bypass may have. With DS or sleeve, you will also be able to able to take NSAIDs when necessary for pain. 

While you will still need to take some supplements with the sleeve, it is far less than with either of the other two surgeries.

You definitely will have to do some research on your own as to what surgery you think is best for you. The vsg is basically a restrictive only procedure, the rny & DS is a restrictive & malabsorbtion type of procedure, as far as I know, none of these procedures are reversible. The only one that is is the lap band which is also a restrictive type of procedure, but I've read that the complication rate is high, so you might want to avoid it.

You also need to take a hard look at yourself as to what you're willing to put up with long term, each surgery has their pros and cons. You have to be on point with nutritional supplements for life with the ds & rny. You will malabsorb nutrients for life with both procedures., there is no malabsorbtion with the vsg but you have to be more on top of what you're eating every day for life. All the procedures you can eat around, so if you're not willing to commit to what these plans require, it probably won't work for you. Good luck in whatever you choose.

I had the gastric sleeve, I went back to work in 3 weeks I was able to return to normal acitivity in 6 weeks. I had minimul pain after the surgery and no complications following the procedure. I began at 260 I loss 100 pounds the first year following all of the doctor guidelines. My lowest weight was 155. With the sleeve I didnt have any dumping or other intolerance that are related to the bypass. The sleeve was great for about 2 1/2 years I then developed severe acid reflux. That cause lots of vomiting, naseau, and dry heaving along with stomach pains. Later I began aspirating in my sleep at night and waking up chocking and I ended up getting pnemonia that two months to completely go away. After having several differnt test I had an EDG done that showed my stomach was twisted and hourglass shaped causing all the problems. Like the previous person said each one has is pros and cons with the sleeve I havent had any issues with low vitamin levels. I am now having my procedure revised to the bypass in 2 weeks. It is suppose to reverse the other medical issues caused by the sleeve. My new surgeon recommends the bypass over the sleeve for long term weight loss expecially since the DS is not an option for you. Good luck.

I'm sorry you are having that issue. I have read of a few others that ended up with an hourglass shaped stomach (instead of a banana shaped) and it's usually an inexperienced or surgeon that is trying to make the sleeve as tiny as possible. I personally don't think they should ever try for less than a 3oz stomach. 

There are surgeons that have revised this issue, (like Ara Keshishian) without resorting to RNY, if that is not what you want. A RNY surgeon will "fix" anything with RNY. When all you have is a hammer, every problem looks like a nail. I hope that whatever you end up with, it will resolve the problems for you.

Thank you everyone that has posted so far. I have my work cut out for me that is for sure. By pass or the sleeve are the only two options open to me. So what is dumping?