Science says the band stinks and the sleeve works.

[CoffeeGrinDR 148]

(ok, I shouldn't say the band stinks - it just doesn't always work - so don't feel bad if it hasn't worked for you!)

Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.

KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.

This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.

Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.

KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.

As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.

Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.

KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).

Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.

Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.

KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.

Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.

Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)

KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.

At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.

Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.

KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)

Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.

Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.

Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.

Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.

Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

Edited December 15, 2013 by Alex Brecher

[ProudGrammy 8,322]

Science says the band stinks and the sleeve works.

CoffeeGrinDr

I'm responding to your post by saying i'm not gonna respond to that statement in fear of my life

there are "lappers" et al on this "community" board now

and out of respect (and a little fear ) i wouldn't touch your comment with a 10 ft pole!!!!

i am sooooo very happy that i had my sleeve done 2 years ago

DOS

12/15/11

235 lbs

5'3

12/15/13

130 lbs

goal

still 5'3

but everyone has a right to their opinion / thought on what surgery to have

especially you - and i respect your thoughts and the interesting listed references/statements

and i/we all wish them well

i see you are about one month pre-op

best of luck to you

speedy recovery

kathy

Edited December 15, 2013 by proudgrammy

[2muchfun 8,927]

Ms Grinder,

Re: Disappointed with weight loss-

Just an FYI, I've been around here for years and I've seen many newbies attack the band with partisan studies as you have. You are not the first here to make these arguments. There are other studies that document just the opposite. It's fine for you as long as you need the validation that you made the right choice, but it's not alright to attack others here who have also made informed choices for themselves.

Your study takes in older bands using techniques(with a very small sampling) that are no longer valid. Newer bands and different surgery techniques along with better follow up have resulted in better outcomes than the 44% cited in your study. The sleeve seems to be a great option and I would never suggest that it was anything less. We all have to make these decisions for ourselves.

Until you walk in our shoes(you know)!

[AmandaRaeLeo 2,145]

<p>Ms Grinder,</p> <p> </p> <p>Re: Disappointed with weight loss-</p> <p> </p> <p>Just an FYI, I've been around here for years and I've seen many newbies attack the band with partisan studies as you have. You are not the first here to make these arguments. There are other studies that document just the opposite. It's fine for you as long as you need the validation that you made the right choice, but it's not alright to attack others here who have also made informed choices for themselves.</p> <p> </p> <p>Your study takes in older bands using techniques(with a very small sampling) that are no longer valid. Newer bands and different surgery techniques along with better follow up have resulted in better outcomes than the 44% cited in your study. The sleeve seems to be a great option and I would never suggest that it was anything less. We all have to make these decisions for ourselves.</p> <p> </p> <p>Until you walk in our shoes(you know)!</p>

How to find a truly unbiased study?

How to convince people it is truly unbiased?

Those two objectives consistently prove to be mutually exclusively. I think my "mutually exclusive" statement is both unbiased and accurate but alas, there will be naysayers....

[Georgia 2,908]

It is definitely a personal choice to be made well informed with your surgeon and fully understanding all options. While LB works for many, sleeve works for others and still other RNY.

WL is not a "one size fits all". For me, I went to seminar for LB and came out enrolled for VSG. Has been great. Wish all the best in your WL journey.

[Pinkgirl1234 761]

The band is problematic.

[VSGAnn2014 12,992]

I am tickled for all those banders who have had long-term success. Very happy for you all. You're champs in my book.

But there are so many other banders whose stomachs and other body parts have been damaged by the band -- or for whom the band has been a pain (literally) or for whom the band has been simply ineffectual in aiding significant weight loss.

I'm so glad I didn't bother with it. More specifically, I'm glad my surgeon's office discouraged me heavily from seriously considering it.

(I'm a sleeve patient -- love it. Lost all my weight in 8.5 months post-op and am now 7 pounds below goal and maintaining easily.)

[More than this 116]

I thought the lap band was temporary in that they had to remove it after a certain time....

[Pinkgirl1234 761]

It is my nightmare.

[Julie norton 2,850]

It is my dream!

There are two sides to every story.

For me, very effective and changed my life. For many years.

I do say that every adult should do what they feel comfortable with.

I'm so thankful for WLS...I struggled and felt "less than" for too long.

Now I feel " just right"!

[More than this 116]

Pink, sorry, I didn't mean to upset anyone. Everybody is different. What works for one doesn't for others. Hey I haven't even been sleeved yet & I am going thru all kinds of fears. I have lost faith in myself as I have failed so many diets in the past....so how am I going to be able to do this? But if we don't try, then we fail anyway....so all we can do is take our chances & try the best we can. Be it another diet, another exercise, the band, the sleeve, or wiring our mouths shut (just kidding)....but we have to try & we have to believe that we can do it, coz that's the hardest battle of all. Believing it will turn out good, no matter what we try. And if that way doesn't work, we try another. If people were scared to try things or believe what they were doing wasn't going to work, it won't work....self defeatist attitude means we are dead in the Water before we even start swimming...if we were all like that we wouldn't be able to fly across continents or to the moon..we wouldn't be able to talk to someone far away without leaving our home...we wouldn't be able to cure diseases that killed people in their prime, in the past...so many things as simple even as a toaster....I could go on & on, but you get my drift..things we take for granted now would not exist if people stopped trying. In the end, that's what we have to do, no matter what we try...as long as we keep trying & do our best...& if we fail? Get back up & try something else! The only true failure is when we fear, which is what causes us to not take that step forward...so don't be afraid! Keep walking & IF the band works for you, then you are another notch on the lap band success stories. If not, then try the sleeve, or something else....just keep trying....that's why we are all here! We aren't perfect. We are doing the best we can & we are our own worst critics. Love yourself & try to believe that you are worth it & whatever you do will be ok....and this is never the end as long as you keep trying!

[jane13 2,256]

@@More than this, if medically necessary it may be removed and covered by insurance. just want it out or at your goal....you pay to have it removed. this is what I was told by hospital, nut, doctor and BCBS.

[Totoro 66]

I never considered the band because of the lifestyle restrictions that came with it. Coupled with the fact that there is a 30% complication rate after the surgery. My surgeon was very up front about discouraging patients from having it. I witnessed the limitations first hand at a dinner party when a banded friend spent half the night throwing up. Very happy with the sleeve. I've lost nearly 30kg in 7 months. My banded friend, 25 in 12.

Edited August 9, 2015 by Totoro

[More than this 116]

Thanks Jane for the info. Torero, that's why I want the sleeve but different things work for diff people. Pink is it making you sick? If it's working for you then great. If not then consider the sleeve

[curvybritt 53]

Very interesting, certainly a good article to read if you are considering between the two. Both have their good and bad points.