Expert: John Pilcher, MD - 9/2/2007

Question
Happy Labor Day Dr. Pilcher,
A question regarding the VSG surgery vs the RNY.  I was leaning toward the RNY following a Lap Band Removal, and I would like your input on the VSG.  Is weight loss considerably less with VSG? If I do not want to have sweets enter into my lifestyle any more does VSG offer a similar type of warning like the dumping that RNY does?  If I'm looking to lose up to 100 lbs will it take longer witht he VSG vs RNY?  I read you can just about eat anything you want with the VSG, and if that's true what's the point of the surgery if you're doing it to lose the weight and be healthier.  Is VSG a safer type of surgery as a revision surgery vs RNY? I'm considered on the lighter side, being 5'9" and 275 lbs and knowing that would there be 1 surgery or 2 with the VSG?
A lot of questions I know, but I am really researching this before doing this surgery over.
Thank you!!!

Answer
Cathy,
I can tell you are researching this question and thinking about it thoroughly - that fact alone causes me to believe you'd be successful with either the GBP or the VSG.

The data on the VSG is that weight loss is almost as much as with the GBP.  It appears that some hormonal changes occur with removal of the reservoir stomach that cause patients to gain a favorable sense of satiety ("fullness") and some aversion to sweets without true dumping.

The cautionary note on the VSG is that no results are available beyond about 3 years.  It could be that over 5 and 10 years the tubular remnant of the stomach will expand and facilitate weight regain.

It is probably true that a VSG is easier to do after a Lap-Band than GBP, but usually either one can be done safely.

I would not recommend you plan a VSG with the goal of a second surgery at some point in the future, but if you do choose a VSG and regain weight, then it is not a very big step to a gastric bypass.

I hope this helps!

Dr JP