comparing the sleeve and bypass

[fatidol]

Put me right in my thinking please, surely by having the sleeve then the chances of malutrician are nil unlike the bypass ? so for hair loss etc are less likely?
Also lesser chance of a leak after surgery?
I am swaying towards the sleeve as it seems less daunting, in no dumping no intesting bypass ?
can anyone let me know of any downfalls?

Thanks peeps

 

[Mixman]

The no dumping lies a problem in itself!

Why would you prefer an operation that's not going to make you dump, because you still want to have sweet/fatty foods? If it's because your willpower isn't good? If it isn't then perhaps the bypass is better to stop you wandering off the path?

People generally like having the dumping problem as it's an extra deterent as well as putting weight on! No option is fool proof. You still have to eat sensibly for any to work. In fact, I'd say you have to be even more strict with the diet after having the sleeve!

With the sleeve you can still suffer from any of the problems assosciated with the bypass too. You still have to take vitamins and minerals and have an B12 injection every 3 months!

Which reminds me.......................

 

[sleevester09]

The Sleeve gastrectomy involves that the stomach is restricted by dividing it vertically and removing more than 70 percent of it. The stomach that remains is shaped like a thin banana. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while reducing the volume.
Note that there is no intestinal bypass or malabsorption with this procedure, only stomach reduction.
In case of high risk patients, the laparoscopic sleeve gastrectomy is used as a first stage to induce weight reduction allowing for the more demanding intestinal dissection (Duodenal switch or Bypass) to be performed under good conditions.

Since this operation does not involve any "rerouting" or reconnecting of the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Unlike the Gastric Banding procedure, the Sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen.

For certain patients, in particular those with a body mass index greater than 60, the Sleeve gastrectomy may be the first part of a 2-stage operation. The 2-stage operation may have substantial advantages for specific individuals.

Advantages of the Laparoscopic Sleeve Gastrectomy

The stomach is reduced in volume but tends to function normally so most food items can be consumed, albeit in small amounts.
Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
No dumping syndrome because the pylorus is preserved.
Minimizes the chance of an ulcer occurring.
By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
Very effective as a first stage procedure for high BMI patients (BMI>60 kg/m2).
Similar results appear as a single stage procedure for low BMI patients (BMI 35-45 kg/m2) with the gastric bypass.
Appealing option for people with existing anemia, Crohn's disease and numerous other conditions that make them too high risk for intestinal bypass procedures.
Can be done laparoscopically in patients weighing over 220 kgs (500 pounds).

Disadvantages of the Laparoscopic Sleeve Gastrectomy

Potential for inadequate weight loss or weight regain. While this is true for all procedures, it is theoretically more possible with procedures that do not have an intestinal bypass.
Soft calories such as ice cream, milk shakes, etc can be absorbed and may slow weight loss.
This procedure does involve stomach stapling and therefore leaks may occur.
Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure.

On average, patients who undergo laparoscopic Sleeve Gastrectomy surgery experience a 60 to 80 % loss of excess weight.

 

[jean13]

I have a sleeve and am really pleased with the results (have lost 3st 11lbs since 3rd Oct) I was advised to have the band but wanted to have the sleeve, couldn't stand the thought of having something alien inside, and all the fills and de-fills.......... The person who has had the best results I know of is Mixman, and he's always willing to share advice. As I said it wasn't an option for me to have the bypass but I wouldn't have wanted it anyway as I didn't want my bowl re-arranged (my personal choice, I'm not speaking for anyone who has had the by-pass) I would love to know how you have done with the sleeve (Sleevester 09) could you let me know please? Fatidol hope someone comes along soon to give you more info on the Bypass, good luck on whatever you decide.

Jeanx

 

[sleevester09]

I have lost 9 stone since my operation in Feb 2009 I now have 2 stone left before I reach my target weight which is 12 stone.

As I am 5feet 9inches tall the Medical team say that is the maximum healthy weight I should be to get my body mass index to 25

I can eat small amounts of most foods and do not feel hungar again yet which is the most helpful thing of all as my main problem was eating for two people and still not feeling full.

I now don't have either of those problems and long may it continue, I am very happy with my sleeve and am so glad I had it done

 

[thinnerangela]

I've had a sleeve as part of a DS.

I don't have Vit B12 injections - haven't needed them. I am on iron tablets but as a result of blood loss during knee replacement - not necessarily as a result of the WLS.

I can only eat small amounts - about 3 oz meat/fish half a potato and a forkful of veg - I then have a rest and slowly eat a yoghurt then slowly a cup of tea.

