If you are on any of the WLS oriented forums out there, one topic you’ll come across fairly frequently is when someone posts that they are looking in to surgery, but they don’t know if they should get RNY or the Band. Sometimes VSG and DS come up, but I don’t know much about those… so I’m going to give you my take on how the two compare.
Remember, I’m no medical doctor or anything, this is just what I’ve learned from reading about other peoples experiences and what I learned in my own pre-op research. This decision is a very personal one, but maybe I can give you some good stuff to think about while making it.
If you are a sweets eater right now, RNY is a good option because of the risk of dumping. HOWEVER, do not count on it. You will need to change your eating habits as well (no matter what). I’m only 11 months out and I don’t dump very easily.
The majority of what I have read/heard out there, either surgery will give you about the same results when you are at about 2 years out ***IF*** you follow your doctors program. With RNY you’ll typically lose much faster for a “brief” period (first 6-9 months) before leveling out to a steady progression, where bandsters take a slow and steady path.
Think of it like the Tortise and the Hare, where the band is the tortise and the RNY the hare. Except in this version they pretty much end up in a tie.
So if the overall end results are the same, here are some key factors to consider when deciding which one to have;
Co-morbidities: (sleep-apnea, hper-tension, diabetes, etc.) RNY will give you faster results, likely decreasing and/or eliminating your co-morbidities much quicker. I walked (slowly, but I walked!) out of the hospital off my blood-pressure meds.. and I’ve been taking meds for nearly 20 years.
Maintenance: Bandsters need to go in for fills, so they have a few more visits with their surgeon over the first year or so. But on the plus side… if something happens, say a pregnancy, you’re going out of the country (where decent bariatric care may not be available), you can get your fill taken out and basically be “normal” for awhile. But typically the majority of your fills are going to happen in the first 2 years, and even RNY types need regular check-ins with their surgeon/nurse during that period.
It’s about 50-50 for bandsters that I know that have gone back for any sort of fill after 2 years or so. All WLS types should be going in for check-ups annually though.
Mechanical vs Physical: Bandsters have a “foreign” object put in them, They will last a long time, but nobody knows just how long at this point. If you’re under 40, there’s a fair chance it will need replacing at some point in your life time. And there is always a risk of “mechanical” failure… the band can slip (though changes in procedures have greatly reduced this risk), it can leak, etc.
Bypass, you’re re-wiring your insides, and you will become mal-absorbtive. Both RNY and Banders need to take supplements, but RNY types especially so, and usually additional supplements. And while it’s rare, the risk of being too mal-absorbtive is there.
Bypass *is* reversible by the way… but it’s very complicated, and not 100%. The unused portion of the stomach is still there, so things could be un-done to a fair extent. VSG however removes a section of the stomach.. so I would think that it’s pretty much non-reversible at this point.
There are other factors that you may personally, like the scar tissue from previous surgeries or other things that may sway your surgeon towards one procedure or the other, but they (and/or their nurses) are the ones you should sit down with and get the final answers to your questions from.
They can look at your complete medical picture and make a recommendation for you based on that and what you expect to get out of the surgery.
Remember though, ultimately, it is YOUR decision.
Great comparison of the two procedures. It’s a tough decision for some that should be made between you and your physician. Your post gives a great viewpoint for both. Thanks!