RNY or VSG?

Greetings;

I am new here and am trying to learn as much as I can. In September I attended the WLS seminar and met with a surgeon and am currently in the 5th month of my supervised weight loss insurance requirement. At my appointment with the surgeon, I went in to talk to him about RNY and he very clearly steered me toward VSG. I questioned him thoroughly because even in the seminar; RNY was touted as the "Gold Standard" of WLS. We discussed the idea that the VSG has not been around as long and he felt that it would eventually become the "Gold Standard". He felt that with my body type and the fact that I need to lose about 225-250 lbs that the VSG would be safer for me. I am ok with heading that direction.

However, I am somewhat curious in that when I see the drastic before and after images on this forum, most of them have had the RNY. So, I thought I would open the subject here. I have seen that many of you have lost the kind of weight that I need to lose. But, from the collective experience of the folks on this forum, is the VSG going to give me the same long term results as the RNY might? I know it is contingent upon me. But all things being equal, I would just like to see some of your thoughts.

Let me say thanks before hand to any and all *****spond.

Jeff

There are many people who have lost 200 pounds with VSG, but I don't think that's necessarily the norm.  I personally know 2 people who have each lost that much, but they have also done an extraordinary amount of exercise.

It can be done, but you're right, a lot of it is up to you.  You'll have to learn to stay away from simple carbs, snacking, liquid calories, etc. no matter what surgery you choose.

Others will tell you the reasons they picked VSG over RNY.  Some have a ready-made list to post, because this comes up frequently.  There are many reasons, like less malabsorption of vitamins and minerals, ability to take certain medications, etc.  I chose VSG because of my family history of bowel problems and arthritis.  Wanted to keep my bowels intact in case things develop later in life and wanted to be able to take arthritis meds if the case arose.

At 200 plus pounds to lose, I would still seriously consider the RNY or maybe even the DS.  Do your research and keep reading all the forums here.

I chose the VSG over the RNY due to some of the complications I saw with two of my close friends. One had her entire stomach turn into an ulcer, then her pouch fused itself to her "floating" stomach. She has to have more surgery to get this fixed. She is 4 years post op as of now. Another friend ended up so malnourished that she ended up under 95 lbs (at 5'5"). Her doctor said she looked like she survived the Holocaust. She also had to have more surgeries to fix what was wrong with her. Mind you, that doesn't ALWAYS happen, but there's going to be risks with each one.

I didn't want any kind of rerouting. We still deal with not being able to take in as much vitamins and nutrients, but it's not to the full degree of the RNY. There's always a chance of some kind of complication, but this one seemed to be the less complicated. At least in my opinion.

Good luck in your choice and your weight loss!

I was considering the Lap-Band, but changed my mind after hearing about the failure rate from friends and doctors. A friend had RNY - lost well over 200 lbs., but he definitely has problems with dumping and malabsorption issues.

My doc did say that RNY was the gold standard, but I didn't like the idea of even possible dumping syndrome. I'm also terrible at remembering to take pills, which is a lifelong commitment with RNY.  Lastly, your stomach is still intact, so you are still producing gherin, which causes hunger feelings. With VSG, that portion of your stomach is excised, thereby eliminating the hunger feelings (if you get "hungry", from what I understand it's normally head hunger or acid related). The complication rate is very similar for RNY and VSG.

The one thing I DID gather is that if you have diabetes, RNY is the way to go, hands down.

Disclaimer - I'm pre-op (but did a lot of research) and "only" have 100 lbs. to lose.

I'm also trying to decide which surgery to do.  I meet finally with a WLS doc on Tuesday morning, question... why is RNY definetly the way to go if you have diabetes?  which I do.... and because of it I do have questions more regarding the RNY.

It isn't, the DS is the surgery that has the best stats with diabetes.  Other surgeries have decent stats, but the DS has the best stats on this.

Yep. the DS is the best for Diabetes. 

You will see more drastic results as there are more RNY's done for a longer time and many Dr. would only do it as it was the gold standard.

Now, the VSG has been used as the first part of the DS.  When they had really large patients that where at to much risk for the more risky RNY, the would do the sleeve, wait until they lost a couple hundred and than do the rerouting DS part.  They found patients did so well with just the sleeve many didn't go back for the more risky part.  Once they saw enough did well with just the sleeve, they started doing the VSG.  (also it has been done for a very long time for cancer patients.)

If down the road you find you do need the rerouting that can be done.  Once you have a RNY, only a handful of skilled surgeons can put you back again and give you the DS.(Which is best for diabetes by the way, not the RNY.)  I would get a DS before a RNY.

Good luck with your choice.

The problem with the DS for me and diabetes which I have heard is the big way to go if you have diabetes, is the malabsorption.  To me thats not good no matter what.  But I've heard people have lots of complications with the DS but also are real happy too. 

Than You don't want the DS or the RNY!