which surgery?

The sleeve is a somewhat simpler surgery, as far as physical procedure goes, but most surgeons have more experience doing RNY surgeries as it's been around much longer. That said, research shows that VSG does have lower complication rates. (Source)

In the long-term, rates of weight loss and regain are very similar between the two surgeries. A LOT of it is based on how you change your eating patterns and relationship with food; it's entirely possible to out-eat either surgery.

I like to make lists, so here are some bullet points on each surgery type that might help.

RNY:

• Has been around longer, so there's more data on long-term success rates
• Surgeons may be more familiar with the surgery since they've been doing it longer
• Best choice for patients with diabetes, because there are excellent rates of putting diabetes in remission
• Has the benefit of malabsorption, though it's not permanent
• Some patients (but not all) experience dumping syndrome when they eat sugar, so it can be a good choice for people who have problems with sweets
• No NSAIDs allowed

VSG:

• Slightly less risky as a procedure
• Less data since it's been in common use for less time
• No malabsorption, which may be a plus for some people
• No risk of dumping (could be good or bad)
• Can be converted to a DS if additional loss is needed for high-BMI patients
• May reduce hunger due to temporary ghrelin removal, but this doesn't happen for everyone. Can be a good choice for "grazers"
• Less risk of nutritional deficiency
• NSAIDs *might* be allowed-- old recommendations said they were OK, but newer research says no
• Can cause reflux in some people, so definitely don't go for sleeve if you have any history of acid problems

Have you talked to a doctor about which choice would be right for you? Your surgeon can look at your medical history and help recommend which surgery will be best. It's ultimately your choice, but getting his/her experience and perspective can be very helpful.

I really don't associate risks with a particular surgical procedure. Instead, I associate risk with two key factors when it comes to weight-loss surgery:

1. The initial health of the patient
2. The skill and experience of the surgeon

Of the weight loss procedures available, LapBand and Sleeve are the most basic, because surgeons are doing one thing - reducing stomach capacity. The fewer things manipulated, the fewer things that can go wrong. Left to an inexperienced surgeon though, all hell could still break loose.

The RNY and DS procedures are more complex, because they are not only reducing stomach capacity, but also altering the way the body metabolizes what it consumes. Some people need this feature to be successful. With these procedures comes certain responsibilities to the recipient to maintain their nutritional health more vigilantly than the restriction procedures. These responsibilities bring risks IF the patient does not take proper care of themselves. The risk is more in the hands of the patient than the procedure, because the procedure does as designed, and the patient augments what the procedure alters.

So, you see, these procedures are not one-size-fits-all. The important thing to figure out within yourself is whether or not you need that metabolism boost that comes with induced malabsorption ( RNY and DS). Those who struggle to lose weight no matter what they try would probably do best with this type. The ones who lose with their diets but always regain later when the diet subsides may do fine with just restriction like the sleeve or lap band, for it keeps their capacity low to make dieting efforts easy.

That all being said, I did mention LapBand, but from the problems I've seen with bandsters over time, this once sold as a least invasive procedure becomes extremely invasive when it has to be removed. If you think you just need restriction, turn right to the sleeve.

What everyone said and here are some links that may help also with making a choice. The bottom line you need to discuss with your surgeon and decide what is best for you.

Articles about surgery type choices

• ROUX-EN-Y GASTRIC BYPASS INFORMATION
• About Roux-en-Y Gastric Bypass
• Risks and Rewards of Bariatric Surgery
• Nutritional Guideline after Gastric Bypass
• Life After Roux-en-Y Gastric Bypass
• Choosing a Bariatric Surgery Center
• FAQ
• Feature Article
• Forum Contributors

• VERTICAL SLEEVE GASTRECTOMY INFORMATION
• About Vertical Sleeve Gastrectomy
• Advantages and Disadvantages
• Frequently Asked Questions
• Forum Contributors

Good luck and keep us posted on how you are doing