CoffeeGrinDR

No probs, Arts. Research is kind of my thing, citations are just habit.

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.

If you want to make it happen keep fighting for another opinion until someone agrees. Medicine is much more of an art than a science than anyone cares to admit. Get your labs done and ask for a truly informed explanation as to why before you give up. No matter what, my thoughts and prayers are with you.

You haven't read these studies. I'm not sure you understand how to interpret results of intervention and outcomes. Quite simply: given regression to the mean, overwhelmingly the majority of folks who are banded are not successful. The only thing I'm stipulating is that the goal of the band is to be a tool in a patient reaching weight loss goals. It is not assisting more than 20% or so of people in doing that. If you read any of these studies you'll see that for many (40-50% average) have to have the band removed due to complications. It's pretty remarkable you all would attack someone on these boards who is struggling. Good health and good luck to everyone. God knows we all need positive support in our lives. And I mean EVERYONE. Good tidings.

The study is complete, did you read either of these studies? You are talking about sampling bias not completion. I'm glad it worked for you - but people should have full information before committing themselves to something. The study you cite states that 1:20 had to have the band removed. They didn't include these people in their statistics...that is what we call sampling bias. According to the original report only 22% people (714/3227) succeeded long-term (success being 50% of EWL). DeMaria, E. J., Sugerman, H. J., Meador, J. G., Doty, J. M., Kellum, J. M., Wolfe, L., ... & Turner, M. A. (2001). High failure rate after laparoscopic adjustable silicone gastric banding for treatment of morbid obesity. Annals of surgery, 233(6), 809. V Giusti MD, P. D. (2006). A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates.Obesity surgery, 16(7), 829-835. Goitein, D., Feigin, A., Segal-Lieberman, G., Goitein, O., Papa, M. Z., & Zippel, D. (2011). Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure. Surgical endoscopy, 25(8), 2626-2630.

Not your fault. A recent study suggests that the band isn't terribly effective (fails 44% of the time). Hang in there! Here's the link and citation if you are interested: http://www.soard.org/article/S1550-7289(13)00392-4/abstract 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.

Ok. Science has confirmed it: we didn't fail, the band fails. Check it out y'all: 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.

No worries, AuriP, I'm glad you raised the topic. It nudged me to do some reading which I was planning on doing anyway. My annoyance is with her, not you. Keep on keepin' on!

(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.

Ok, I know this needs to go into the research/science area and I'll cross post it, but just to follow up with some...you know...data...here is a summation: 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.

I'm all for counter-points and information but she is very slanted in her commentary. She also never follows up with any factual information. Based on your questions and my own curiosity, I plan on examining the medical literature for long-term gastric sleeve/gastrectomy outcomes. I'll let you all know what I find. (disclaimer: I'm not an M.D. just a Ph.D.)

Hi! It's interesting how much variation there is in the pre-op diet. I went through a number of abdominal surgeries in the past few years (not all bariatric-related) but the rationale for the liquid diet, as explained to me, is to shrink the liver and make the area easier to work in for the surgeon. Particularly as many of us have "fatty" livers, apparently the healthier liver also does better through the recovery process. It's not just about numbers for outcomes but viability. At least that's the prevailing philosophy (for now) amongst surgeons I have seen. Interesting to hear a myriad of experiences! Personally, it makes me less nervous so thank you for sharing!

