VSG vs. RNY - how did you decide....
I went to my first appointment with my surgeon today. He recommended the sleeve over rny or band. He said the weight loss is about the same a few years out (sleeve vs rny) without the long term malabsorbtion issues - which stops being helpful after a couple of years. He said if there is not sufficient weight loss with the sleeve, it could be converted to the ds or rny at that point. He told me that 80% of his patients get sleeves - evolving from mostly rny a few years ago.
I agree with the other posters that you should find a surgeon with a lot of experience with the sleeve.
I guess with surgery, my thought was "get the minimum amount of work done that will get the job done." VSG fit the bill... good results and less complications, chances for error, etc. AND if it didn't do the job, there's a logical next step (DS) that would help further. I was able to lose 120 lbs in a few months, got to 100% goal, and i've been in maintenance mode for just under a year now.
Every person that i know that had RNY had significant weight regains after a few years. For them, I don't think there's really a logical next step that would help.
Heaviest: 313/VSG Pre: 295/Surgery: 260/Maintenance target:190 - Recent: 195 (08/15/19)
1st 2015&2016 12-Hour Time Trial UMCA 50-59 Age Group
1st 2017 Race Across the West 4-Person 50-59 Age Group
4th 2019 Race Across America 8 Person Team
One thing you may want to look at is what your BMI is and how much you want/need to lose. I had wanted to do the Sleeve, but after having a long talk with my surgeon, I opted for RNY because he said that although he generally recommends the Sleeve for his patients, with patients with a BMI over 50 (which mine is) RNY tends to be more effective. So I went that route as I want to be succesful. Had my BMI been below 50, however, I probably would have gone with the Sleeve.
Keeping your pylorus has a lot of benefits, and, as others have pointed out, if the Sleeve doesn't give you all the help you need it's pretty easy to revise it to a full DS. Revising an RNY is NOT---it's the most complicated revision out there.
You need to think seriously about how well you can lose weight with just portion control. In the past, have you lost well as long as you could restrict your calories, or did you struggle for every pound? If you lost easily, go for the Sleeve. If you struggled, go for the full DS.
You couldn't pay me to have an RNY. In fact, I chose to pay my surgeon's fee out of pocket in order to get the DS rather than the RNY I could have had pretty much for free.