Band vs Sleeve

[laceemouse 631]

User Error is the #1 reason.... in ALL WLS.....failures. that's not to say some problems aren't due to product and or doctor issues.... My friend had sleeve and ended up in the hospital for a month due to the doctor f*cking up.

100% tue. BUT there must be some reason that more and more surgeons are dropping the band from their options. They can read about statistics all day long but their personal experiences ultimately determine their opinions.

[laceemouse 631]

I had the band for 7 years, successful as well, lost over a hundred pounds, kept it off by eating right and exercising. No serious complications but did get an esophageal dilation a few times for being too tight. User error? No, I don't believe that. Perhaps in some but the band, overall, is more fussy. It depends on many things, like how your body adjusts to the band after adjustments, and it depends on the precision on who does your fills, their knowledge, their experience... Etc. For example, my first surgeon was excellent, found my green zone fast... But after moving, and my body changing due to weight loss, finding a competent surgeon/nurse was not as easy as some may think, especially since the surgeons tends to favor the sleeve over the band these days.... And unfortunately, for me, it not only required technician skill, but it costs $$ and time for each adjustment to find that green zone. Would I recommend it? Sure. I loved my band when I had it, but I think it's good to know all the aspects, the good, the bad and ugly. ^^

I think by "user error" my surgeon meant compliance, that in his experience band people were less likely to follow the rules. But with any procedure we have to follow the rules to be successful. We all know that.

I wonder why of all WLS the band people are less likely to follow the rules? My doctor said the same thing. Now the balloon or whatever it is they got going on now seems to be less problematic compared to the lap band.

I think (and this could have a lot to do with the doctor) that getting the band filled just right must be hard. So many people either can't eat at all or seem to be able to eat too much.

I understand that even if you THINK you can eat too much you shouldn't do it. That's a no brainer. But for me (and I will only speak for myself here) the main reason I got obese to begin with was that I was HUNGRY. All the time. Starved. I would be worried, for ME anyway, that my big old growling starving stomach would still be there, under the band, screaming to be fed.

But that's just me, obviously many people have done well with the band.

[dvons 63]

This is an abstract and only reflects a small sample set. It does not go into the causation of the failures such as non compliance with food, follow up appt., taking medications that can cause issues. Without having the full study and understanding the study criteria, rigorous of the analysis, etc this abstract is not scientifically interesting.

I read a lot of success stories from people who have the band and are successful.

I choose to focus on encouraging everyone to reach their goals.

Had lapband surgery 10/12/16

I believe in encouraging people as well but I also believe I gotta be straight up with people who are trying to make a decision like the original post in this. I used to push the lap band back in the day, and I've seen a lot of people (my family members) suffer. Guilt makes you think to do research a bit more. If they already got the band, then I try to encourage people of course.

Edited December 2, 2016 by dvons

[Travelher 915]

This is an abstract and only reflects a small sample set. It does not go into the causation of the failures such as non compliance with food, follow up appt., taking medications that can cause issues. Without having the full study and understanding the study criteria, rigorous of the analysis, etc this abstract is not scientifically interesting.

I read a lot of success stories from people who have the band and are successful.

I choose to focus on encouraging everyone to reach their goals.

Had lapband surgery 10/12/16

I believe in encouraging people as well but I also believe I gotta be straight up with people who are trying to make a decision like the original post in this. I used to push the lap band back in the day, and I've seen a lot of people (my family members) suffer. Guilt makes you think to do research a bit more. If they already got the band, then I try to encourage people of course.

agree. I have to say the number in that study that indicated that more than 33% of patients had late complications which the majority were erosion, slippage and port issues with major surgeries at 21.7%. also each year adds 3-4% to major complication rate. You can't rationalize these are "user error" you can with some of the failure with excess weightloss. It would be interesting to see a study of pregnancy and band complications since mine started with that and I have seen a lot of posts on this and other forums about that. it makes sense, given all your organs moving and shifting around during pregnancy.

