Band vs Sleeve

[StacyS 20]

Hi I'm Stacy. I've been jumping through hoops to get the lapband but had a 3 month set back with my insurance and decided to see a different doctor. I have been dying to get the lapband but after talking to more people and researching the two procedures, I'm swaying more toward the sleeve. Can I please have some advice from others why they went with the sleeve rather than the band? Or why you got your band removed and crossed over to the sleeve?

I'm really confused and need all the guidance I can get.

[NanaNanner 7]

I started out thinking I wanted the band as well but didn't realize all the maintenance required. I also don't like the idea of having a port. Too many potential complications.

[LilMissDiva Irene 3,281]

Stacy, welcome!! I am a revision, and the reason was I lost some weight with the band (through my own blood, sweat and tears - no help from the BAND) but just like any other diet that never worked once I stopped doing the right things the weight piled back on so fast I didn't know what happened!

So I revised to the sleeve through lots of suggestions from some folks. Thanks to them I finally have a tool I know I can work with and keep the weight off. It's really hard to explain, you just have to be there, know what I mean?

Do some searches here by "band vs. sleeve" or "revision". Also check out our Band to Sleeve revisions page. You will find a great deal many folks here who have once been banded and are now loving sleeved life.

http://www.verticalsleevetalk.com/forum/13-band-to-sleeve-revisions/

Good luck!!!

[Douceur72 3]

Hi I'm Stacy. I've been jumping through hoops to get the lapband but had a 3 month set back with my insurance and decided to see a different doctor. I have been dying to get the lapband but after talking to more people and researching the two procedures, I'm swaying more toward the sleeve. Can I please have some advice from others why they went with the sleeve rather than the band? Or why you got your band removed and crossed over to the sleeve?

I'm really confused and need all the guidance I can get.

Hi Stacy,

I am going thru the pre-surg process right now and have been reseraching like crazy to help me decide as well. When I went to the first seminar in November I was pretty sure I wanted the band, but now I am 99% sure I will choose the sleeve. Even though it's permenant it seems to be tolerated better than the band. So many people who are banded need to have it removed or revised. Plus it would be difficult for me to do the follow-up required for the band. At the seminar the surgeon mentioned that many patients come from hundreds of miles away and it would be impossible to come for adjustments/fills etc, so they opt for the "sleeve 'em and leave 'em."

The more I read about sleeves the more confident I am that my WLS will be a success.

Best of luck in making your decision!

[Tiffykins 672]

Forewarning, this is going to be a huge post:

I had the band and revised 8 short months later to the sleeve. The band has the lowest and slowest weight loss with the most long term complications out of the 2 procedures. The sleeve works like the band is advertised to work without all the b.s. band complications. If you're a member on obesityhelp.com check out the failed weight loss forum, the revision forum, and the band forum and you can read story after story of bandsters looking for revisions or struggling to lose weight, and essentially dieting and depriving themselves of good food because the band causes major issues with some foods such as dense meats and lettuces.

My WLS journey started back in 2006 with just tons of research. Then in 2007, I moved myself, kiddo and cat across the country to be with my now husband in MA, and all research stopped. He proposed, got the ring, got orders for a PCS(move) to Florida from the Air Force, we got married, and then life started happening. I started researching options with our insurance. It was band or bypass, so I chose the band (placed October 2008) going in knowing the complication possibilities, and thinking I could beat the odds. Well, that didn't pan out so great. 8 months with the band, I had all the band issues, plus a flipped port that was causing the tubing to pull on my band that was attached to my stomach. I sought a revision again it was bypass only, and I just refused. Luckily, I stumbled upon some others that had VSG performed at a base close to us. I put in for my referral, and was approved.

In March 2009, my husband was deployed to Afghanistan. My complications had already started with my band, and were getting worse. We discussed waiting until his return, but extensions and delays are a common occurrence, and I could not continue to live in pain from the port issues. I was at a pain level of 6-8 on a daily basis, could not work out, my band surgeon was/is a douchebag and wouldn't help me. While everyone thinks our insurance is a "cadillac plan", we do have red tape, and other hoops to jump through so it wasn't an exactly easy process. But, June 3rd, 2009 I had my revision. Surgery went well, recovery the first 2 days was good, on the final leak test 2 hours before discharge time, a leak was detected. Back to surgery I went, I had anesthesia complications, and landed in ICU on a ventilator for several days. My husband's command was contacted yet he wasn't allowed to come home. I was touch and go for those days in ICU, but did recover. I went home with a home health care nurse, a pic line in my arm feeding me TPN for 20 something days, and nothing to eat or drink, no ice chips nothing by mouth for those 22 days. Least to say, my recovery was hell. I had to resign from my job, I was on restriction for 3.5 months, and the recovery, eating process was just exhausting. I was hospitalized again in mid-July for abscesses in my abdomen and pelvic cavity, had drains placed again, loads of antibiotics, but I recovered from that as well. I was super strict with my dietary guideline, and attribute that and the loss of my physical hunger to my success. Yes, I had complications, but I worked my butt off to win, and beat the odds. It wasn't easy, but it was so worth it. The damage that was caused by my band was not repairable, or reversible. I lost all the stomach tissue where the band was wrapped around my stomach. They have to suture that little booger to your stomach and fold it over to secure it to help prevent slippage (which still happens), and then scar tissue secures it. That little capsule of scar tissue around my stomach from the band was placed is where the leak was because that tissue was so damaged. I was my surgeon's first and only leak.

