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Lapband Vs Sleeve Vs Bypass Surgery

Hello to all,

I am in the early stages of starting my wls journey and jut when I think I know which surgery I will opt for, I read some of your threads and it completely makes me question which one to go with.... Pleeeease share your own weight loss journey and which surgery you chose, why you did so.....and if you could change it would you?! Please can you tell me how long it's been and your current weight loss total? Thanks for any advice, experiences and wisdom shared!

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Your metabolism re adjusts about 18-24 months. You basically have that amount of time to get used to eating right! I worry about banders. Your metabolism should do the same , kinda slows down, so what happens when the band comes off!!!! Is that why, when band problems happen , people need to get revisions! ?

Usually a revision is due to a slip, erosion, prolapse, dilation. All are dangerous to one's health so a revision or removal is usually a necessity in these cases.

I will tell you this , for me it was risk, and quality of life! A local dr in my area won't even touch bands any more, way to many risks! And the problem with the band and bypass is the risks can happen any time! 1 year to 20 years from now! With the sleeve, risks , from what several dr have told me, only happen during the first couple of month during the healing process! You also have no restrictions on food and it is just as successful as the bypass! If you are a good candidate , sleeve is also less invasive, no foreign object, no retorting, limited complications! Bypass is a good option though if you have diabetes! And it can be reversed!

I will tell you this , for me it was risk, and quality of life! A local dr in my area won't even touch bands any more, way to many risks! And the problem with the band and bypass is the risks can happen any time! 1 year to 20 years from now! With the sleeve, risks , from what several dr have told me, only happen during the first couple of month during the healing process! You also have no restrictions on food and it is just as successful as the bypass! If you are a good candidate , sleeve is also less invasive, no foreign object, no retorting, limited complications! Bypass is a good option though if you have diabetes! And it can be reversed!

Can you explain the no restrictions on food an the "less invasive" part?

Can you explain the no restrictions on food an the "less invasive" part?

After you are on full solids, there is no restriction on food types that you are able to tolerate with the sleeve, since you have not modified your overall digestive system. Some people do have intolerances to really dry tough mega or really tough veggies though.

Less invasive than the bypass because nothing is rerouted. Only the shape of the stomach is changed.

I'm assuming this is what she meant. It is my viewpoint as well, although such terms are naturally subjective.

As for the person who said that the complications only happen early on with the sleeve as opposed to the band or bypass, we don't have the science to back this up yet. There is very little data on the sleeve 10+ years out. However, I do believe this will end up being true.

For me the sleeve is relatively new hadn't heard of it until about a year ago so that's why I didn't have that surgery. I certainly didn't want to be all cut into, stapled, etc with the possibility of gaining my weight back. I have relatives and friends that have had gastric bypass and you would never know because they have gained all their weight back. What a waste of money and having your body cut like that. So the lapband was my option. It's reversible although I don't plan on having it taken out. I lost 88 pounds in two and a half yrs with my band. I will be three years banded next month. It was the best decision for me. I suffer with osteoarthritis and have not been on any medications in over two years. I'm not diabetic or have any other issues that go along with being overweight. Good luck on your decision.

I just wanted to clarify , not negatively but I too had never heard of the sleeve, but actually it's been around for 20+ years! It was originally used and still is in cancer patients! My dr explained they used to sleeve in people who had stomach cancer/tumors! After the years went by they noticed weight loss, and started exploring it as a weight loss option!

I would have considered the sleeve, but the possibility of leakage from the staples took it completely off the table. Though it's a small possibility, it does happen. And when it happens, you can be in the hospital for 4-6 weeks. Being self employed, that was a risk I couldn't afford to take. I would lose ALL of my clients, and for me, that made it the riskiest of all procedures.

So far, I'm very happy with my banded plication. Though the long term jury is still out on the plication, the last 3+ years have shown a dramatic reduction in slips. For me, given that the whole thing can be reversed, I sleep better at night. But as I mentioned, had the sleeve not come with it's own margin for serious complications, I may have chosen that.

