I guys, any thoughts on Lapband removal and going to sleeve?

I was banded April 2008 and have many complications over the last few years from GI issues to slippage causing weight gain.

Spoke to my doctor today originally thinking of going to gastric bypass, but after much discussion of how I am dedicated to working out, counting calories and portion control, that he feels the sleeve would be a better option for me to lose the weight Ive gained and help me obtain my goal weight with out dealing with the complications of re routing intestines and malobsobtion.

Any thoughts?

Definitely do your homework. I would also take to heart what your doctor recommended as it sounds like he is wanting what's best for you.

Personally, I know many people that have been successful with the sleeve. I get very concerned with the bypass due to the malabsorption issues. My mom has had many struggles and health issues as a result; even with getting injections and being on very high doses of Vitamins. That's just her story and I know it has worked well for many others.

Good luck in whichever decision you choose.

Band taken out 3 weeks ago, will be getting bypass in February. Worst case scenario, you try diet and exercise and are not successful....then you can consider the sleeve more seriously. If you are truly dedicated to diet and lifestyle changes, maybe you can do it now, maybe the band was the training weeks you needed and now you'll be fine without anything. If you are gaining, if you are getting out of control, set down and have a serious discussion with your surgeon about it.

Good luck!!!!

This is strictly my personal opinion, but I decided before even getting the band that if it didn't work for me, the next step would be the Sleeve. To me, it just seems like the natural progression. Band first because it's not irreversible and doesn't change my anatomy, Sleeve next because it's not rerouting my intestines and there's no malabsorbtion issues. Gastric Bypass would be my absolute last resort.

I had never really considered the sleeve only because I had read that those who failed with the band would fail with the sleeve. And with my track record lol...

Let see banded April 2008, lost about 30lbs in 10months

Bad break up on Feb 2009 prompted the run/drink water/smoke diet and lost 40lbs or so in 2months.

April 2009 got life back on track and was less depressed so was able to eat and hold down food and gained 60lbs in 6months

Aug 2010 went back to nutritionist and was put on phentramine (yet have lb but still needed diet pills) and lost 30lbs in 6months.

July 2011 delt with slight weight gain and possible ulcer

Nov/Dec 2011 nearly hospitalized from GI issues and had ever test they could think of to figure out what was wrong with me and scoped from WMD to end. Off phentramine

March 2012 learned my band had slipped which wa cause of a lot of the issues my GI doctor was trying to figure out. And band unfilled and began discussions on revision to gastric bypass

May 2012 band looked better had partial fill and more talks about revision, up 7lbs, back to other doctor an put back on phentramine weightloss program

July 2012 gained another 13lbs and another fill, stated to start researching revison options. Got personal trainer at gym for 2xs a month work out for extra support. Still on phentramine

Aug 2012 down 3lbs, still having issues with band, can't lay on stomach because port site hurts, can't do certain work outs because it hurts to twist. Still not much restriction but fear tha because my band is tighter when I stress that any fill can cause issues. Discussed my fears of gastric and my doctors/my fears that of band is completely removed I will gain even more back and then some. Doctor recommended sleeve over bypass.

So yes I've been looking into it for awhile, I'm doing everything that has been asked of me and then some to lose the weight and keep gaining the min I'm off diet pills and sometimes even when on them. Doctor expressed that believes its my intolerance to certain healthy foods (the good Fiber ones) is a big problem, cant have a salad or fresh veggies with out getting stuck, sliming or PBing.

So that's why I'm torn, hadn't given much thought to the sleeve before it scared me more than bypass until I read all the horror stories of it and heard stories from friends who knew people who died from gastric complications months after surgery.

I've spent 4hour today just reading and researching and so far the sleeve really does seem like the best option. The idea to continue to have a tool to help me control my weight gain and the ability to eat a salad at the same time with out being in pain or throwing up sounds heavenly lol

Wow Ashejre, that's a lot of complications, and I'm sorry to hear that.

How tall are you? I don't know if I'd get things rerouted to lose 60 pounds, unless I had some other medical problems (diabetes or what have you).

I hope you're finally on the road to recovery!

This is strictly my personal opinion, but I decided before even getting the band that if it didn't work for me, the next step would be the Sleeve. To me, it just seems like the natural progression. Band first because it's not irreversible and doesn't change my anatomy, Sleeve next because it's not rerouting my intestines and there's no malabsorbtion issues. Gastric Bypass would be my absolute last resort.

Missy,

Come on, now. It's been scientifically proven that trolls don't even have intestines. But in spite of that. I agree with your response to the OP.

I'm 5'3"

I'm pretty well qualified to address this because in April my beloved band was removed and just last Thursday I revised to the sleeve.

I'm not sure what's behind the suggestion that someone who failed with the band is going to fail with the sleeve. It's really hard to draw a firm, clear line and say, "This is where the patient failed," or "This is where the band failed." Then you throw in dumb luck, shake vigorously, and get nothing intelligible or palatable out of the mess.

I do think that someone who struggles to lose weight with the band (for whatever reason) might not be a good sleeve candidate because the sleeve, like the band, is a chiefly "restrictive" procedure (I hate the term restrictive, but it's the best we've got at the moment). That person might need the malabsorption of RNY (gastric bypass) or DS (duodenal switch). I know several people who've revised from the band to RNY and DS and their weight loss has improved, but it's not breaking any records, either.