Now, at 20 months out. I live an extremely normal life. I made it to goal in 6.5 months with 115lbs loss, and continued to lose sporadically until about 10.5 months out when my body got comfortable at my current weight of 125-129lbs with a total loss of 135-138lbs with the sleeve alone. I literally eat anything and everything I want. I live a very active, fun-filled social life. I'm back to working as a direct sales jewelry advisor, and LOVE LIFE. I'm often asked "do you have regrets?" "would you do it again if you were given the option?" My answer remains the same as it was at 2 months out, , Zero regrets, and HECK YEAH I'd do it again. Complications and all, I'd do it to be living this life. My husband and I are currently trying to conceive, I'm healthy physically and mentally. I'm in control, and food is just an afterthought. I still never experience hunger, and enjoy a life that is not consumed by thoughts of my next meal.

Here's some before and afters:

Highest Weight 270lbs (band day)

Revision weight: 263lbs

Current weight: 128lbs

Pre-op Size - Pants 22W/24W Tops: 3X 26/28W (I was all belly and boob)

May 2010 Security Forces ball

Life is fabulous. I'm wearing a range of sizes from a size 0 at the Gap, to a size 2/4 at Old Navy, and other retailers. I'm in XS to Medium tops because I'm actually pretty large boned. I am wide around my rib cage, and to get shirts to fit properly around the little bit of boobage I have left, I have to try on every shirt or blouse. But, me and fitting rooms have a good relationship going ! ! !

Don't think you can't be successful. Don't doubt yourself or the sleeve. Don't let my complications scare you. I'm not the best surgical patient because of other personal medical conditions. Do not allow obesity and food to rule your life. You can and will succeed if you CHOOSE to succeed ! ! ! I CHOSE me, my health, and it's the best thing I could have done for myself, my family, and our future.

Here is some statistical information and research links for you if you want more than just personal horror stories on the band. This study is directly from the band makers, it shows 1 in 4 band patients need a 2nd surgery within 3 years to either repair, replace, reposition or remove and revise to another surgery after being banded. On top of the other complications listed which shows 88% out of 299 patients experienced complications with adverse effects.

I've highlighted some key points.

http://www.lapband.c...ty_information/

Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. In the United States clinical study, with 3-year follow-up reported, 88% of the 299 patients had one or more adverse events, ranging from mild, moderate, to severe. Nausea and vomiting (51%), gastroesophageal reflux (regurgitation) (34%), band slippage/pouch dilatation (24%) and stoma obstruction (stomach-band outlet blockage) (14%) were the most common post-operative complications. In the study, 25% of the patients had their band systems removed, two-thirds of which were following adverse events. Esophageal dilatation or dysmotility (poor esophageal function) occurred in 11% of patients, the long-term effects of which are currently unknown. Constipation, diarrhea and dysphagia (difficulty swallowing) occurred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. The access port design has been improved. Four out of 299 patients (1.3%) had their bands erode into their stomachs. These bands needed to be removed in a second operation. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications.

Adverse events that were considered to be non-serious, and which occurred in less than 1% of the patients, included: esophagitis (inflammation of the esophagus), gastritis (inflammation of the stomach), hiatal hernia (some stomach above the diaphragm), pancreatitis (inflammation of the pancreas), abdominal pain, hernia, incisional hernia, infection, redundant skin, dehydration, diarrhea (frequent semi-solid bowel movements), abnormal stools, constipation, flatulence (gas), dyspepsia (upset stomach), eructation (belching), cardiospasm (an obstruction of passage of food through the bottom of the esophagus), hematemsis (vomiting of blood), asthenia (fatigue), fever, chest pain, incision pain, contact dermatitis (rash), abnormal healing, edema (swelling), paresthesia (abnormal sensation of burning, prickly, or tingling), dysmenorrhea (difficult periods), hypochromic anemia (low oxygen carrying part of blood), band system leak, cholecystitis (gall stones), esophageal ulcer (sore), port displacement, port site pain, spleen injury, and wound infection. Be sure to ask your surgeon about these possible complications and any of these medical terms that you dont understand.