A sleeve removes the part of the stomach that produces grehlin - a hormone inplicated in hunger signals - but it is the actual inability to get food in that works at stopping me over-eating!! It doesn't stay down!!

Have had one dumping experience.

And have lost 12 1/2 stone since pre-op diet - but remember I have had a DS as well

Hope this helps

Angela

 

[jaxx]

I wasn't given the option of a sleeve. For some reason the provider I'm with doesn't provide that surgery. I was given the options of a bypass, duodenal switch, gastric band or a gastric balloon. After a slide presentation on those particular options I felt the best option for me was the bypass. I have a large amount of weight to lose and I wouldn't be able to indulge in sugary or fatty foods nor would I be able to stuff my face with huge portions of food either (not that you can with any of the options) and I was hoping it would steer me to a healthier diet and lifestyle. Although I've had complications I'm starting to appreciate the surgery and it's change to my life.

 

[cah-ching]

My surgeon said to me on Sat that he thinks the grehlin thing in respect to the Sleeve is nonsence

 

[thinnerangela]

It was my surgeon who told me that the part of the stomach that produces grehlin was removed with a sleeve. He does make particularly small sleeves apparently using a small bougie.

As Mr Dexter is a pioneer of weight loss surgery especially laparoscopic I think he probably knows what he's talking about - I definitely very rarely feel hungry since my DS!

Suppose all surgeons are entitled to their opinions

Angela

 

[Mazza]

Hi

Im a bander but a friend of mine who has lost loads of weight with the sleeve does 'dump'. so has to be careful with fats and sweet foods etc. He was too big for a bypass but hasnt needed the sleeve converted. Like Mixman said though if you think avoiding sugery and fatty foods could be a problem then maybe you should consider a bypass.

Good luck with your decision!

 

[samsmum]

A friend of mine had the sleeve and has lost a lot of her hair and has had to have additional suppliments and hospital visits to make sure it slowed/stopped. She has done fantastic though with the weight loss.

I was offered the band or bypass. It was the amount of follow-up and the idea of something being left inside me that put me off the band. I chose the bypass as it was all risk up front and I liked the idea of the dumping to keep me in line in years to come. My team is now offering the sleeve instead of the band a lot of the time as it is giving results as good as the band without all the problems of slippage and errosion.

 

[fatidol]

Jean a big thankyou

Sorry i am late replying been on holiday, I have taken on board your comments and they have been so helpfull to me, I do prefer the sleeve for the same reason you commented on but i wanted to make sure i covered all areas as afterall you guys who have had the op are the experts, Jean how was you after the op?

Linda x

 

[fatidol]

thanks for you info, you have done so well on the sleeve,

Linda x

 

[fatidol]

Bless your friend hope her hair grows back, thanks for replying to my thread
Linda x

 

[fatidol]

Thanks for you reply, i am in favour of the sleeve at the moment due to the intestine being left alone, and malsorbation is less likely this way , dumping i know can still happen i know but i can be dissaplined with the sugar sweet things,
Linda x

 

[fatidol]

you have done so well, I feel i can be as disaplined as you with the sweet things, i like the sleeve for the reason of the intestine is left alone and this sounds better to me less risk of a leak, you have so much experience behind you with this i will be asking you loads, i read your experience very interesting reading a big thankyou
Linda x

 

[fatidol]

you are deff are the sleeve master your reply to me was wow, so helpful to me, i was swayed towards the sleeve anyway but wanted to confirm my way of thinking was correct as, and you have answered this in great detail a big thankyou again, could you tell me how you felt after the op? you have done so well and thanks for helping me
Linda x

 

[fatidol]

The sleeve i was told on my first visit by the nurse was a no go, but it turned up being a option that Dr Dartec offered he said he felt the bypass was a better option to me but would do the sleeve if i wanted, On checking out the sleeve with the help of this wonderful sites people i have decided on the sleeve, you have done so well on your journey thanks for your help
Linda x

 

[jean13]

Hi Linda, I was great after the opp, had the opp on the Sat at 5pm and was home on the Monday. I was getting around within a couple of day's and went to hospital on the Friday with no problems and seen my Surgeon.

I will just explain though I had my opperation done using the SILS method (Single Incission Laprascopic Surgery) The opp was done through my belly button. I only have a slight scar either side of it, just remember though everyone is diff. My Sister had me out of bed the next morning walking up and down the corridor attached to my drip. We bumped into the Physio who said I don't have to visit you then lol. I was in a lot of pain on the Sat night mostly in my lower back though so don't know what that was all about, but as soon as they got me suitably medicated I was fine. If there's anything I can help with don't hesitate to pm me.

Jeanx