On the other hand, someone who struggles with the band because of side effects & complications (as opposed to poor weight loss for unknown/unspecified reasons) but otherwise is on board with the lifestyle changes (making good food choices, portion control, exercise, resisting head hunger), is actually a good candidate for the sleeve.

Your struggles make mine seem insignificant. If I were you, I'd want to revise to a procedure that's basically done when I leave the operating room. No adjustments, no searching for restriction or the mythical sweet spot. If that sounds appealing to you, then your surgical choices need to be evaluated using other criteria. For example, the DS provides excellent weight loss but can also cause serious medical problems because of the extreme malabsorption (to visiting trolls: please do not waste your virtual breath on lecturing me about DS and malabsorption. I personally know a great guy who lost a ton of weight with DS, has extremely serious health issues despite all the supplements he takes, and has regained 75 lbs.) So let's say you're the parent to a young child who depends on you for everything. Can you afford the risk of serious future health issues? If not, then you need to drop back a step, and maybe another step, to a "safer" procedure.

I originally chose the band over the sleeve because I actually liked the idea of adjustability, and that fit with my lifestyle at the time (in 2007). Permanently removing a big part of my stomach sounded too scary to me, but now I can't really say that the part of my stomach that got flushed last week was really doing me any favors. People have survived and thrived gastrectomies for decades. In the 1970's, I worked with a lady who'd lost much of her stomach due to bad ulcers. She was active and healthy and died of natural causes in her late 80's. The VSG is only new as a stand-alone WLS procedure. It's been used as a first stage for DS patients (who were often too heavy to safely have the intestinal routing done at the outset) for years. (Someone else can jump in to quote statistics and all that stuff as soon as I'm done with my speech. I'm not going down that road because I know perfectly well that figures can lie and liars can figure.)

The other thing to consider about the sleeve is that it is not strictly restrictive. It has neuronal/hormonal aspects that greatly reduce the patient's physical hunger along with reducing the amount of food it takes to satiate the patient. That's a big plus for me. That's what my band did for me, except that my band also reduced my appetite (my desire) for food.

Speaking of trolls and statistics (which go together like Soup & sandwiches), someone will no doubt point out that the sleeve poses a terrible risk of leaks along the staple/suture line. Guess what? So does RNY and DS. There is no such thing as a risk-free surgical treatment for obesity, nor is there any such thing as a permanent cure for obesity. Sometimes you have to choose the lesser of several evils.

Finally, your own surgeon, who has guided you through all your band struggles, thinks the sleeve is a good choice for you. That counts as valuable input to me. The fact that he started out favoring RNY and changed to favoring VSG for you is a good sign that he's really thinking about what's best for you instead of just what's best for him (making $, giving him a challenge, etc.).

When my surgeon told me my band was going to have to go, my response was to ask about revision surgery. I told her, "I am NOT going back to obesity. I refuse. I have worked way too hard to get here and I'm not going backwards." My life was very confusing and upsetting in the months that followed as I slogged through medical tests and weight regain, but one thing that I knew then and I know now kept me on track:

I AM NOT GOING BACK TO OBESITY. I REFUSE.

As a sleever myself, I think you would be making a great choice. I highly recommend logging into Vertical Sleeve Talk, it is run by the same people that run this forum. You can log in with the same acct you have here , we have a whole forum dedicated to Band to Sleeve Revision. I think you'd be pleasantly surprised at how many people there are that have been right where you are at now.

Here is a link to a recent thread on the topic

http://www.verticalsleevetalk.com/topic/49125-has-anyone-who-failed-with-the-band-succeeded-with-sleeve/

Missy,

Come on, now. It's been scientifically proven that trolls don't even have intestines.

ROFL I almost nurfed my Water laughing when I read that!!

Thank you, I needed that

Great well balanced answer by Jean as always. ( Jean glad you are now on the other side of your surgery and hope everything goes well)

I think the point about listening to what your surgeon thinks is particularly pertinent.

Must admit that I am a bit upset that I missed the trolls.

ROFL I almost nurfed my Water laughing when I read that!!

Thank you, I needed that

My pleasure. It's the least I can do for all the entertainment I got the other day when a troll called you a troll.

Some comics might judge their success by getting a million-dollar contract to perform in Vegas. Me, I judge it by how often I can make a beverage come out someone's nose. I get double points when the victim - I mean, audience - showers another person with the beverage.

Great well balanced answer by Jean as always. ( Jean glad you are now on the other side of your surgery and hope everything goes well)

I think the point about listening to what your surgeon thinks is particularly pertinent.

Must admit that I am a bit upset that I missed the trolls.

Hey, Elcee, get with the program!

Holy cow you have WAY too much time on your hands!!!!!!

Holy cow you have WAY too much time on your hands!!!!!!

Ain't that the truth! And I should be using my post-op down time to write the Great American Novel instead of playing on the internet. Oh, for the good ol' days, when I had to write by candlelight using my own blood for ink and the back of the Emancipation Proclamation for paper.

Not.