Back to Top What are the specific risks and possible complications?

Talk to your doctor about all of the following risks and complications:

• Ulceration
• Gastritis (irritated stomach tissue)
• Gastroesophageal reflux (regurgitation)
• Heartburn
• Gas bloat
• Dysphagia (difficulty swallowing)
• Dehydration
• Constipation
• Weight regain
• Death

Laparoscopic surgery has its own set of possible problems. They include:

• Spleen or liver damage (sometimes requiring spleen removal)
• Damage to major blood vessels
• Lung problems
• Thrombosis (blood clots)
• Rupture of the wound
• Perforation of the stomach or esophagus during surgery

Laparoscopic surgery is not always possible. The surgeon may need to switch to an "open" method due to some of the reasons mentioned here. This happened in about 5% of the cases in the U.S. Clinical Study.

There are also problems that can occur that are directly related to the LAP-BAND� System:

• The band can spontaneously deflate because of leakage. That leakage can come from the band, the reservoir, or the tubing that connects them.
• The band can slip
• There can be stomach slippage
• The stomach pouch can enlarge
• The stoma (stomach outlet) can be blocked
• The band can erode into the stomach

Obstruction of the stomach can be caused by:

• Food
• Swelling
• Improper placement of the band
• The band being over-inflated
• Band or stomach slippage
• Stomach pouch twisting
• Stomach pouch enlargement

There have been some reports that the esophagus has stretched or dilated in some patients. This could be caused by:

• Improper placement of the band
• The band being tightened too much
• Stoma obstruction
• Binge eating
• Excessive vomiting

Patients with a weaker esophagus may be more likely to have this problem. A weaker esophagus is one that is not good at pushing food through to your stomach. Tell your surgeon if you have difficulty swallowing. Then your surgeon can evaluate this.

Weight loss with the LAP-BAND� System is typically slower and more gradual than with some other weight loss surgeries. Tightening the band too fast or too much to try to speed up weight loss should be avoided. The stomach pouch and/or esophagus can become enlarged as a result. You need to learn how to use your band as a tool that can help you reduce the amount you eat.

Infection is possible. Also, the band can erode into the stomach. This can happen right after surgery or years later, although this rarely happens.

Complications can cause reduced weight loss. They can also cause weight gain. Other complications can result that require more surgery to remove, reposition, or replace the band.

Some patients have more nausea and vomiting than others. You should see your physician at once if vomiting persists.

Rapid weight loss may lead to symptoms of:

• Malnutrition
• Anemia
• Related complications

It is possible you may not lose much weight or any weight at all. You could also have complications related to obesity.

If any complications occur, you may need to stay in the hospital longer. You may also need to return to the hospital later. A number of less serious complications can also occur. These may have little effect on how long it takes you to recover from surgery.

If you have existing problems, such as diabetes, a large hiatal hernia (part of the stomach in the chest cavity), Barretts esophagus (severe, chronic inflammation of the lower esophagus), or emotional or psychological problems, you may have more complications. Your surgeon will consider how bad your symptoms are, and if you are a good candidate for the LAP-BAND� System surgery. You also have more risk of complications if you've had a surgery before in the same area. If the procedure is not done laparoscopically by an experienced surgeon, you may have more risk of complications.

Anti-inflammatory drugs that may irritate the stomach, such as aspirin and NSAIDs, should be used with caution.

Some people need folate and Vitamin B12 supplements to maintain normal homocycteine levels. Elevated homocycteine levels can increase risks to your heart and the risk of spinal birth defects.

You can develop gallstones after a rapid weight loss. This can make it necessary to remove your gallbladder.

There have been no reports of autoimmune disease with the use of the LAP-BAND� System. Autoimmune diseases and connective tissue disorders, though, have been reported after long-term implantation of other silicone devices. These problems can include systemic lupus erythematosus and scleroderma. At this time, there is no conclusive clinical evidence that supports a relationship between connective-tissue disorders and silicone implants. Long-term studies to further evaluate this possibility are still being done. You should know, though, that if autoimmune symptoms develop after the band is in place, you may need treatment. The band may also need to be removed. Talk with your surgeon about this possibility. Also, if you have symptoms of autoimmune disease now, the LAP-BAND� System may not be right for you.

Back to Top Removing the LAP-BAND� System

If the LAP-BAND� System has been placed laparoscopically, it may be possible to remove it the same way. This is an advantage of the LAP-BAND� System. However, an "open" procedure may be necessary to remove a band. In the U.S. Clinical Study, 60% of the bands that were removed were done laparoscopically. Surgeons report that after the band is removed, the stomach returns to essentially a normal state.

