Lap-Band vs. Sleeve gastrectomy

[medicgipson 0]

Ok, so tonight I attended my first weight loss surgery seminar. I went into it with my mind made up that I wanted the Lap-Band. But after listening to the lecture, I am now wondering if the sleeve gastrectomy would be a better option. It seems to have a higher success rate (as far as weight lost and keeping it off) and according to the surgeon, less hunger. Has anyone else researched this and compared it to the lap-band? If so, why did you decide to go with the band? Help me sort through this!

[GLove 44]

What a coincidence. I just returned from a seminar tonight also and had the exact same thought. I have researched the heck out of the lapband procedure not giving a thought to the sleeve or gastric bypass and the doc said some things about the sleeve that made me wonder if that would be a better choice. The band is reversible and 3/4 of my stomach will not be removed, so those are the 2 biggest reasons I will stick withthe band.

[THEgeorgiaPEACH 3]

Personally, I could never choose the sleeve over the band. Yes, the sleeve will make it so that you loose weight more rapidly, but the band is reversible, and adjustable. My mom works in the hospital & she's seen so many fatalities & problems with the sleeve & gastric bypass, she told me she'd never support that decision. My opinion is that the band is safer. Ask your surgeon this question "if you had to recommend either the band or the sleeve to your sister, which would you recommend?" ...I guarantee his answer would be the band. Only because it's proven to be so much safer and so much less invasive. I'm 4 months out and already 40 lbs down. The band works! Hope this helped & I hope you don't feel like I'm shoving it down your throat. Just my opinion! Good luck in whatever you choose!

[farmer2120000 1]

I was thinking the same after doing more research on vsg vs the band and what i understand the vsg is a two part surgery with the second being swiched to a gastric like bypass procedure. i read they are trying to see if the vsg can be stand alone procedure. i am currently banded and i've lost 31lbs in a month the lap band works I was home after the surgery in an 1hr and was'nt in a whole lot of pain after my surgery mainley i was sore but hey whichever surgery you chose is a personal choice good luck to you

Personally, I could never choose the sleeve over the band. Yes, the sleeve will make it so that you loose weight more rapidly, but the band is reversible, and adjustable. My mom works in the hospital & she's seen so many fatalities & problems with the sleeve & gastric bypass, she told me she'd never support that decision. My opinion is that the band is safer. Ask your surgeon this question "if you had to recommend either the band or the sleeve to your sister, which would you recommend?" ...I guarantee his answer would be the band. Only because it's proven to be so much safer and so much less invasive. I'm 4 months out and already 40 lbs down. The band works! Hope this helped & I hope you don't feel like I'm shoving it down your throat. Just my opinion! Good luck in whatever you choose!

[elcee 3,340]

the sleeve is the first part of a 2 part procedure but it has now been proven to work as a stand alone procedure.

The advantages of the sleeve

no fills

you reach a level of restriction straight away and should lose from the beginning

less issues with bringing food back up

you should be able to eat most things

disadvantages

higher risk surgery

if the sleeve is not made the correct size then you may still be able to eat too much and not lose weight

most sleevers seem to be on antireflux meds as a matter of course

The advantages of the band

it is adjustable(some may tell you this is not an advantage as it just means more effort to get to the right spot)

much lower risk surgery

it can be removed ( but there could be lasting damage)

disadvantages

it is a longer slower process to get to the correct level of restriction

more aftercare and consequently this means ongoing costs

some people find there are lots of foods they can't eat

stuck episodes!

some people develop reflux

I think both surgeries are probably equally as effective. The sleeve is still relatively new so there are not a lot of statistics on its success a number of years out.

Both these types of WLS are a tool and not a magic wand. The level of success with either will depend on the commitment of the person. If you decide to graze all day long, eat Cookies, candy etc neither will stop you from doing so. Also neither will force you to exercise. So at the end of the day it is best to choose the surgery that you think will suit you best.

Don't get a band if you don't intend visiting your Dr regularly or if you think you may not have insurance or money in the future to cover the visits.

[Matt Z 4,138]

Unless you are a self pay, check with your insurance company. For me, the band was covered, the VSG was not because it was "too new".

