[Elisa]

I love the input that I get from all of you. There is so much knowledge here, so many different outlooks, experiences, one can only learn by being here. (not to mention the great support! )

Well, today I met with my surgeon, who offered me two different procedures. One being the RNY (open incision) and the other being sleeve gastroplasty (VG)(lapriscopically) .
I have never heard of the latter, I was wondering if anyone has had any experience with it? It seems much less invasive and risky than the RNY. I do intend on reading up on it, but was wondering what you all thought of it? Anyone know about it?

[DocSanae]

Here's the link to an article in the main page of this site.
Hope this info helps you in your research.
http://www.renewedreflections.com/ga...-kind-is-best/

I'll be attending a workshop on WLS on Saturday, and the program has vertical sleeve on the agenda, so if there is anything that may be use for you, I will post later on.

[fr1endly2]

I am hearing more and more on that sleeve procedure..
wasnt an option for me..
im sure you can find alot of information on it!
and maybe someone here too know alot!
hugs

[Lilly]

I thought maybe this too might help you out a little bit...
About Weight Loss Surgery - Gastric Bypass, LAP-BAND, Duodenal Switch, and others

[Elisa]

Thank you for your responses!

Well, I have read up on sleeve gastroplasty (VGB) and I think I am too confused for comfort It does seem less invasive, but RNY seems more successful, bur VGB doesnt have dumping, leaves the pyloric valve alone, its safer, less complications BUT RNY, you lose more (i think, lol), and I could always start with VGB and get a revision to RNY later (but do I really wanna go through it twice?). Im not a good puker, RNY seems to be more the procedure to get me puking, then there is the malabsorption, the strictures...sighhh....I just dont know...and the more I read, the more I just dont know!

Thanks Doc for looking out for VGB at the workshop, very thoughtful

[DocSanae]

I spent all day today at a WLS workshop. It was very educational, with a lot of new concepts and review of data.

Here's a short summary on what was said of sleeve gastrectomy.

This is a relatively new procedure, which the speaker, Michel Gagner M.D., (Professor of Surgery, Weill Medical College of Cornell U., Director of Minimal Invasive SUrgery Center and Chief of Division of Laparoscopic Surgery at Mt. Sinai School of Med.) started doing in year 2000. In the US, there is an ongoing study on it sponsored by NIH, and 7 bariatric centers in the US are involved in this, including Prof. Gagner.
While the percentage in the US is still small, it is the most popular procedure in Europe, especially in Sweden.

The ratio of WLS surgery in the US is, 77% gastric bypass, 16% lap banding, and 3% gastric sleeve. Gastric sleeve is rising rapidly.

This procedure can be done independently as a restrictive bariatric surgery, or it can be done as the first part of duodenal switch, in which case the switch is formed as a second surgery. This two part surgery was devised to bring down the mortality/complication ratio of DS done in one fell swoop.

Basically, the what is done is this.
The stomach looks like the flappy ear of an elephant, and that flappy part is cut off, and the rest is left as it is. This is the first part. Later, if the patient's weight loss is not enough, the switch, a bypass, is made.

The surgery is performed on BMI over 50 in the US (less than that in Europe), and sustained effective weightloss over the long term is somewhat better than bypass. Also, the resolution of various co-morbidities is the same as, or just a bit better than bypass with the exception of calcium deficiency.

The down points of this surgery is that
1) the sleeve can enlarge which leads to weight regain, but this can be controled by changing the surgery to DS.
2) a high incidence of developing acid reflux, especially those with hiatus hernia.

This does seem a promising new procedure in that
1) the success ratio is the same as, or may surpass, that of gastric bypass
2) if the desired weighloss is not achieved, the second operation can be done.
3) less malabsorbtion (however, when switched to DS, the rate of deficiencies increase some.
4) surgery mortality rate is very low.

Do not forget to ask your surgeon what his surgery statstics are.

[Elisa]

Thank you, Doc!

Such great info you have brought back to us! you have an excellent way of explaining things so that it is understandable to us! (LOVE the "elephant ear" example lol!)

I really am leaning towards this surgery. In your opinion.... what do YOU think about VSG? I'm liking most everything that I read about it. It seems so much less invasive to me and I really feel comfortable with that. My surgeon says the RNY is done open incision, no lap...I like lap lol. I found a little niche of "sleevesters" on the net who are providing me with some wonderful info as well....its always good to get personal accounts of others' experiences too. Thanks again for remembering to come back here with the info

[DocSanae]

Sleeve is still a new surgery, but it does seem a good option.
I say, talk it over well with your surgeon, ask about his own statistics, and if you feel comfortable, it may be the choice for you.
The advantage over Roux en Y bypass is that if revision (switching to DS) is needed, it can be done relatively easily.
Also, the fact that your surgeon does only open RenY, would be in favor of the sleeve for you since he does lap for that. However, keep in mind, with any/every lap surgery, the surgeon will always prepare to go open if the need arises, so even with sleeve, your surgeon will switch to open surgery if the neccessity is there.

[AnneN]

Elisa, how is it with you? My surgeon suggests VSG too and I'm looking for more info. What have you decided?

[BreeChick]

I've only talked to a few on another site that have had that sleeve done and I wondered what it was exactly since they couldn't seem to explain what it was! (that always scares me!)

But I think the overwhelming thing that stood out was a few of their attitudes..--negative response coming here--- they went on and on and on about how they could eat ANYthing and were losing, no dumping etc. So until now I've had a pretty negative attitude towards the sleeve surgery because of their irresponsible attitudes.

Thanks to the Doc's post I have a better idea of the purpose of it. I never knew it was a two part type of surgery. I know that most of the ones I know with the full out DS have gotten very thin.

Thanks again to the Doc for providing the 'real deal' on info and also with all the good info about the %'s of who is getting these different types of surgery done!

-bree