At this time, there are no known reasons to suggest that the band should be replaced or removed at some point unless a complication occurs or you do not lose weight. It is difficult, though, to say whether the band will stay in place for the rest of your life. It may need to be removed or replaced at some point. Removing the device requires a surgical procedure. That procedure will have all the related risks and possible complications that come with surgery. The risk of some complications, such as erosions and infection, increase with any added procedure.

Research links for your review:

LapSF Five Year Study - abstract only

LapSF Five Year Study - presentation (requires Windows to play)

Literature review on the sleeve - requires $ to get the full text unfortunately

Sleeve best for over 50 crowd

Video of a sleeve with lots of education discussion

Video of a sleeve that is more about the operation

Ghrelin levels after RnY and sleeve

Ghrelin levels after band and sleeve

Diabetes resolution in RnY vs. Sleeve

Comparison of band to sleeve - literature review

Best wishes in your research. Think TWICE, CUT ONCE ! ! !

[StacyS 20]

Wow!!!!!!!! thank you so much for all the information! Its very helpful in making my decision!!!

[StacyS 20]

One more thought....there is so much maintanence involved with the band that its so scary that it may or may not even work. OMG, I'm so confused. I thought the band would be right for me in many ways, especially since I eat without even being hungry, but the post above really opened my eyes!!!!

[Tiffykins 672]

One more thought....there is so much maintanence involved with the band that its so scary that it may or may not even work. OMG, I'm so confused. I thought the band would be right for me in many ways, especially since I eat without even being hungry, but the post above really opened my eyes!!!!

I was constantly hungry with the band. I would eat my portion (that is if I could eat that day), and then the food would pass into the big portion of the stomach, and boom, I'd be hungry again.

Keep researching, read many people's stories, and check out the research articles.

[newmoo 0]

Hi Stacy,

WELCOME! I feel like I already know you!

Everything Tiffykins said is so true.

So glad you're here!

[StacyS 20]

Thanks newmoo!! You are an inspiration and I truly am happy you are here and doing well!!! Good luck on your weight loss and please use me as a support!!!!

[Billy363627 15]

I too had trouble deciding band or sleeve... The band is very know to fail after 4 to 5 years of service life..Erosion of the stomach,slippage of the band,hunger etc etc etc...That was enough to kinda turn my nose up at it..I didn't want to go through this surgery and then have to go back through surgery again to get it fixed.. Tiff is absolutely right and she is a very respected member on this board. I really hope everything works out with the surgery you choose. I chose the sleeve it out of all surgeries have the least of the complications..Good luck and keep us posted..

[Becca 108]

Here was my life with the band:

1. I did lose 70 pounds the first year, but that was from working out 6-7 days a week. I still fought hunger and slimed up the good foods. I ate junk most of the time.

2. I lost ALL restriction due to a leak at about a year and gained 35 pounds back almost instantly. I was self pay so no luck in getting it fixed unless I had about 5 grand.

3. My tubing broke in half and caused me extreme pain. I could not sleep for months. The doctor had to go searching for all the broken parts. It's amazing to me that this complication was never brought up before I had lapband surgery.

4. I had a slip and could barely swallow days before my revision. Luckily the exclusion was taken off my insurance so I could have my sleeve!

Life with the sleeve:

1. I can eat good healthy foods!

2. I am not hungry.

3. I don't feel controlled by food, and in fact- I'm not!

4. I lost 22 pounds the first month and I am so happy!

I LOVE my sleeve. I am so thankful to the wonderful peeps on this forum for helping me make the wonderful decision to have the sleeve when my band failed! I wish I could have had the sleeve instead of the band. Who knew life could be so great!

[wannalise 15]

Can't speak to the band, but the sleeve has been the best thing I have ever done for myself. You have to do this homework and find what is going to be the best choice for you, no surgery will fix it all. I have lost weight that I was never able to loose on my own, but I still stay mindful of why I am eating, and how I am feeling. The whole they operate on your stomach not your brain! Best of luck with your decision!!!

Anna

[klus263 9]

When I went to my seminar last February, I was planning on the band. My insurance did not cover the sleeve. I had to do 6 months of diet counseling with my PCP so I did not see the surgeon until October. At that time he suggested the sleeve as my insurance was now covering the sleeve. I quickly went home to start my research. After finding this forum and with many other articles, I decided the sleeve was for me. I was sleeved on Dec 1st. I am no longer on any diabetic medication and the day I came home from surgery I weighed 224. This morning I weighed 183.8. I don't think I would have seen this type of result with the band. I feel great and never regretted this decision. Good luck in making the right decision for yourself.