RNY vs gastric sleeve

Hi,
I thought I was all set to get the gastric bypass surgery -- in fact I'm scheduled for March. But then I started reading about complications and I'm getting really scared. I hate to trade one set of problems for another set because of the malabsorption. Then I started reading about the gastric sleeve -- how it used to be a first surgery for the really, really overweight people who couldn't get RNY, but people had such good results that it's now offered as a permanent solution.  I know you're not supposed to lose as much weight on it as the RNY, and it doesn't automatically fix your diabetes (which I have). But I think I'm motivated to keep the weight loss going, and I'm pretty sure my diabetes will go away if I lose enough weight.

Has anyone here gotten the sleeve? If so, what do you think?

And for those RNYers, what made you pick that over other surgeries? Are you worried about malabsorption?

I got my VSG on October 20th and have lost 67 pounds since surgery.  If you are a volume eater, you would probably do well with VSG.  I currently don't have much of an appetite and need very little food to sustain myself.  If you can follow the rules of protein first, there really is no room for high carb foods or very minimal quantities, i.e. a bit to get a taste to satisfy a head hunger moment.  Some people need malabsorption so that is something you need to do some soul searching for yourself on.  I don't accept that it is a given I would lose less than a person with a RYN.  Everyone is different and different surgeries fit different people and their situations. 

Edited to add:  Since you mentioned diabetes, I never had diabetes but my fasting glucose preop was 126 and my fasting glucose on 1/13 was 91 so I would think any surgery that helps you lose a substaintial amount of weight will help with the diabetes. 

I wanted a sleeve. It looked like the least 'unnatural' surgery. I was also a volume eater.

I got the RNY because it was the only surgery my insurance would cover at the time. I was prediabetic, hypertensive and was starting to have problems with my legs.

I don't like having to take so many supplements. I do miss drinking with meals. But I think the malabsorption is working for me.

I figure (probably naive of me) that if there are any serious, bad-bad-bad revelations about long term issues with the RNY that I can get it reversed. Of course, it will have to be something covered by my insurance.

If you have diabetes have you looked into the Duodenal Switch? It has a 95% resolution rate for those suffering from type 2 diabetes, in fact they do the switch part (without the stomach restriction) in europe as a treatment for diabetes.

Long term the VSG and RNY have about the same amount of success. You'll be lucky to keep off 50 percent of your excess weight.

Scott

Also a lot of insurances that won't cover the sleeve will cover the DS.

Yes well I got two denials from insurance because of the gastric sleeve. My docor said he wanted the sleeve first but most insurances will  not approve them because they usually have to do the RNY after the sleeve is done. So insurance knows this and did not approve the gastric sleeve. I about lost it when my surgery was denied and we appealed it with inusrance. Next, he wanted to do both the gastric sleeve and the RNY but they DENIED it again. I was so angry at this point, thinking I would get my surgery in June 2009 but just had my surgery on Feb. 3, 2010. It was a long wait but when we appealed again but just for RNY it was APPROVED immediately. They like the RNY and the Gastric Sleeve had to many complications. So I am happy with my RNY and had it 3 days ago and feel great!!

I wanted the sleeve for exactly the reason you cite:  it doesn't have the malabsorption component to it.  My insurance would not cover it - they said it's still 'experimental'.  I have BCBS-NC State Health Plan.  I do have to supplement daily, and for vitamins, will probably have to supplement for the rest of my life.  It is manageable, though sometimes I find it a little overwhelming.  So I try to think of it as a 1 day at a time kind of thing.  That seems to work for me. 

However, I have learned, since having the RNY, that after abour a year to a year and a half, the body compensates for the bypassed duodenum, growing more villi (the absorption mechanism in the small intestines) in the non-bypassed part of the small intestines.  Long term members here say this means, by one to one-and-a-half years out, the RNY patient is probably absorbing all of the calories consumed - but not all the vitamins and minerals.  That's why long term results for RNY patients and Sleeve patients are pretty much equal (expecting to keep off about 50% of the weight lost).  Because if we don't learn to approach food differently in our heads for the long haul, we won't be very likely to keep it off.  Bummer, I know, but still, if my insurance had paid for the sleeve, that's what I would have had. 

I could not consider the DS because the absorption factor was so much higher there, and I saw it as much too risky.  But maybe not.  Supplementing is supplementing.  Anyway, I wish you much success as you pursue your goal!  connie

I want to bump this topic up...

I just met with my surgeon today and he is suggesting the VSG for me over RNY...

I was 110% ready to do RNY and it's not that he won't do it but he is concerned since my BMI is 61. 

I have been reading everything today and I am not convinced that VSG is better for me.  I love sweets and chocolate in particular and I am afraid that I won't dump with VSG (even though surgeon said I would everywhere else uses it as a selling point). 

I just don't know what to do....    I am so confused !?!?!?!


Insurance will cover whatever I want  so that isn't an issue and surgeon doesn't do DS ...

I just saw my surgeon yesterday. He feels the RNY is best for me because, like you, I love sweets and chocolate. The dumping is almost like a "disipline" sort of reaction. He told me the sleeve would NOT have the dumping effect. My insurance currently won't cover the sleeve, but will cover the RNY.     Any thoughts?

Go to DSFACTS.COM. 

DS has been proven to have the most effective long term weight loss results.  Isn't that worth changing your surgeon???? 

For goodness sakes, I am traveling over 1100 miles to have DS surgery because it has been proven to give people the best odds of keeping the weight off forever. 

You hear about a lot of people with bands and RNYs revising to DS.  How many DSers do you ever hear about revising to RNY? 

Why wouldn't you want the surgery that has been proven to be the most effective?