Question About Different Bariatric Surgery Procedures

Ultimately, they are going to want you to make the decision for yourself. But, given your diabetes and acid reflux, their suggestion will probably be RNY (Gastric Bypass).

Vertical Sleeve (VSG) is associated with a higher risk of acid reflux and does not statistically provide a "cure" for diabetes but RNY does in about 80% of cases (according to my surgeon, hopefully, I'm quoting the proper number).

I think a note of "Uncertain but leaning toward..."

I was pretty confident I wanted the sleeve when I met with my surgeon the first time, but I was also willing to listen to him and his expertise if he had advice in a different direction.

Most all of these surgeries are done with one night in the hospital. I rarely read about same day procedures or two night stays these days.

I opted for VSG (sleeve) and have never regretted that choice. HOWEVER, if you have any issues with acid, which you do, you should NOT get the VSG unless it is clear that the acid is due to a hernia that will be fixed during surgery. RNY (bypass) also has a greater chance of resolving diabetes, so that's worth considering/talking to your surgeon about.

Reading what you've written, it seems like RNY would be the best option for you.

I didn't know VSG was not recommended for people with acid reflux. I have an esophageal stricture due to acid but was leaning to VSG. I have my first consult with the surgeon a week from today (eek!) and I'm sure he will have more advice.

With that history, there is no way I would consider VSG and I'd side eye a surgeon *****commended it.

There's a Law called Boyle's Law that states, in a nutshell, if you decrease volume you increase pressure. Since the VSG leaves the pyloric valve intact and removes so much stomach, this is an issue.

Thanks for your reply! This is why I love the boards, always learning something new.

I didn't have reflux prior to VSG and DID have a hiatal hernia repair. So, I would say that even if your surgeon thinks your reflux is caused by the hernia, there is no guarantee that fixing the hernia will cure the reflux (if this even makes any sense). Given my history, I'm firmly in the better safe than sorry camp and if I had reflux/GERD prior to surgery I would never pick VSG.

OK...now I'm scared. The RNY seems so much more invasive and risky, but plenty here have had it. Am I wrong?

Are you wrong about what? Plenty of people here have RNY and do wonderfully. All I'm saying (and there are plenty here who will disagree with me) is if you have been diagnosed with GERD or Reflux, there is a strong chance that VSG will make it worse. The sleeve, because it retains the pyloric valve, is a high pressure closed system. The acid is under pressure and has no where to go but up. Is it more invasive and risky, maybe. But so is needing a second surgery to revise to RNY if the acid is unbearable. If you stay on plan, take your supplements and do what you should be fine with RNY.

I'm not sure that the RNY is more invasive or more risky. I mean, the VSG permanently removes the majority of your stomach and leaves you with a long staple line. That ultimately doesn't seem more or less invasive and risky than what the RNY does.