[Amanda61082 28]

Same with me. The only options I had was the Band or Gastric bypass. I am going with the band in February. I am so excited!

Unless you are a self pay, check with your insurance company. For me, the band was covered, the VSG was not because it was "too new".

[Dave_NW 92]

Something to consider if deciding which type of surgery is best for you:

You may lose faster initially with the sleeve or bypass, but over time bandsters tend catch up to bypass and sleevers, and generally have fewer complications. Depending on how much weight you have to lose, one of those other surgeries may be a good choice for you. However, after a few years, once you've lost the weight and are maintaining, does it really matter HOW you lost the weight? If the goal is to be thinner and healthier, wouldn't you want to follow a program that is (sort of) reversible, where nothing was cut up or out, just in case there is a problem?

When I was exploring my surgery options I was told bandsters usually lose only about 50% of their excess weight. That wasn't a good enough answer for me, and I really worked hard to lose as much of my excess weight as I could. And I was within about ten pounds of my goal weight within about 9 months. Now, just a few weeks shy of my one-year bandiversary, I'm basically at my maintenance weight, I look great, feel fantastic, and I'm having zero side effects or issues. Given the ongoing medical issues associated with the other surgery choices, I'm glad I chose this route.

Good luck with whichever way you decide to go.

Dave

[GLove 44]

@Dave - excellent post. You raise a question that has been on my mind and haven't asked anyone yet. I see that you are 58. I am 57 and have not yet had the lp surgery; looks like it will be in late February. Anyway, so what is the plan after the goal is met? Do you unfill a bit so you can eat on a maintenance plan? Can you now eat bigger portions ?? Obviously you need to continue eating smart and excercising but do your options open a bit after goal is met? Im thinking long term here...what will life be like at 75? If Im at goal and eat a slice of bread will I be get stuck? Will I still need to get fills adjusted? Im unclear on long term protocol. Thnk you.

[Dream4tc 192]

Ok, so tonight I attended my first weight loss surgery seminar. I went into it with my mind made up that I wanted the Lap-Band. But after listening to the lecture, I am now wondering if the sleeve gastrectomy would be a better option. It seems to have a higher success rate (as far as weight lost and keeping it off) and according to the surgeon, less hunger. Has anyone else researched this and compared it to the lap-band? If so, why did you decide to go with the band? Help me sort through this!

I researched them all quite extensively before I decided to make my choice. I am a nurse and have taken care of many patients with bypass and sleeve procedures and have taken care of them when they had complications arising from the surgeries mainly from non-compliance with the dietary restrictions and electrolyte imbalances causing other problems based on nutrition. I have also taken care of banded patients as well who have their own complications from being too tight.

Bypass and Duodenal switch procedures are restrictive and malabsorptive meaning that it will give you Portion Control but the malabsorptive part of it means that you don't absorb the nutrients that you need which can cause nutritional deficiencies and electrolyte imbalances. Hence, therefore its a must that you take Vitamin supplements for life.

With bypass, the stomach is not removed but rerouted.

With D/S, there is rerouting but the difference is that it limits absorption of fat

The risks with either of these surgeries run significantly higher than other WLS procedures which include readmission due to complications causing long hospital stays. Weight loss with both are rapid. They both carry lists of risks and they are not reversible.

One of the nurses I work with had gastric bypass and is having extreme difficulty retaining Calcium and Vitamin D levels. She has had many problems and 3 additional surgeries just this year from bowel obstructions and ileus.Our best man of our wedding also had bypass 6 years ago and has stretched his stomach out from overeating that now he has gained all of his weight back. The risk of all WLS is that if you overeat, you will stretch your pouches and the potential for gaining weight will happen if you don't change your dietary habits.

Gastric Sleeve- this procedure will remove a large portion of your stomach (removed out of your body) that secretes an appetite stimulating hormone called Ghrelin. The stomach turns into a banana like bag and is a restrictive procedure. The risks are less than the bypass or D/S. This is not reversible.

Lap-Band or AGB- is the lowest risk and safest WLS available. It is a restrictive procedure. It is reversible and safe for those who are pregnant, or who may want additional children.

There are lists of risks associated with each WLS procedure that I will not list here. I encourage you to research each one and write down the list for each.

