What if I Need my Tummy Back?

Hi Everyone... I'm pre-op and trying to decide between having the sleeve and gastric. I've been doing  a lot of research on the pros and cons of both. I'm actually leaning a bit more towards the sleeve. My informational seminar is 6 days away (Yes, I'm excited. lol) so I haven't had a chance to speak to a surgeon yet. Does anyone know of any medical reasons that would require me to "need" the portion of my tummy that would be cut away during the VSG process? I know that once it's gone there's no turning back. I've searched all over and haven't been able to find anything. I know this could have something to do with there not being a lot of long term information available about this fairly new process. My family has a long history of cancer (not the stomach though) so I think that's my biggest concern, that I would need my belly and it be gone or that I would need to absorb more calories and nutrients and was unable to because of the smaller size.

Also, do you guys think that if I, for whatever reason, "needed" my stomach to be larger do to some future ailment that the bypass could be reversed to accommodate this? I've read a lot about revisions to other procedures but never absolute reversals. I understand that the VSG is not reversible.

Thanks in advance for your help and input. I will be sure to ask this question of the medical staff when I meet with them next week and update the response on this thread. I was just kinda thinking that I CAN'T be the first person to raise this question, even though I am known to over think things a bit. LOL

Wow wow wow... where to start?????

Gastric means stomach.  There is a gastric band, gastric sleeve, and gastric bypass.  Which gastric do you refer to?

I know of no medical reason why you would want your fundus back.  It basically serves two purposes.  One is to stretch to hold more food and the other is to over produce a hunger causing hormone called Ghrelin.  I haven't missed mine in 5 years.

There is plenty of long term info on partial gastrectomies they have been done for 100 years.  Just not for weight loss.  There is nothing new about the sleeve other than stats and the long term stats are out, they have been for about 5 years.  Partial gastrectomies have been done for 100 years for ulcers and stomach cancer.  They started doing sleeves in the 70s as the first part in a 2 step surgery for very high BMIs  wanting DS or RNY.  In the 90s they started doing it as a stand alone procedure but they made big huge sleeves.  Weight loss was good, regain was very bad.  Today they make much smaller sleeves, weight loss is good, regain is not bad at all.

Your stomach does not absorb nutrition, your intestines do.  The only thing you might malabsorb is B12 and that is not common.  So you would need to tell us which vitamins you believe you will not absorb with a sleeve vs. bypass. ;)  Your stomach does not absorb calories either, your intestines do for the most part.  So cancer really isn't an issue for sleeves.

A cancer patient doesn't eat ANYTHING.  You could beg and plead for them to just drink an Ensure.  They don't want it.  One way the body does try to deal with cancer is to starve the cancer cells so end stage cancer patients.. that is one of many reasons they don't want to eat food of any type.  The problem is, it starves the healthy cells of the body as well.  So cancer patients don't need massive quantities of food, they need even 100 calories here or there.  A sleeve is more than what a cancer patient would need.  Again, cancer patients don't need a full stomach so they can eat large quantities of food, just trying to get them to sip water can be a challenge because they flat out don't want it.  Cancer is a non issue for sleeves in this regard.

Bypass can potentially be reversed but you have to go into it assuming it is forever.  It can be reversed, just not 100% of the time.

Make sense?

Hi... thank you for responding!!! You seem to be very knowledgeable on the subject matter.

I guess you can tell from my post that I have absolutely no medical background which is funny because I'm an Accountant that works in a hospital and get lots of medical questions I can't answer. (LOL) Thanks for your understanding. When I said "gastric", I was referring to gastric bypass.

5 years is a long time and I have met several others that have had their surgeries that long and even longer ago and are doing well so that offers hope. I'll start looking into "partial gastrectomies" instead of VSGs. Maybe I can gain some more insight that way.

I was worried about the malabsorption of calcium and iron in particular with both surgeries and the likeliness that it would occur. I've read a few articles where VSG patients need to only take multi-vitamins everyday. I'm hoping that would be the case with me. But I know everyone isn't the same.

My uncle is a stage 4 cancer patient right now and he is able to eat now that his numbers are improving. He basically was told that he needed to eat at least 2,000 calories a day to put on some weight. He had health drinks and a meal plan to help him accomplish this but, as you mentioned, he had no appetite. I know I can eat more than 2,000 cal/day if I had to as my body is now. (That's why I'm in trouble now) But, I can't imagine how that could be done with only 1/4 the amount of room I have now. I'm happy to know cancer is a non-issue though. It's my biggest fear.

