Choosing between Bypass and Sleeve

I am 35 and have a BMI of 56.   I need to lose about 180 or more lbs to get to my goal weight.  Initially, I was set on getting the gastric bypass but every surgeon that I have spoke to has pushed the gastric sleeve over the bypass.  However, most of the patients I have spoke too in other forums have recommended the bypass over the sleeve?  Now I am torn between the two proceedures.  

I'm really surprised to hear that surgeons are pushing the sleeve versus the bypass.  Not because I think the sleeve is better than the bypass or vice-cersa (I got VSG in 5/13) but because I think you have to choose based on your personal situation after deciding what's important to you. And I've always read on here that surgeons are pushing bypass rather than sleeve. 

These are the reasons I picked the sleeve even though my internist thought the bypass would be better for me because I am a Type 2 diabetic: 

1. No blind stomach left inside me
2. No re-routing of intestines
3. #2 meant I wouldn't deal with malabsorption of vitamins, etc. 
4. #3 meant I wouldn't have to take handfuls of extra vitamins each day 
5. It was a simpler surgery and would require less time under anesthesia
6. My doctor was very experienced and skilled in creating the sleeve

I think you have to ask these surgeons "why" they prefer you get the sleeve.  Is it because they have more experience doing that surgery?  If yes, that's not a good reason for you to get it.  You need to pick the surgery that's best for you and then find the surgeon who is most skilled in that particular surgery.  That's going to help ensure the best results for you.  

Good luck! 

The sleeve is easier for the surgeon to do but will not give you any malabsorption.  They are possibly thinking that you will lose some weight with the sleeve and then add the switch portion of the DS

With your BMI, I would look into starting with the full Duodenal Switch.  There are few surgeons qualified to do that.  Try posting this on the DS board.

They also get paid the same. I had a surgeon tell me that is why many push the easier one. He told me that is why many don't do the DS because it is the same payment as an RNY with way more work. 

I'd ask the surgeon why he is pushing 1 procedure over another, maybe he's more comfortable with the sleeve & it'll be easier down the road to revise to a ds if you have to? My surgeon never pushed 1 surgery over another. He just gave me the facts of each one & let me decide. 

I also had a high bmi but I still chose the sleeve & am happy with my choice. Good Luck in whatever you choose to do.

I've noticed this trend at my surgeons office. More sleeves. That being said I needed to lose 180-200 lbs and felt I needed my malabsorption to get me on the road. I had restricted my intake on diets and not lose weight, so I wasn't willing to take a chance.The vitamins really don't seem that overwhelming at this point.

My surgeon did not push one procedure over another.  He gave me the pros and cons of each and told me that the best surgery is the best one for Me.  He let me decide.  I did not have a high BMI (36) relative to some others, but wanted the malabsorption component.  I probably could have been successful with the sleeve too.  I am almost 2 years out and very happy with my choice.  

With a bmi of 56, I'd be looking for a surgeon that can do the DS. Better stats.

Medicaid only covers the bypass, sleeve or lapband.  

Do they specifically exclude the DS?

If you think you might want the DS---which I highly recommend---visit www.bariatricfacts.org and look for a woman anmed Diana Cox. She does pro bono work helping folks get the DS.