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Top Doctor's Opinion re Revision options-Posted on Complications Forum



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Dr Keshishian is a well respected bariatric surgeon who is well practiced in all types of WLS. In his own words :

Adjustable Gastric Banding

The adjustable gastric banding was approved and became widely used in the United States starting in 2002-2004. The early resulting data was acceptable in regards to the excess weight loss and the complications rate associated with it.

As more and more scientific data was published, it became clear adjustable gastric banding was not as benign or effective as initially thought. The associated weight loss was significantly less for the majority of patients. This information was even present in the literature provided to the patient by the manufacturer. Additional patients started developing Delay complications associated with the band, which includes esophageal dysmotility, a worsening of reflux, and continuous nausea and vomiting, in addition to inadequate weight loss.

In my opinion, the adjustable gastric banding procedures are inferior to the alternatives available. The specifics of different surgical outcomes are outlined on the poster available on our website. Adjustable gastric banding should be considered as a last resort, if at all, as a surgical procedure for treatment of morbid obesity and its associated comorbidities. Other complications that continue to plague adjustable gastric banding include slipped band, erosion, esophageal dilatation, and the required need for frequent adjustments.

The LAP-BAND AP® System

http://www.dssurgery.com/procedures/adjustable-gastric-banding.php?subnav=2

http://www.dssurgery.com/images/weight-loss-surgery-poster-large.jpg

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At least if there are serious complications, the procedure can be reversed; lap band removed & you're on your way. Can't say that once 75% of your stomach is removed, or your digestive system has been rewired.

My surgeon is not a huge fan of the band, either. I don't know that many bariatric surgeons are. But even with all of its potential ongoing problems, it's STILL less risky than the other options. I remain hopeful.....

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The article you stated was just opinion. Not a study and not fact. Opinion.

I'm sorry but opinions are useless. It's facts that matter.

This is an actual study and fact: "Gastric banding is safe and effective for managing obesity long-term, according to a study of patients 10 to 15 years after their surgeries."

Weight Stays Off Long After Lap Band Surgery

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So, the fact that other surgeries have a much higher complication/mortality rate has no bearing MsMaui? Oh look, here is a clinic that does all three types of surgeries as well http://www.trueresul...loss-surgeries. They claim that the sleeve has 3 times and GB has 4 times the complication rates of banding. That doesn't even deal with the much higher rate of people who die from those surgeries.

Let's be fair shall we and stop combing the Internet and posting just what the dangers of the band are. Before you scare someone into having 3/4 of their stomach cut away, and their intestines re-routed post the dangers of those surgeries as well.

I had a surgeon recommend the sleeve to me as well, know why? He was out of state and I couldn't find a Dr. who would do fills in Utah if he did the band. He didn't give a damn about what was best for me, he wanted the income from the surgery, ANY surgery.

Heck, my surgeon has over a 1000 bands by now, he won't do the sleeve or GB because he objects to making major modifications to a person's body such removing major portions of their stomach.

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here is another (observation)

http://www.wlshelp.c..._medium=twitter

let me add,

i stand by my belief that the small risk of band surgery was WORTH saving my life...i also stand by the fact that ANY surgery can have complications...

msmaui, i find that until you had complications, the band actually helped you lose weight and you seem to forget that...sorry if that is rude but i find your constant harping of the band failures also rude......

yes you are able to post what you want, good and bad....and i respect that and i support you and your recent surgery....

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So, the fact that other surgeries have a much higher complication/mortality rate has no bearing MsMaui? Oh look, here is a clinic that does all three types of surgeries as well http://www.trueresul...loss-surgeries. They claim that the sleeve has 3 times and GB has 4 times the complication rates of banding. That doesn't even deal with the much higher rate of people who die from those surgeries.

Let's be fair shall we and stop combing the Internet and posting just what the dangers of the band are. Before you scare someone into having 3/4 of their stomach cut away, and their intestines re-routed post the dangers of those surgeries as well.

I had a surgeon recommend the sleeve to me as well, know why? He was out of state and I couldn't find a Dr. who would do fills in Utah if he did the band. He didn't give a damn about what was best for me, he wanted the income from the surgery, ANY surgery.

Heck, my surgeon has over a 1000 bands by now, he won't do the sleeve or GB because he objects to making major modifications to a person's body such removing major portions of their stomach.

I don't know why people post this sh-t. Clearly, people come to this site for support and encouragement, not fear and negativity. I'm annoyed, but clearly we cannot control who posts what, where. I will take what I need, and leave the rest.

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To be honest, any WLS is only as good as it will be to the individual. Broad studies may be conducted on the effectiveness of each, and opinions provided on which may be more effective, but a patient SHOULD look at all the pros and cons of each type of surgery and make an informed decision as to what's right for THEM at that point in time.

After I got my band in 2008, I went through huge sleeve envy when a colleague got her sleeve at the same time as me. But the band was incredibly effective for me and has been for years until I sprung a leak. Now I'm looking at band replacement because in the end, I would be silly NOT to go with a WLS surgery that helped me lose 130% of my excess weight and helped me keep it off easily for 3 years.

It may turn out to be the wrong decision in the future but right now, I believe it's the right decision for me. And I think that that's what everyone needs to weight up - what's right for you?

On a personal note, I'm excited to have the option to 'start from scratch' with a new band. I'm not sure what happens next with a sleeve where, like my colleague, she started gaining again after a few years...

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I don't know why people post this sh-t. Clearly, people come to this site for support and encouragement, not fear and negativity. I'm annoyed, but clearly we cannot control who posts what, where. I will take what I need, and leave the rest.