I don't see these are very great results and I think a lot of surgeons are saying the same thing, out of curiosity I looked to see how this fared against the complication rates with breast implants and it is not far off. Implants complications rates are 27.6%...way higher than what i assumed. just under 26% require re-operation. like the band the chances get higher the older they get. Lots of people get breast implants despite the complication rate and just have them replaced every 10-20 years and are ok with that. so if you view the band in the same way as other implants it carries roughly the same risks.

By the way there are other studies that support this data like one done in Sweden which has a 14 year span. they showed a reoperation rate of 30.5% at 14 years. Excess weight loss dropped to 15.6%! after 14 years of follow up.

https://www.hindawi.com/journals/jobe/2011/128451/

Now what my Dr says about the sleeve is that so far the results look good, but he's never 100% sold until a procedure has been around for 10 years. That is when he starts having confidence in the results longer term.

[BayougirlMrsS 3,933]

User Error is the #1 reason.... in ALL WLS.....failures. that's not to say some problems aren't due to product and or doctor issues.... My friend had sleeve and ended up in the hospital for a month due to the doctor f*cking up.

100% tue. BUT there must be some reason that more and more surgeons are dropping the band from their options. They can read about statistics all day long but their personal experiences ultimately determine their opinions.

This is just my opinion.... and what opinions are like.... lol

I think they don't want to be bothered with the maintenance of the band either.... I think they are all about the IN and OUT. like a herd of cattle.... The ones that still do them are the ones that stress compliance and want to make sure there patients are getting just the right care....

[BayougirlMrsS 3,933]

@@Travelher i still stand by my User Error comment. But i do understand that there are problems that happen due to product .... but any surgery can have that.

I hope to be one of the lucky ones that's still around in 10+ years saying.... I told you so.... fingers crossed.

I may be wrong with my assumption.... but when you got Preg. did you get an unfill?

[Travelher 915]

@@Travelher i still stand by my User Error comment. But i do understand that there are problems that happen due to product .... but any surgery can have that.

I hope to be one of the lucky ones that's still around in 10+ years saying.... I told you so.... fingers crossed.

I may be wrong with my assumption.... but when you got Preg. did you get an unfill?

I think you absolutely could still be going strong at 10 years (just don't get pregnant )

Yes I did get an de-fil during pregnancy. complications started after when i started getting my fills back in. I never got to the same fill level as before the pregnancy and felt terrible! the acid reflux was unbearable it was especially frustrating because part of the marketing was this is perfect for young women because if you get pregnant yada yada. Prior to pregnancy i dropped down to a weight I was happy with and maintained for 4 years (160-170). I got a partial de-fill to frankly survive and basically stayed at my pregnancy weight (which was halfway between my maintenance and high weight). Still had reflux but figured I just needed to live with it. what was weird for me post pregnancy was the daily variability in restriction. in the morning I struggled to get liquid in, at dinner I could eat a 4oz steak with no issues (I would have preferred the opposite to be honest).

It never occurred to me that I could get a revision. Then one day I woke up starving and i knew something was wrong. booked a fill appointment and they said the band was empty...that is when i started doing my research and finding out I was not alone and instead of re-banding which i was initially considering, i did a revision. I was at 11 years when it broke.

Re: user error: Erosion, slippage and port issues accounted for the majority of re-surgeries so by looking at the studies you can't say user error is the #1 reason. you could make a case that slippage is more likely when there is not enough fill and erosion surgeon error, not user error and port issues...nope. The swedish study gives more detailed data about the actual reasons for revision. Most lap band patients I've seen (anecdotally only) got revisions because of complications, not lack of weight loss.

I'm working really hard to get down to my band low weight, unfortunately for me the data shows that revision patients don't get the same weight loss results as first time RNYers...I'm hoping to be one of the exceptions, because of my success with the band, which you just have to work harder at. so I'm used to that. I'm hoping that will translate to me being successful with RNY. I'm halfway to the top of the low weight range i maintained for so many years!