Hi LGBT sleevers, This is general relationship stuff but given that I identify as an "L" in the LGBT crowd I thought I would post it here. Also, I'm really emotional this week and concerned that is clouding my judgment. I don't know what my problem is...hopefully this will pass after a full night of rest. At any rate... I went through a zinger of a breakup this past year and am focusing on self-care. One major aspect of that is my WLS and getting to a weight that I am happy with. I'm not saying I will put off dating until I reach that weight but I know I tend to get distracted from self-care when get into relationships and I want to ensure that I am totally focused on myself for a good while to make sure this major effort gets my full attention. Long story short, I just moved back to the country after a year abroad and a friend and I have been growing closer and closer. She wanted me to spend time with just her when I got back and I have put off doing so. I'm now moving across the country and she is leaving to go abroad for 4 months. Am I silly to put off our rendezvous thinking that my weight will be a determining factor on the success of our relationship? I can lie and pretend that my hesitation isn't about my size but a good deal of it is (coupled with the getting over the last breakup). I know it is ridiculous to say I will lose 100 pounds before I start dating again but right now that is how I feel. Fortunately, with her headed abroad it gives me time to do my self work. But I worry I'm missing out on seeing her before hand because of my stupidity. I sent her flowers that she will get this week so she knows that she is special to me (and hopefully doesn't think I'm not interested because of my dragging feet). I really like her. And it's not like she doesn't know my shape - we've been friends for 9 years or so - I just want to get to a different place before I begin something. THOUGHTS??

WOW! Way to LIVE!!! Inspiring Congrats!

I'm not telling anyone but you all out there (who get it), my god, and the angels that get me through each day. Everyone else and their opinions can suck it. I'm tired of living my life for other people.

Anybody else planning on using an abdominal binder? Thoughts??

DUDE, you are hilarious. I watched your vid on the interwebz. "They said don't go chasing waterfalls...and well...I did." Hilarious.

I'm not sure there is really any recourse in the US healthcare system unless you happen to be particularly well-off. Given the rate of comorbidities most of us have, it's not as though the army of lawyers any US hospital has is going to make an easy case for any US lawsuit. Also, a business model has little to do with the reputation of a surgeon's track record. The deposit makes sense. It's an elective surgery, I imagine without some aspect of financial good-faith people would be scheduling and backing out all the time (I've already shifted my date once and they were great about it). I don't think it's fair to cast a US/Mexico dichotomy (I've lived in three different countries and been through all kinds of medical systems -- here and abroad). Indeed, the first and most prominent university in North America was in Mexico before the US even existed. Due diligence is important no matter what your latitude or longitude. When you incorporate "elective" surgery and the market factors in play here it's important, just as anything else in life, to be informed. I find that people are best able to think clearly when they aren't panicked, afraid, or rushing. I like to think this board is a safe place for people to come and ask questions. Personally, I spent last night reading the complications board (just as one source of data) and found that overwhelmingly the surgeons were insurance-backed US-based doctors. Sometimes nuance matters. And also: trust yourself and your body, you know what's best for you! Always advocate on your own behalf in ANY medical setting...I think we all know what fat prejudice in healthcare feels like!

I suppose since you're in Oz you'll actually be a day ahead of us over here! No worries, we can be overseas sleeve buddies. I just moved back to the States from Oz. Good luck!

I'm also scheduled for January 16th!

THAT IS AWESOME! CONGRATS!

Oh my gosh. We might need to start a comic strip. Your stomach can be called "Stars" and mine will be called "Stripes" and we'll write all about their adventures across Mexico after we leave! HILARIOUS! (Can you tell it's almost 3am??)

Hey chica! Well...this has crossed my mind so I'll chime in publicly. Sometimes I feel like I've already eaten a lifetime's worth of carbs and sugar and I'm looking forward to not wasting so much time and energy on craving things. I've been also wondering, though, what a good mourning process is. A grieving process and an adjustment for how to cope now that the carb "release" is taken away. Will exercise be my replacement crutch? I FREAKING LOVE pizza. I know I'm not going to be able to slam in half a pizza in about 10 minutes like I can now. THANK GOD. Nothing really tastes as good as I think it will taste. I need to start daydreaming about what I will be able to do not what I plan on eating. This is a toughy. I'd be glad to see what some of the successful sleeve vets on here have to say about their transition away from carbs was like. Thanks for your honesty, NoLa! *hugs*

I think their threshold is a fever (as they wouldn't want to risk infection). Hopefully its just one of the quick bugs that have been circulating. Sounds like you're doing everything possible. Sleep, zinc, and vitamin C are your best weapons. Hang in there! We're with you!

Thank goodness for the internet of things!!