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Is the sleeve the right thing after the Lapband?



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Hi--I am brand new here and I apologize for being ignorant about the sleeve. I have been banded since 2008 with not much success. I saw my internist today and he said most people only lose on the average of 50lbs on the lapband, whereas the sleeve the average weight loss is 120lbs. He said it is also done laprscopically, like the lapband. So he highly recommends that I do it, because I am going no where on my band and my dieting is not working, and I need to lose over 100lbs, then I will be at my ideal body weight. He says that all the recent medical journals are now recommending the sleeve. My questions:

1. Is all this true?

2. Are there more than 1 type of sleeve operations?

3. Is it difficult to transition from the lapband to the sleeve?

4. Does Insurance cover it? (I have Blue Cross)

5. Are there other important questions that I am not asking?

Thank you in advance for any info you can share,

My name is Jim K

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Hi, I had the band back in 2009 for only 3 months. It slipped and I had to have it removed. I waited a year (my own reasons) to have the sleeve. I can tell you this.....it's WAY better and WAY more of a normal way of life. No more getting nervous with every bite I took, no more horrible food stuck feeling. There is only one type of sleeve operation that I know of but doctor use a different size bougie (a guide) to make the pouch different sizes. But it is a very small difference in the pouch. It is NOT difficult to transition but the recovery is much more involved. I am not going to lie, the first couple days are rough, but you will get through it. I have BCBS and it was covered. I paid zero for the band.

1. I would ask the doctor if he had any paitents with a leak.

2. How many sugeries he has done. is he board certified.

3. What size bougie does he use

4. Does he sew or glue over the staple line? (my doctor used this mesh stuff with glue)

5. Does he place a drain and if so, how long does it stay in? (A drain is very useful is detecting a leak even before u get symptoms)

6. Has he done any band to sleeve revisions?

Good Luck on this journey....it's sure worth it!:rolleyes:

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Hi there-

I am a revision patient. I had a band for almost 4 years - lost 40 pounds, gained back 20. Totally not worth it.

That said, only you can decide if the sleeve is the right thing to do after the band. I wanted an "insurance policy" after I had my band taken out. I wanted to make sure that I wouldn't baloon up again after the band was gone. It has been 6 weeks since my revision and I am ECSTATIC with the results. The recovery was hard, but the positives outweigh the negatives. I am at a point where I can eat almost anything (but very small quantities) and it feels really good.

Make sure you read through this board extensively - there is so much infromation here! Also, there is a band to sleeve revision topic on the main page (scroll down until you see it). A lot of us revision folks post info there.

As far as your questions:

1. Is all this true? Averag weight loss is just that - an average. Since I have less to lose, I am not sure how close I will get to my goal or how soon. People lose well over 100 pounds with the surgery.

2. Are there more than 1 type of sleeve operations? There is one variation that I know of - sleeve plication. You might want to do a search on this board for "plication" and send messages to some of the folks who have had it done. It is not nearly as common.

3. Is it difficult to transition from the lapband to the sleeve? Surgically, it can be challenging if you have had complications or excessive scarring. The doc won't really know until they get in there and see what is going on. My revision was not terribly complicated - Dr removed scar tissue and adhesions from my liver and my total surgery time was less than 90 minutes. Emotionally, the transition has its ups and downs. You will feel restriction like you never had with the band. This is good, but the first few weeks on all liquids and very strict diet can be tough on you emotionally. The good thing is that it doesn't allow you to cheat. After 4-6 weeks you are eating normally (but a lot less) and it gets much easier.

4. Does Insurance cover it? (I have Blue Cross) For some people it does - you will have to explore that option.

5. Are there other important questions that I am not asking? Read through the boards extensively and you will most likely come up with a list of questions for your doctor. Also, feel free to ask all of us questions about our experiences. The knowledge and support here is invaluable.

Good luck to you in your decision!

Lara

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These replies to my post have been extremely helpful. Thank you so much. I have copied your answers and will be using them when I discuss this new operation with my doctor. I am a little concerned, though, that both of you had BCBS and one was covered and the other wasn't. So I guess it will come down to my individual policy--and mine seems to cover absolutely nothing, so I am a bit worried there.

I plan on calling my lapband doctor tomorrow, whom I like a great deal, and ask him these questions.

Thanks again for responding. I will keep you all informed of my progress.

--Jim K

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I was originally considering the lapband, but I kept hearing so many mixed stories about it. Some loved it, some hated it, some just didn't see results. And then I came here and saw the MANY stories of people who started out with the band and ended up ditching it for the sleeve and figured "Why put myself through that?"

It does take longer to heal from a revision due to the additional scar tissue caused by multiple surgeries. And there's a SLIGHT increase in complications. But that's all I know about it.

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I didn't have hardly any scar tissue and I actually healed quicker and lost more weight the first month than patients that had the sleeve the first time. Doctor told me that at 2 weeks, I was where a 4 week post-op usually it.

Just goes to show you that every case is different. I wish you all th luck in the world :)

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I had the band put in july 2007 and had similar weight loss results as you. I also had serious problems with food sticking and my esophagus became eroded with some ulcers. I went to my doc to have the band removed and he suggested the sleeve. Surgery experience was not bad. No real pain. Healed well. I am 5 weeks out and eating pretty much what I want but much, much less. chicken was always a sticking food so I avoided it. I have begun to enjoy eating it again. I highly recommend doing the revision. The same MD that put in my band did my sleeve. I have BCBS Federal and it was covered.

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