GB vs VSG

Im currently waiting for my surgery date and I was just wondering if anyone knew how the doctors will determine which procedure to do?

Normally it would be your choice based on your discussion with the surgeon, your own research etc. I have never heard of a surgeon imposing the type of surgery. I have heard of cases where a surgeon would refuse to do this or that surgery but not impose one.

I think you have to listen and see what the doctor recommends. My surgeon doesn't really recommend the Band anymore. I think if you have more to lose they often recommend bypass. I saw on one Dr's you tube video that he recommends gastric Bypass if his patients have a BMI over 50. You don't have to decide that day, take the information and go home and think about it. Good Luck!

Some major differences between surgeries, and my surgeon was suggesting a surgery based on what would be fasted for him so he could crank out one more WLS that day.

But I needed what would help me lose, maintain, and resolve my co-morbs best and be easiest for me to live with. I chose the DS, and then told them that was all I was willing to get. 

It's your life, and health. You pick what sounds best and tell them what you want. You deserve the best.

Barring some sort of medical condition that makes a certain procedure dangerous, it's ALWAYS YOUR DECISION. No one should be telling you which form of WLS you can or can't have.

I highly recommend you research all four currently-performed forms of WLS and decide which one would be the one that's both more effective for your problems, and the one that you can live happily compliant with for the rest of your life.

There's the LapBand, which really isn't being done much any more, due to a low success rate and a high complication rate. Yes, some people are very happy and successful with their Bands, but they are increasingly more rare.

There's the VSG/Sleeve, which reduces your stomach by about 90%. It causes a few metabolic changes, since much of your stomach tissue is gone and so no longer producing some hormones (chiefly ghrelin, the so-called 'hunger hormone'.) The Sleeve basically works by curbing your hunger and making it physically impossible to eat much at one sitting.You still have to make good choices and be mindful of what and how much you're eating. For people who've lost well in the past when consciously dieting, it's a great tool.

Then there's the RNY/gastric bypass, which is *probably* the one you're most familiar with. The RNY divides the stomach into a tiny food pouch and a huge, blind, remnant stomach. It also bypasses some of the upper part of the small intestine, causing more dramatic metabolic changes than the Sleeve. It also causes temporary malabsorption of a small per centage of calories, and permanent malabsorption of certain vitamins and minerals.

At five years post-op, the Sleeve and the RNY have pretty much the same maintained weight loss stats.

And finally there's the DS/Duodenal Switch, the 'power hitter' of WLS. The DS has the same stomach as the Sleeve, plus an intestinal bypass that's more aggressive than that of the RNY. Like the RNY, the DS causes permanent malabsorption of certain vitamins and minerals, but unlike the RNY, the caloric malabsorption the DS causes is a significant per centage and it's permanent. Since DSers' only absorb about half the protein we eat, about 60% of the complex carbs, and only 20% of the fat we eat, long-term maintenance is pretty easy. The DS has the very best long-term, maintained weight-loss stats, especially for those with a BMI greater than 50. It's also the best at resolving or preventing diabetes and high cholesterol.

So---YOU need to decide which is best for you, and then choose your surgeon based on his or her experience with doing that procedure. DO NOT settle for something YOU don't want.

That you your decision, not your surgeon's.