I'm now almost 4 months out from having a LapBand to VG conversion and I would like to summarize my experience.

Positives

1. "Caught food", Sliming, etc is almost a non issue. I have had it happen ONCE off of overcooked eggs, and one other time off of chicken was not chewed up well enough, both times I tried to drink Water afterword. This is in contrast to the same issue that would happen several times per week, sometimes several times per day with the band.

I can now eat chicken (even white meat!) , pork, beef, bread, raw vegetables, citrus, etc, (All of these would get caught with my band during proper restriction) without worying where the nearest bathroom is. I do stay away from overcooked eggs (mostly scrambled) though.

2. Back pain is completely gone! My surgeon concurs with my belief that either the port or band was setting off a few nerves which would cause referral pain to my back.

3. Very little hunger. What hunger does exist is taken care of nearly IMMEDIATELY after eating.

4. Alcohol makes me DRUNK very fast and with very little of it, but I hardly drink anyway.

5. NO food RESTRICTIONS (after a while). The first 10 weeks I had some pretty undesirable dumping effects from fats and sugars, even from basic Protein shakes. Most of these effects have disappeared.

I still dump from very high sugar content foods (maybe more than 25grams of sugar), but this can vary. For instance, I have eaten a Drumstick brand sundae cone and haven't dumped, even though it contains quite a bit of sugar. I can also eat approximately 4 oreos without dumping, yet if I were to immediately "chase" it with liquid, thus "washing it through", I would most likely dump, at least if it were early in the day. For some reason, dumping is worse in the morning.

Dumping seems to occur in about 10% of VG patients, and is assumed to go away. I suspect it will disappear completely within a year.

On a related note, I get tired of many artificially processed type foods such as oreos, snack foods, etc. For some reason, my senses of taste have changed and have become extremely turned off by artificial flavorings. Many such products will make me queesy, but they will not make me dump.

Also, if I eat and then "Wash through" the food, I am not hungry again like I was with the LapBand. As far as I can tell, it is next to impossible to "Wash through" any solid protein source or fruit/vegetable... I have yet to do it, the water simply goes through around the food.

6. I CAN BURP!!! No more "stuck air" that has to take the long way out. I have virtually no gas now, unless of course, I eat a gassy food like bell peppers.

Negatives:

1. Acid reflux. I ABSOLUTELY MUST take a proton pump inhibitor daily, otherwise I will have moderate heartburn. This effect is supposed to fade over 6-12 months as the pouch stretches, but I have had little to no stretching as of yet, and am becoming annoyed with this side effect.

2. Initial dumping. As I stated earlier, this effect is mostly gone, but it can sneak up if I eat junky/processed/fast food. Or items with alot of sugar and then "chase them down" with water or such. Dumping seems to occur in about 10% of VG patients, and is assumed to go away. I suspect it will disappear completely within a year.

3. It can be difficult to drink fluids. One must CONSTANTLY remember to drink enough Fluid, BEFORE eating, otherwise you may subject yourself to dumping induced by washthrough, or worse, the water may come back up.

4. You may be fatigued for up to the first year after surgery, this comes from the severe caloric restriction and weight loss. My first 10 weeks were hellishly draining. I no longer have energy problems as long as I get my 150grams of whey protein per day and FORCE myself to eat enough each day.

OVERALL

I am totally satisfied. I am currently at 223, the slimmest I've ever been and am still losing weight. Mind you, the lowest weight I ever attained via LapBand was 238, and that was with a constant "I'm starving" sensation. That physical sensation is now gone.

While it was VERY easy to "out eat" the band, it is fairly difficult to outeat my VG, sure it may be possible with carb laden foods that compress down to nothing when chewed, but overall, the physical desire eat, AKA hunger pangs, have simply been removed.

Related to this last point, I should reiterate the fact that I must FORCE MYSELF to eat enough protein to keep up with my active lifestyle (surgeon is recommending 150g-250g per day total). When I say FORCE myself to eat, I don't really know how to explainit, other than the fact that once I consume a certain amount of calories, I no longer have the desire to eat. I could fill up my calories with relatively empty carbohydrates which will leave me tired the next day, or I can eat all of my protein first and then consume carbohydrates if I feel like it.

In other words, I could physically eat more at the end of the day, but after a certain quantity of calories, I simply cannot mentally stomach another bite of food. For lack of a better explanantion, it's almost as if the "eat food" circuit in my brain shuts off at this point.

Hi,

I have a question. I am back and forth between the band and VG. My main concern are those staples, it freaks me out, the band can come out but I also don't want the problems that can happen with the band or a chance I just can't handle it in me, I am self pay so I have to be sure.