Edited December 2, 2016 by Travelher

[Bugaboo77 18]

I've had my band for 6 years. When I got mine placed, the lap band was the latest and greatest thing. Now, not so much. But the sleeve is getting more popular. Remember the only weight loss surgery that has been around the longest where you can see long term success/failure is RNY. Who's to say that 5-10 years down the road, there will be problems with all the sleeves?

I totally agree with the above statement... who's to say that problems won't accrue with sleeve and no one knows the long term successes... because it fairly new..... I can tell you that i have had numerous friends that had the band, GB and a few sleeves. I see the biggest long term success are with people who are complaint with their doctors and the rules of their surgery which ever it is. Just in the past day or two... i saw post from long term GB patients that are now back or close to their weight and looking for advice...

The biggest thing I wish I would have known before my band was placed, was how finicky it would be. A little stress, and it is too tight. You have frequent adjustments and have to pay copays every time you go in and get it adjusted. And before you meet your deductible, it's like $150- $200 every time. I just don't have the time or the money to be going to the doctor every month for maintenance. Nobody told me any of that.

Devils advocate..... no one told you all the above? Why didn't you take it upon your self to research as much as you could... I had mine done Nov. 2009 and all this information was out there... i know because i read it as much as i could get my grubby hands on.

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I read through ALOT of information and thought it was the best for me at that time. I guess I was too stupid for not thinking to find out how often it would need to be adjusted and how much it would cost each time. I trusted the doctor to be very upfront with me and tell me everything I needed to know. Plus, the cost is different depending on your insurance. So if you've switched jobs like I have over the years, the insurance coverage changes.

THIS is the VERY REASON why I made the statement I did. So that OTHERS can think about it while making their choice.

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[bloomie85 0]

Thank you for all your information. I'm swaying more towards the Sleeve because of how physical my job is and the concerns I have of having a port and getting a kick to the stomach

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[BayougirlMrsS 3,933]

I've had my band for 6 years. When I got mine placed, the lap band was the latest and greatest thing. Now, not so much. But the sleeve is getting more popular. Remember the only weight loss surgery that has been around the longest where you can see long term success/failure is RNY. Who's to say that 5-10 years down the road, there will be problems with all the sleeves?

I totally agree with the above statement... who's to say that problems won't accrue with sleeve and no one knows the long term successes... because it fairly new..... I can tell you that i have had numerous friends that had the band, GB and a few sleeves. I see the biggest long term success are with people who are complaint with their doctors and the rules of their surgery which ever it is. Just in the past day or two... i saw post from long term GB patients that are now back or close to their weight and looking for advice...

The biggest thing I wish I would have known before my band was placed, was how finicky it would be. A little stress, and it is too tight. You have frequent adjustments and have to pay copays every time you go in and get it adjusted. And before you meet your deductible, it's like $150- $200 every time. I just don't have the time or the money to be going to the doctor every month for maintenance. Nobody told me any of that.

Devils advocate..... no one told you all the above? Why didn't you take it upon your self to research as much as you could... I had mine done Nov. 2009 and all this information was out there... i know because i read it as much as i could get my grubby hands on.

Sent from my iPhone using the BariatricPal App

I read through ALOT of information and thought it was the best for me at that time. I guess I was too stupid for not thinking to find out how often it would need to be adjusted and how much it would cost each time. I trusted the doctor to be very upfront with me and tell me everything I needed to know. Plus, the cost is different depending on your insurance. So if you've switched jobs like I have over the years, the insurance coverage changes.

THIS is the VERY REASON why I made the statement I did. So that OTHERS can think about it while making their choice.