Cancer was my BIGGEST concern with both surgeries and you broke everything down pretty well. I plan to go into surgery with a mindset that it's the beginning of a healthier, happier life.I guess I just like the security of knowing "if" the worse case scenario plays out on me that they can "fix" me.

Yes, you make perfect sense. You should be teaching one of these classes! Thanks again!

Sleeves do not malabsorb calcium or iron, only potentially B12.  Your stomach produces an enzyme called Intrinsic Factor or IF.  IF is needed to absorb B12.  Some people with smaller stomachs do not produce enough IF so they can't absorb enough B12.  For those people they need to supplement B12 via another route such as SL or IM.

We do not malabsorb iron or calcium.  Women take Calcium because we are women and we need it with or without surgery.  If you malabsorb B12 you could become anemic, it's not that we malabsorb B12.

With sleeves we do have reflux for awhile, stats are less than 1% long term have reflux.  I think that is very low, I believe it is higher.  So we take PPIs.  If you are taking a PPI longer than six months you need to double your daily calcium because with PPI use you don't absorb calcium well.  That goes for anyone, even non ops taking PPIs.

Liquids and sleeves- I can down a 16oz bottle of water in about 5 minutes.  Liquids go right through.  I could do 2000 calories in shakes in about an hour if I HAD to. I wouldn't want to, but if I had to, I could.  The sleeve does not stop us from eating, it stops us from eating massive quantities in one sitting.

Thank you!! It was my (mis) understanding that the sleeve was just as restrictive as the bypass. I'm happy to hear that the potential of malabsorption is not as great and most likely just issues with B12. I don't do well with pills and can't even swallow them whole so I'm sure I could get a B12 shot or even give it to myself if I had to but the thought of taking multiple pills per day saddens me which seems like would be my fate if I don't do something about this weight of mine.

How far out are you and what would you solid capacity do?

Due to a sleeve you need a multi vitamin 2x daily.  You might need a PPI due to stomach acid once a day.  You might need to put a B12 vitamin under your tongue once a day/or once a week.  Anything else really has nothing to so with a sleeve.

We do NOT malabsorb calcium or iron.  That is bypass, not sleeves.

Sleeves ARE just as restrictive in quantity as bypass, that's the whole idea of the surgery.  To restrict the quantity of food we can eat.

Vitamins come in chewables for ADULTS, calcium comes in candy versions, B12 is cherry flavored under your tongue, Nexium MUPS dissolves in water if you can't take a PPI capsule.  This is tiny in the whole scheme of things.

I am 5 years post op, I am not sure what the rest of your question is.

 Depending on your health and co-morbidities, talking to your surgeon, case manager, personal researching the subject online, DVDs, and at the library will help you make better decisions on your WLS choice.

Does not matter if it is VSG or RNY, you will have to take vitamins for life, since there is mal-absorption from both surgeries. Chewable and liquid vitamins specifically made for Bariatric are best and they make sure the deficiencies you'll get wont wreak your health.

Stomach reduction is with both, and can get stretch out eventually, and you could consume more calories and mostly likely start gaining undesirable weight back.

What I learned so far: If you have GERD, VSG will make it worse. RNY if you want to see a complete remission or extreme reduction from diabetes, just to name a few benefits.

Pre-op, I was diabetic, had GERD, had HBP, plus more. Now post-op medication free for 3 months. I only take vitamins now.

WLS is only the tool, you will have to control your food choices and amounts, drink 64 oz or more of water, and exercise daily to achieve the desired health and fitness.

Why anticipate cancer?  It is like claiming it for yourself now or sometime in your future.

All Best,

L.

Hi Zee,

I realize how you could get that impression from my post. I'm not claiming it. I don't want it! Unfortunately, the Big C ha**** my family hard and if I have to fight it off (we have a lot of survivors), I want to be in the physical shape to be able to do so. But I also believe that I have to remain positive and look toward the good things.

Stomach cancer is tracked to genetics, if you are worried then get tested.

Obesity is a huge cause of cancer.  Are you in good shape now to battle that issue?  ;)