Extra skin hanging isn't a concern of mine since I only need to drop 70 pounds and I work out, I don't think it is a big deal for me.

Is there a site/message board that lists complications with VG ? I am curious to read people that have had those with this surgery as well as the band. They have to be out there, most all swear by the surgery on OBH.com

I also have problems with Acid, the stomach growling all the time, etc. and I suffer from IBS big time. I am seeing my Gastro this Wed and plan to ask him is opinion as well about all of this.

thanks!:help:

Hi,

I have a question. I am back and forth between the band and VG. My main concern are those staples, it freaks me out, the band can come out but I also don't want the problems that can happen with the band or a chance I just can't handle it in me, I am self pay so I have to be sure.

Extra skin hanging isn't a concern of mine since I only need to drop 70 pounds and I work out, I don't think it is a big deal for me.

Is there a site/message board that lists complications with VG ? I am curious to read people that have had those with this surgery as well as the band. They have to be out there, most all swear by the surgery on OBH.com

I also have problems with Acid, the stomach growling all the time, etc. and I suffer from IBS big time. I am seeing my Gastro this Wed and plan to ask him is opinion as well about all of this.

thanks!:help:

When I was researching lapbanding, considerations for me were the possibility of having to convert to another procedure or future health conditions requiring me to make adjustments in my intake of certain foods. I found the only procedure which really offered that flexibility was the lapband. All the other procedures seemed to involve some type of intestinal rerouting or stomach removal without any future adjustability, in essence -- what you get is what you get.

So, whatever your choice, don't forget to think futuristically about your health and the possibility of health changes due to diseases/disorders that may run in your family (i.e. cancer, ulcers, Iron deficiency, reflux, etc.)

Personally, I would go with the lapband first and keep the VG as the backup conversion procedure. In fact, that is my EXACT plan should a conversion ever become necessary.

My friend had the VSG and is doing great. I have been a complete success with the band. I am glad that this surgery is working so well for you. All I can say is I guess some people are "special." Good luck to you.

Thanks for the link it was very informative. I was considering the VG if my inusrance company refused the band. But they approved me and everything is OK thus far. Many insurance companies do not pay for the VG. Where you self pay and if so how much was it.? Another thing is many programs don't have a surgeon who does VG in Maryland anyway. So far there is only one program that offers it as self pay only because again no Maryland insurance policies cover it yet. After reading that it is sometimes used as part one of the other surgery I do not know why there are not more surgeons who do it.

Again thanks for the link and Good Luck

Anthony: what a great read!! Congratulations...what is the update? How are you feeling? Weight?

I had the band in 2001 and have had two port repair surgeries and now my band has slipped AND have hiatal hernia. So, after waiting since Dec 2006 - today, my insurance approved the removal of the band and resurgery of bypass or sleeve (I am not sure which one is approved). I am hoping for the sleeve (is that VG?) I looked at the pic on the website you posted....I think it is a sleeve.

Anyway, I have to wait until Monday when dr. office opens to find out for sure. However, I am so grateful!!! Every single night, I go to bed with an empty glass (10 oz) for throwing up in, and rolaids (with the antislime-agent in it - about 4) and a cup of Water - just in case. Not to mention prescription of prilosec and the phenegran. I have been doing this since December! I have learned to not eat or drink even water past 5pm - if I want to get a few hours sleep that is. And when I do that, than I don't throw up as much, but have terrible bile. And don't forget when the stuff gets into the lungs before you wake up gagging!!!

So, on May 1st...that will all come to an end. Hopefully. I understand that my esophagus has to be in perfect condition before they will go in...so....what about that hernia???? I am scared to ask! I just want the band out. I really want the sleeve - but I read something you stated Anthony....with the bypass AND the sleeve, the patient will experience stretching of the stomach...eventually???? Pls explain.

I have 2 friends that did gas.bypass and both have gained about 20 lbs this year. They had their surgeries about 2.5 yrs ago.

Which is better gastric bypass or sleeve??? I think the sleeve is less invasive????

Any advise would help. I no longer look forward to bedtime - it is a job all night long, to keep myself from choking to death!!

There's a new study that was just published on the Sleeve that shows weight loss as good as RNY and DS... but complications lower to or similar to a Lap-Band. VSG is definitely better in terms of complications/malabsorption... plus, they remove the portion of the stomach that produces ghrelin... so you aren't hungry at first.

As for staples... not all docs use them... some use glue and sutures. (I think Rosenthal at the Cleveland Clinic in Florida is one who doesn't use staples.)

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17356932&query_hl=4&itool=pubmed_DocSum

"Vertical Gastrectomy for Morbid Obesity in 216 Patients: Report of Two Year Results" Lee, CM, Cirangle PT, Jossart GH

From Surg Endosc. 2007 Mar. 14. Epub. ahead of print.

Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA, gjossart@lapsf.com.

BACKGROUND: The vertical gastrectomy (VG) is the restrictive part of the technically difficult biliopancreatic diversion with duodenal switch operation (DS). The VG was originally conceived of as an independent operation-the first stage of a two-stage DS that would reduce mortality and morbidity in the high-risk superobese because of a shorter operating time and no anastomoses. This article presents two-year data after VG. METHODS: Laparoscopic VG was performed in a nonrandomized fashion in obese patients that met the NIH criteria for bariatric surgery. By using 5-7 firings of 45-60-mm linear 3.5-mm GI staplers along a 32-Fr bougie, a greater-curvature gastrectomy is performed and a 60-80-ml gastric tube is created. VG was compared to adjustable Lap-Band(®) placement, Roux-en-Y gastric bypass (RGB), and DS. RESULTS: Between November 2002 and August 2005, 216 patients underwent VG. The mean age was 44.7 years (range = 16-64) and 173 (80%) were female. The mean preoperative weight and body mass index (BMI) was 302 +/- 77 lbs and 49 +/- 11 kg/m(2), respectively. Of the 216 patients, 5 (2.3%) had a BMI > 80 kg/m(2), 6 (2.8%) had a BMI of 70-80 kg/m(2), and 25 (11.6%) had a BMI of 60-70 kg/m(2). The mean operative time was 66 +/- 11 min (range = 45-180) and the mean length of hospital stay was 1.9 +/- 1.2 days. Complications occurred in 20 (6.3%) patients (vs. 7.1% after Lap-Band). Leaks occurred in 3 (1.4%) VG patients, reoperations were performed in 6 (2.8%), and no conversions to open or deaths occurred. Weight loss on par with the DS and RGB was achieved with just the VG alone. CONCLUSION: The VG operation is able to achieve significant weight loss comparable to the RGB and DS operations but with the low morbidity profile similar to that of Lap-Band placement.

PMID: 17356932 [PubMed - as supplied by publisher]

Hello all! I'm doing very well.

My biggest problem is my inability to eat enough maintain long durations of physical activity. I'm lucky if I canbreak 1800 calories per day, which isnt nearly enough for my work/school/ average recreation. I've actually had to cut back on hiking severely due to this.

I recently had surgery on a direct inguinal hernia which was work related, and boy, do I wish I could eat more. It would have made recovery much easier.

I also continue to take Nexium when I take NSAIDs, but I don't need it for the most part anymore.

I think I've slimed/thrown up from food about 5 times now, it is ALWAYS connected with raw vegetables, particularly carrots or other difficult to digest products like pineapple. Not bad, considering that is over an 18 month period. When I had the band I would slime and vomit up to twice per day.

Back pain is still gone.

Anthony,

Did I mention that my biggest problem these days is keeping weight on? I never thought I'd ever be in this situation, it's just beyond weird!

Isn't the VG band 10 cc? Just wondering...my first fill was 4 cc's; second another 2 cc's and next week, he will put in another 2 cc's making it 8 total. I haven't reached my sweet spot and quite frankly, I'm having trouble understanding exactly what that is.

Isn't the VG band 10 cc? Just wondering...my first fill was 4 cc's; second another 2 cc's and next week, he will put in another 2 cc's making it 8 total. I haven't reached my sweet spot and quite frankly, I'm having trouble understanding exactly what that is.

He's referring to a Vertical Sleeve Gastrectomy... also known as a Vertical Gastrectomy. Basically, it's the first part of a DS... with no intestinal rerouting. 80% or so of the stomach is removed... and one is left with a long tube like stomach. It's a restrictive-only operation that has shown good results. Some people who are considering a Band may go for this operation, especially if getting regular fills would be a problem for them. It's also a popular revision for Bandsters who lose their Band for whatever reason, but don't want to go for a new Band, RNY, or DS.

Anthony, Well it is Nov 2007... I was just wondering how you are doing with your sleeve!

This was an amazing post. After 3.5 years I am just starting to have trouble with my band. In the event (hopefully not) that I have to have it removed this is definately an option that I will consider. Your candor and thorough comparison was very helpful

When you went from the band to VG, did your doctor use the same incisions or does your stomach look like a roadmap for the two surgeries?

Did I mention that my biggest problem these days is keeping weight on? I never thought I'd ever be in this situation, it's just beyond weird!

Anthony,

How did you find a surgeon that was experienced in removing lap-bands & converting to the gastric sleeve?

I went to Dr. John Feng, who was then at LapSF, he is now at his own firm called Crystal Springs ( www.gastricbypasssanfrancisco.com )

I highly recommend him.