Question:
What is the difference between a "sleeve" and a Roux-en-y?

I have just gone through 7 weeks of my options class (mandatory 6 month classes before surgery). and I am not sure what the difference is between the two surgeries. I am 40 yrs old and 5'2" and weigh 255 pounds. I am told that I can lose 100 pounds with the surgery. Won't that still leave me overweight? I am worried about not being able to keep the pre-op diet and if I just fail all together. I only have 1 friend and shes skinny, so she doesnt understand what I am going through. Please help.    — Michelle T. (posted on January 18, 2009)

January 17, 2009
With the sleeve u will be able to eat more volumn and there is no mal asorbtion meaning no intestine is bypassed only the stomach is smaller.The RNY bypasses some small intestine so u will not asorbe everything u eat.keep doing your research and choose the one that is best for you.
   — Bette Drecktrah

January 17, 2009
hi, my name is Lisa, and I understand what you are going through. I don't know anything about the sleeve, but I had rny Feb 12th last year, so I am 11 months out. I have lost 111 pounds, and I tend to lose aobut 2 to 3 pounds a month now, so if you have the surgery, after 6 months kinda watch what you eat, because by then you can eat more, you will do fine, and will lose more than 100 pounds. Also I am 44 now and will be 45 in april. I am 5 foot 1 and weighed 266 when I started. I now weigh 155. I don't know what to tell you about the pre-op diet, I would lose 2 pounds gain it back, I think I really watched what I ate the last couple weeks, and lost 6 pounds before I had surgery. if you want to talk or anything just addme to your friends list. Lisa
   — Lisa Koch

January 18, 2009
The difference between the Gastric Bypass, and the Vertical Sleeve Gastrectomy are vast. With the Gastric Bypass, the surgeons create a small pouch out of the top section of your stomach, and then attach a segment of your intestine to the side of that pouch. They BYPASS the bottom part of your stomach, and leave a section of intestine intact to take the bile from your gall bladder and route that to the section of intestine that was moved to the side of your new pouch. There are advantages and disadvantages to this procedure. One of the advantages is a fairly rapid weight loss when compared to SOME other weight loss surgeries. Another advantage that this surgery has over some others is that it is WIDELY accepted as a relatively safe and effective method of weight loss surgery by most INSURANCE COMPANIES. This means that they will often READILY pay for this surgery when they will NOT pay for OTHER alternatives. The negative aspects are the sometimes SEVERE side effects that can come with this surgery. Not every patient responds to this surgery in the same way. Some experience "Dumping Syndrome." Dumping syndrome is a rather PAINFUL experience for most people. It involves intestinal cramps and severe diarrhea. It is often triggered by eating certain foods. Some experience dumping syndrome from eating fatty foods. Some experience the syndrome from eating SWEETS. Some get the symptoms from eating BOTH. Others have the symptoms and do not KNOW what the triggers are. Dumping syndrome is considered by some to be a blessing because it ENFORCES good dietary behavior on these people that they would OTHERWISE not be able to enforce on themselves. They consider themselves weak, and the dumping syndrome keeps them from eating foods that they would otherwise indulge in. Other folks find it to be a curse, and find the pain to be more than they can bare. The syndrome keeps them from enjoying foods that they would otherwise like to enjoy in moderation. If you go into the Gastric Bypass thinking that you WANT the dumping syndrome, there is no guarantee that you will be one of the people who get it. There is no way to determine who will react to the surgery in what way prior to the operation. Another side effect of the Gastric Bypass is malabsorption. This is due to the fact that your re-routed intestines are functionally shortened by the bypass part of the surgery. This often causes problems with the malabsorption of food and medications. People who have the Gastric Bypass, and the Duodenal Switch, are required to take dietary supplements for the rest of their life. They are often forced to change medications for some of their medical conditions because the medications that they are taking are not as effective with the shortened intestinal tract. Other medications cause difficulty with the intestinal tract, and are proscribed because of that. A third side effect that sometimes troubles people with the Gastric Bypass is an excess of gas in the intestine due to the shortened digestive tract. Many people are embarrassed by the flatulence that sometimes occurs with this procedure. A related problem that I have come upon in my research is the "Stinky Stool." This also causes some of the people with this procedure embarrassment. It too, is related to the shortened digestive process. There are other negatives and positives about this procedure, but I do not want to write a book about the subject here. The Vertical Sleeve Gastrectomy is a rather simple and straight forward procedure. In the VSG, the surgeon simply removes approximately 85% of the stomach. What is left is a banana shaped tube, or SLEEVE, that retains all of the digestive properties of the FULL stomach, but at a greatly reduced VOLUME. One of the BENEFITS of this surgery is that it USUALLY removes most of the HUNGER that the patient has experienced in the past. This makes it much easier for the patient to avoid cheating, and overeating. The greatly reduced volume of the stomach also helps to reduce overeating in that it severely restricts the amount of food that can be consumed at one time. Many of the patients that have this procedure are required to eat 5 or 6 small meals a day instead of the typical 3 large meals that is traditional in American society. This surgery is almost EXACTLY as effective as the Gastric Bypass in achieving the desired weight loss. The Gastric Bypass is about 81 to 82 percent effective at helping the patients that have this procedure achieve their desired weight loss goals. The VSG is about 78 to 79 percent effective. The difference is statistically negligible. There are no undesirable side effects that correlate to the Gastric Bypass or Duodenal Switch. It is extremely rare for someone with the VSG to experience "Dumping Syndrome." The intestine is not shortened, so there are no malabsorption issues. Once the patient recovers from the surgery, there are few, if any restrictions on medication that occur. It is quite rare for a patient to have an adverse reaction to medication AFTER the VSG that he or she did not have BEFORE the surgery. There are usually no issues with excess flatulence beyond the first few weeks. In the first few weeks after surgery, the patient will often experience excess flatulence due to the gas that was pumped into the abdominal cavity escaping through the intestinal walls. It will often take a few weeks for this gas to dissipate, but once it does, the VSG patient usually does not suffer from any MORE flatulence than he or she did BEFORE the surgery. in some cases, the patients have actually experienced LESS flatulence since the volume of food in their intestines has been greatly reduced, and the intestines receive less stress. There is usually no change in the stool of the patients that have the VSG. About the only downside to the VSG is that it is not accepted as a safe and effective weight loss surgery by ALL insurance companies. This is due to the relatively SHORT period of time that this surgery has been practiced in the UNITED STATES for WEIGHT LOSS. This surgery has been performed SAFELY and has been PROVEN to be effective at helping patient ACHIEVE weight loss in the US for DECADES, but it has NOT been performed PRIMARILY for that purpose. It has been performed in the past as a method to treat stomach ulcers and stomach CANCER, and one of the SIDE EFFECTS of those surgeries has been a NOTED loss in weight by the patients that the surgeries were performed on. Because the procedure has NOT been PRIMARILY used for weight loss surgery in the US for more than 10 years, many insurance companies will not COVER the procedure, but will instead insist that you receive the "proven" Gastric Bypass. I have HAD the Vertical Sleeve Gastrectomy, and have lost 110 pounds since the beginning of March in 2008. I am a PATIENT and NOT a doctor, so take what I have written with a grain of salt. PLEASE do your own research. It is VITAL that you know what you are getting when you go for weight loss surgery. I initially went looking for the LAP-BAND surgery with the mistaken impression that it was the SAFEST of the weight loss surgeries. Fortunately, I chose the VSG instead. Research has since shown me that my preconceived notions were FALSE about the LAP-BAND surgery, and it probably would have been a poor choice for me. If you want to learn more about your weight loss surgical options, check out my profile page at: http://www.obesityhelp.com/member/hubarlow/. Look for one of my posts called "Surgical Comparisons." If you do not see it on my main profile page, look for it in the March 2008 archives.
   — hubarlow