With any WLS, if you don't change your dietary habits you will stretch your pouches causing weight gain and complications.

For any person who is considering WLS, I recommend to educate yourself, make a list of questions to ask, and ask your surgeon. It is a personal choice. Just make sure you arm yourself with all of the information that you need to make the best possible decision for yourself because no one can make that choice for you, not even your surgeon.

A list of pros and cons for each surgery may help you make the best decision.

Ask "what if" questions for everything, remember this is your weight loss journey. Knowledge is power.

I personally have chosen the Lap Band due to its reversibility, low risk of complications and safety for pregnancy if I choose to later have additional children. I will be banded 11/1611. Before I made my decision, I researched risks, complications, read blogs and forums such as this one, watched youtube videos of people who have had the band and what problems or positive outcomes they have experienced, I researched studies, and questioned my surgeon on numerous occasions to arm myself with the knowledge to make the choice for me.

I am and have been addressing the behavioral part of dietary changes by seeing a behavioral therapist since the beginning of this year. If your mind is not in the right place, then you need to get it there before starting WLS or you will continue to make the same poor choices. I also have an excellent supportive husband who is completely on board with my decision.

Best of luck to you

[Dave_NW 92]

@Dave - excellent post. You raise a question that has been on my mind and haven't asked anyone yet. I see that you are 58. I am 57 and have not yet had the lp surgery; looks like it will be in late February. Anyway, so what is the plan after the goal is met? Do you unfill a bit so you can eat on a maintenance plan? Can you now eat bigger portions ?? Obviously you need to continue eating smart and excercising but do your options open a bit after goal is met? Im thinking long term here...what will life be like at 75? If Im at goal and eat a slice of bread will I be get stuck? Will I still need to get fills adjusted? Im unclear on long term protocol. Thnk you.

My goals after I'm totally done losing is to continue to tone and maintain muscle mass, so I remain healthy. I don't plan to remove the band or reduce the fill level, since I'm currently at a very "liveable" restriction. If I get stuck, it's ALWAYS due to something I did: I ate too fast, took too large a bite, didn't chew properly, or whatever. I don't eat plain bread now, so won't be eating it later. But toasted bread IS doable, so I have some toast once in awhile. My long term plans with my diet are to continue to manage my nutrition, because I know that if I stop managing my diet and exercise level, I no doubt WILL gain back the weight. And I will NEVER go there again. So I'm committed to staying the course, and living life to the fullest -- until they carry me out horizontally.

Thanks for asking. Good luck wth your journey!

Dave

[xavier 153]

I think these are all good posts and for me Lap band was right. But heres my thoughts on how to choose:

I believe many of us have a touch of mental illness that lead us to obesity (otherwise why not just eat less, burn more etc?) so for me I call that part of me the 'fat/crazy'. The part I couldnt control and all the crazy thoughts that went with it like a running monolog in my head of what I should or shouldnt eat and what I should or shouldnt do since I ate something I shouldnt...sound familiar?

Well I have been successful and reigned in the fat/crazy but a little of it is still there. I'd say my band does 75% of the work but on a different day I might say different!

I think the choice between LB and VSG is how much of the fat/crazy you have. If you dont have any will power at all and the fat/crazy is 100% in control of you you should lean toward VSG because it does more of the work for you. (My doc told me he has met patients who have NEVER dieted or lost weight...they probably need the sleeve or even GB) But I had dieted successfully many times, lost a lot of weight, and even kept it off (for a while!) so he thought I could handle the LB which does require you to reign yourself in a bit!

Just my thoughts...oh, if I lost my band, I would get the sleeve!

[omamilam 11]

