Which Surgery is Best?

Question
Hi Karla, Im  30 yrs old,219lbslbs and am 5"4. My BMI is 38 and the only surgery  my insurance will cover is gastric bypass. I've read also about the lap band  and VSG. I would like to get whatever surgery is the least complicated medically and  changing completely the foods I eat . The lap band or VSG I would have to pay for, but I think I would be approved for the bypass   because im also pre diabetic and am already taking metformin. But I dont want money to prevent me from getting the proper surgery. Also most of myw weight is in my stomach. If you could please tell me the pros and cons of the various surgeries. I would like to continue to eat red meat and have children in the future ,if this helps. Thank your  so  muchf or sharing your time and experience! :)

Answer
Hi Sophia:

In my opinion, you would do best with the Vertical Sleeve Gastrectomy--even if self pay.  There are two very well thought of Mexican docs who offer surgery for around 10k.  There are also some US docs who have good self-pay prices, but honestly, Drs. Aceves and Dr. Alvarez both have great reputation and experience.

Why the VSG?
1) Least changes to your diet. Your pyloric valve is still in-tact, so you can still eat all of the normal foods you like, albeit in smaller quantities.  With a Lap-Band, meat and others can be a problem, either getting stuck or causing you to PB (productive burp).

2) Great success rates, especially for those with a BMI under 40.  

3) Easy, low-risk operation.  

4) Would not impact any future pregnancies (but honestly, there aren't issues that can't be managed with any bariatric surgery.)

5) If you actually end up needing a revision later down the line (unlikely with your BMI), easiest (along with the Lap-Band) operation to revise.

Why not the Lap-Band?
Way too many revisions.  It has fallen out of favor because of this.
Repeated trips to the doctor for adjustments/fills--which can be cash pay if you're self-pay.
Food intolerances.  Some people call the Band surgery-induced bulemia based on the amount of vomiting they do when food gets stuck.

Why not the RNY?
Still a lot of revisions done in the 5-7 year period.
No pyloric valve (it's bypassed)--thus you have a pouch, and all of the issues that can come with a pouch.
Food intolerances.
Dumping.

Hope this helps!
Karla

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