January 18, 2009
the difference betweent he sleeve and rny is that the sleeve you still get to keep your small intestines and the rny you don't, with the sleeve you still absorb everything that goes in but you have a new tummy just like the rny and with the sleeve they remove about 80% of you old tummy. Your doctor should be able to go into further detail with you, I had the Sleeve June 6, 2007 and have lost 83 lbs. its slow and I can only eat so much at one sitting, and after about 1 year I started eating choclate around the holidays and certain foods fill me up very quickly and especially bread, carbs, etc... I wish it was coming off quicker, loosing alot of inches but I need to exercise and stop playing around with this and get serious again, have not gained any weight still at the same exact weight as I was a year ago and also though the inches are coming off, was almost a 30 pants and now I am into 22 jeans and 18/20 tops, its a great feeling. If you have any questions, please feel free to email me [email protected]. Stephanie
   — Steshob

January 19, 2009
Michelle, I would suggest you read Hugh's reply carefully. It is right on the money. I do not disagree with anything he said. I did my research for a long time before making my choice. I too, initially, thought I would have the Lap-Band, but discovered the sleeve during my research. I am so greatful that I did. I am a 51yo woman, 5'4" tall and have lost 118 lbs since my surgery on March 31, 10 months ago. I can eat foods that I enjoy but do want to add that, with ANY of these surgeries, you still will be making choices. Weight loss surgery is a TOOL that makes those choices almost effortless to make. Do your research! Whatever your choice it is life changing and, other that the band, FOREVER.
   — corky1057

January 19, 2009
I had the sleeve on Nov. # not quite 3 months out and almost 100 lbs lighter. The sergeon said that the insurance may not give me what I wanted but they Did. The Medical reason for the sleeve was I only have one kidney and need to have full absorbtion of any drugs I may need later in life. That is why the RYN was not for me. But with the tool that i have now use to lose weight I'm doing well. Most of my friends that had the RYN had lose 180 lbs in one year and still use the tool to keep it off. Start a all protien diet now and get use to it because it will be your life and you need to learn what to eat and what not to eat. I started slow for the perop diet and started getting use to diet drinks and cooking with splinda. It took me from May to September to lose 30 lbs to get the surgery then almost lost the date because I coght a cold with a fever. So also start the multi vitamins and the even a multi B since B is what we don't get enough of to keep us alive. Talk to the surgeon because the surgeon will know what is best for you. After the classes ( though I only had two classes to get mine ) and the weight loss then the surgery, this not a fast fix even though you may think so. because the time it takes to lose can all come right back on and then there is no quick fix again. Your skinny friend will be jealous as I have heard from friend that have had siblings that get mad because they fit in a smaller size than them. It is life changing and once you start there is no going back. Good Luck Scott
   — Scott Ambrose