Hi,

I am also making the decision between LB or VSG and doing a lot of research. After being in the LB chat room for 3 weeks now, I have noticed that there are a lot of dr. visits to fill or unfill because of discomfort, or not losing, food getting stuck, emergency surgery because the band slipped etc. I became frustrated that there was never anyone in the VSG room to talk to about the sleeve. I had an epiphany one morning that is because no one has anything to complain about after they have healed from the surgery. That spoke volumes to me. Yes, it is more invasive, recovery is longer and leaks are rare but you do not have a foreign object in your body that you have to continually adjust. Yes, the LB is reversible but if you are not committed, why do either surgery? Are you really going to have the band removed? I have noticed that after you heal with VSG you are more normal and can eat whatever you want with no food restrictions to speak of with the band you can not have many of the foods you love EVER. I like the fact that your pouch is larger than with the band. You can actually go to a restaurant and eat a kids meal where with the band, one or two bites is all you can tolerate. Having a pouch the size of a golf ball (LB) as compared to a banana (VSG) and the hole to your stomach is normal size instead of restricted by a band so food can't go through easily, I have elected to be more "normal" and just have my stomach reduced to the size it should have been before I got fat and made it the size of a football. The part of your stomach that stretches is removed so you will not stretch back out and the part of your stomach that senses hunger is removed so you don't get hungry. I would rather go to the doctor every 3 months for a check up with VSG than every month with the band (if not more than that for problems.) Did I mention every fill with the LB is $150? Also, most people that have the band removed due to slipping end up with the VSG anyway. I also do not want to be stuck drinking Protein Powder the rest of my life 3 times a day just to get my Protein requirements in because I can not consume enough food orally. This is why I am choosing VSG over LB. Its a personal decision, do your homework and research. Talk to Bandsters and VSG patients before you make your final decision. Good Luck

[xavier 153]

Well good luck and I hope you make the right choice for you. A lot of your negatives about the band are not true for me. I eat every food I ate before and have really had no problems. I can eat a small meal in a restaurant but if we are comparing a golf ball to a banana (four times as big?) my golf ball has put me fairly easily into a size 6 and if I doubled let alone quadrupled my intake I might have never gotten to goal and below it...hard to know until you see how whatever choice you make works out for you...either way its a leap of some faith!

Hi,

I am also making the decision between LB or VSG and doing a lot of research. After being in the LB chat room for 3 weeks now, I have noticed that there are a lot of dr. visits to fill or unfill because of discomfort, or not losing, food getting stuck, emergency surgery because the band slipped etc. I became frustrated that there was never anyone in the VSG room to talk to about the sleeve. I had an epiphany one morning that is because no one has anything to complain about after they have healed from the surgery. That spoke volumes to me. Yes, it is more invasive, recovery is longer and leaks are rare but you do not have a foreign object in your body that you have to continually adjust. Yes, the LB is reversible but if you are not committed, why do either surgery? Are you really going to have the band removed? I have noticed that after you heal with VSG you are more normal and can eat whatever you want with no food restrictions to speak of with the band you can not have many of the foods you love EVER. I like the fact that your pouch is larger than with the band. You can actually go to a restaurant and eat a kids meal where with the band, one or two bites is all you can tolerate. Having a pouch the size of a golf ball (LB) as compared to a banana (VSG) and the hole to your stomach is normal size instead of restricted by a band so food can't go through easily, I have elected to be more "normal" and just have my stomach reduced to the size it should have been before I got fat and made it the size of a football. The part of your stomach that stretches is removed so you will not stretch back out and the part of your stomach that senses hunger is removed so you don't get hungry. I would rather go to the doctor every 3 months for a check up with VSG than every month with the band (if not more than that for problems.) Did I mention every fill with the LB is $150? Also, most people that have the band removed due to slipping end up with the VSG anyway. I also do not want to be stuck drinking Protein powder the rest of my life 3 times a day just to get my Protein requirements in because I can not consume enough food orally. This is why I am choosing VSG over LB. Its a personal decision, do your homework and research. Talk to Bandsters and VSG patients before you make your final decision. Good Luck

[elcee 3,340]

Oma you do have some strange misconceptions about the band.

I for one do not have any food restrictions to speak of(unless you include tough, dry meat). I can eat anything.

I would never go to a restaurant and order a kids meal as the choices are awful. I go and order what I want, sometimes just a starter, sometimes a full main and I eat as much of it as I want and I can assure you that is a lot more than 2 bites.

I also believe that you are slightly misinformed about the sleeve. Yes it is true there is less aftercare but there are people that do have issues. I believe it is possible to have foods that are difficult to tolerate and if you read all the threads on the sleeve board you will discover that there are people with hunger issues. I am not saying there is anything wrong with the sleeve or your choice just that it may not be quite as perfect as you currently seem to believe.