People need to know the dangers of WLS, but they need to know the comparative dangers of ALL types of WLS, not just a skewed view. When I told my wife I wanted to be banded, it scared the **** out of her until she looked at the relative complication/mortality rates of the different types and pointed out that fewer people died by far from banding than the other two.

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To be honest, any WLS is only as good as it will be to the individual. Broad studies may be conducted on the effectiveness of each, and opinions provided on which may be more effective, but a patient SHOULD look at all the pros and cons of each type of surgery and make an informed decision as to what's right for THEM at that point in time.

After I got my band in 2008, I went through huge sleeve envy when a colleague got her sleeve at the same time as me. But the band was incredibly effective for me and has been for years until I sprung a leak. Now I'm looking at band replacement because in the end, I would be silly NOT to go with a WLS surgery that helped me lose 130% of my excess weight and helped me keep it off easily for 3 years.

It may turn out to be the wrong decision in the future but right now, I believe it's the right decision for me. And I think that that's what everyone needs to weight up - what's right for you?

On a personal note, I'm excited to have the option to 'start from scratch' with a new band. I'm not sure what happens next with a sleeve where, like my colleague, she started gaining again after a few years...

Weight gain is possible with ALL of the surgeries. The bypass has a 12-18 month honeymoon period, where the weight starts melting off. But after that, if the person doesn't "do the work", they can end up back where they started. And now with a rewired system, that doesn't function the way God intended.

I think with the band, if someone is truly motivated, and in it for the long haul, they will have long term success. As bandsters, our work starts the minute we wake up from surgery. There is no free ride with this, which for me, is just fine. At some point they all become work, and I'm totally fine starting my work right out of the gate.

Congrats on your great success with the band. THESE stories are the ones I come here for :)

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People need to know the dangers of WLS, but they need to know the comparative dangers of ALL types of WLS, not just a skewed view. When I told my wife I wanted to be banded, it scared the **** out of her until she looked at the relative complication/mortality rates of the different types and pointed out that fewer people died by far from banding than the other two.

I know that people need to hear the good, bad & the ugly before making such a big decision. But somehow, the way this post went up, felt anything BUT supportive or helpful. Just my feeling......

Before choosing a surgery, I scoured everything thing I possibly could, and talked with any and everyone who'd been through it. My doctor felt that the bypass was a good choice, and I almost went with it. Two weeks before the surgery, I freaked out and canceled it. And I'm SO glad I did!! I sleep much better at night knowing that I'm not permanently altered. And I know a few who are having issues years out, from the malabsorption aspect of the bypass. I'm at peace with my decision.

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I won't lie, I worked my ass off to lose. But once I got to my goal weight, I actually stopped formally exercising and the weight kept dropping off. I eventually got to the stage where my BMI was under 21 and my dr was talking about unfilling me, so I actively ate to GAIN some weight. When I say it was effective, it was VERY effective for me. It took away my hunger almost completely.

Even now, when I get fills while waiting for my surgery, I can go from hungry to not hungry at all with the right fill level. It takes away cravings, keeps me full for hours and I can then go about living my life.

The band may not be successful for everyone as it was for me, but hell, what surgery gives you 100% gaurantees anyway? So you do your research, take a punt that it will work for you, and get on with it.

And you know what's NOT in the studies? I learnt more about food and hunger with my band than any othe time in my life. I gained initally when my band started leaking, and now I'm maintaining without the help of the band, and am in fact slowly losing. So it's given me more than it has ever taken. And that's MY opinion piece on it! :P

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I have only been on my journey since Feb 28 and I think if you are on this site for the purposes that are intended these posts are not necessary. If you are thinking WLS gosh I hope you have really researched it because this is not an easy ride, but I am so happy with my choice to go this route. I wish it was faster to get to the green but I have lost almost 30 pounds in less than 2 months which is pretty amazing. And I am healthy. Healthier than I have been in years. To each his own, but for my purposes, this site is for encouragement, not for negativity. Just saying.

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here is another (observation)

http://www.wlshelp.c..._medium=twitter

let me add,

i stand by my belief that the small risk of band surgery was WORTH saving my life.

i also stand by the fact that ANY surgery can have complications...

msmaui, i find that until you had complications, the band actually helped you lose weight and you seem to forget that...sorry if that is rude but i find your constant harping of the

band failures also rude......

yes you are able to post what you want, good and bad....and i respect that and

i support you and your recent surgery....so how about supporting those of us who are having success.

very well said. I liked the Band because you can reverse it and cutting out your stomach-you're f**ked!

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I guess I am the strange one here. I never ever did research. My lung doctor hooked me up and said you are having this and I never questioned anything. I am not sorry at all. I don't care about what other people say about the cons.

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It's hard because for those for whom the lapband was not successful, I'm syre that they feel like they need to let others know so that others won't go through what they went through.

It is the flipside to those who, like me, make the band seem like it's easy peasy (it was for me, I'm not going to lie, but it isn't for everyone, and that's the truth). Or for whom complications (like my leaky band) happen but given that, we'd still choose the band.

But sometimes, and I've seen it often on the years I've been on this site, it goes from 'here's what I know so you don't suffer like I did' to completely ignoring the fact that there are people like me for whom the band has been successful. So it becomes about 'here's some downsides so you know the full story' to 'YOU WILL RESPECT MY AUTHORITAE!'. I actually don't think this post is one of the latter btw, but it's showing small shades of it.

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