Sent from my iPhone using the BariatricPal App

I completely understand..... I to have changed insurance 3 times since my LB surgery. I lost my insurance the day i went back to work from having LB surg. I got laid off from my job i had for 10 years. thank god my surg covered the first 7 fill or a year which ever came first. The fills came first i can tell you that. My next job that i had for 6 years didn't cover WLS ... so the office charge was 2??... i can't remember. but, me being the bi*chy person i am. Went to Him and argued my case about OOP fill charge and told him that i called around all the places that did them in Louisiana and said the the average cost was $125 i think.... he agreed and changed it. Victory...... No im at the job i have now and im just getting insurance and I'm not sure if they cover or not. But, im lucky in the fact that i have a close personal friend that is a surg and now does my fills for free.

[Travelher 915]

On 2016-12-01 at 9:51 AM, Treadmillwalker said:

I disagree with your percentages, but respect your right to your opinion. I just don't agree with it, but wish you success in reaching your goals.

Had lapband surgery 10/12/16

You can disagree but his percentages are based on real studies not people's feelings. Even the most positive band study that recommended the band as a viable option had a 50% complication rate. Hopefully you'll be in the 50% with no issues and you will have a very good malpractice case if you are not because surgeons are well aware of this data now. Make sure you hang onto any data and information your doctor gave you about the band...just in case.

[Treadmillwalker 486]

You can disagree but his percentages are based on real studies not people's feelings. Even the most positive band study that recommended the band as a viable option had a 50% complication rate. Hopefully you'll be in the 50% with no issues and you will have a very good malpractice case if you are not because surgeons are well aware of this data now. Make sure you hang onto any data and information your doctor gave you about the band...just in case.

Surgical techniques have significantly improved to help reduce slippage. My surgeon is the chairperson of a bariatric center of excellence and holds an officer position on a national bariatric association. I trust his confidence in the band and the surgery techniques he performed. That does not mean there is a guarantee that I won't someday have an issue, but the possibility of issues exists with all WLS.

I'm losing 10 pounds a month and feel great. I don't have any regrets about my decision.

Lap-banded and love it!

[hermione53 157]

I was first banded 17 years ago as part of the FDA trial. I loved it at first but had complications. It did produce results, as I was maintaining an 80 pound weight loss for a while. I had a new band installed and a hernia repair done seven years later due to slippage. I really wish I'd just gone with a bypass from day one because I had no results from that band. I wasn't perfect with my eating, to be honest, but I felt almost no restriction, even with a max fill. I gained a LOT of weight back and my PCP suggested I consider another bariatric referral last year. I was not convinced that I should have a conversion, but with the support of a new surgeon and her team I had sleeve surgery 9 weeks ago and feel GREAT. It's a totally different experience. Also, for years I'd assumed I wasn't having any trouble with the second band (beyond not losing weight), but I wound up needing a second hernia repair. Note, I had none of my prior symptoms. I don't know what my ultimate results will be with the sleeve and I know it's up to me to do the real work, but from my perspective I would not choose a band if I had the opportunity to do it all over again. Good luck!

[Travelher 915]

5 hours ago, Treadmillwalker said:

Surgical techniques have significantly improved to help reduce slippage. My surgeon is the chairperson of a bariatric center of excellence and holds an officer position on a national bariatric association. I trust his confidence in the band and the surgery techniques he performed. That does not mean there is a guarantee that I won't someday have an issue, but the possibility of issues exists with all WLS.

I'm losing 10 pounds a month and feel great. I don't have any regrets about my decision.

Lap-banded and love it!

Actually slippage isn't mentioned in the 2013 study...these were the complications and rates..... "A high number of revision procedures were performed-proximal pouch enlargement (26%), erosion (3.4%), and port and tubing problems (21%)."

Happy you are happy and I hope you stay in the 50% with no issues. I never had a slip. I had irritation, reflux and then eventually device broke. I lost as well and I felt great as well for the first 3 years. The point of my post is for people to know that if it does go bad...don't put your head in the sand. Do something...