I was actually scheduled for the RNY initially, but freaked out & cancelled it 10 days prior to surgery. My doctor thought I'd do well with that procedure, but I couldn't live with the permanence. I know a couple of people who are so Iron deficient, that they have to go for daily IV infusion. Even after two months of this, they've still got issues. That is just too scary for me. Sure, the idea of having surgery done without the continual follow up is attractive. But when I think long term……too scary. If for some reason I need to get the band removed, I will not have a revision. But that's just me :P

<p>I would have considered the sleeve, but the possibility of leakage from the staples took it completely off the table. Though it's a small possibility, it does happen. And when it happens, you can be in the hospital for 4-6 weeks. Being self employed, that was a risk I couldn't afford to take. I would lose ALL of my clients, and for me, that made it the riskiest of all procedures.</p> <p> </p> <p>So far, I'm very happy with my banded plication. Though the long term jury is still out on the plication, the last 3+ years have shown a dramatic reduction in slips. For me, given that the whole thing can be reversed, I sleep better at night. But as I mentioned, had the sleeve not come with it's own margin for serious complications, I may have chosen that.</p> <p> </p> <p>I was actually scheduled for the RNY initially, but freaked out & cancelled it 10 days prior to surgery. My doctor thought I'd do well with that procedure, but I couldn't live with the permanence. I know a couple of people who are so Iron deficient, that they have to go for daily IV infusion. Even after two months of this, they've still got issues. That is just too scary for me. Sure, the idea of having surgery done without the continual follow up is attractive. But when I think long term……too scary. If for some reason I need to get the band removed, I will not have a revision. But that's just me :P</p>

I agree with that. Yes the band is more maintenance but if complications occur like in any WLS (heaven forbid) ITs reversible and taken out and your back to normal. Plus it's now an outpatient procedure which appeals to me because I have a high demand job and have 2 kids and a husband and I need to get in and get in with my life!!

My sister in law had bypass last year and has lost 118 lbs and looks amazing! However she lost hair, became nutrient deficient, got a hernia and had to go back in for hernia surgery.

I will tell you this , for me it was risk, and quality of life! A local dr in my area won't even touch bands any more, way to many risks! And the problem with the band and bypass is the risks can happen any time! 1 year to 20 years from now! With the sleeve, risks , from what several dr have told me, only happen during the first couple of month during the healing process! You also have no restrictions on food and it is just as successful as the bypass! If you are a good candidate , sleeve is also less invasive, no foreign object, no retorting, limited complications! Bypass is a good option though if you have diabetes! And it can be reversed!

Can you explain the no restrictions on food an the "less invasive" part?

Once you are healed , the chances of dumping are slim and only last a year to two! You can eat what ever you want just not much of it lol! My wounds were 5 tiny little cut that are already almost nonexistence 4 weeks out, plus my dr said its the least riskier of all and maintenance free! It's great tool to teach you to eat less and not be malabsorption!

It's not half, its 85%. I love my sleeve, have not had any complications, have reached 100% EWL and rock the 100 staples. I eat what I want, in moderation. I have never puked, I never had to visit the Doc for maintenance (except to check my labs... all good). Everyone has to do what they feel is right for them. If you are afraid of cutting out half your stomach, and getting 100 staples, then don't do it. Who could blame you. Personally, I think the size of my stomach was part of my problem, so saying goodbye to it was more of a relief than sad. It may be part of your problem too, and thats why you are looking at WLS, which all reduce the size of your stomach somehow. After years of trying to work my regular stomach to lose weight unsuccessfully, I was looking for a permanent solution, and with a lot of work on my side, with support, exercise, and daily accountability I think I might just make it work for the long haul. Without revision. Fingers crossed.

Just as an FYI the last time I checked the complication rate for the sleeve was 3.2%. That is very low. And that includes all surgical complications not just leaks. I'm not sure what the band and RNY rate is but with a good surgeon and proper post op care/compliance all of us can help our chances of being successful.

I see alot of personal biases here being used as a reason to not have this or that surgery. I guess that's perfectly natural...human nature. The way some people don't want all those staples inside them, I didn't want that band inside me. But when I think about it.....neither one is a "foreign object". Both were meant for exactly that usage. Both work very well and the risks of both can be mitigated by patient compliance. Not eliminated but mitigated.

I still say take a look at the post op protocol of each surgery....from the recovery time to life 5 years out and beyond. The diet, the doctor follow ups, everything. Decide which of the protocols you think you would like to adapt your life to...because that is key to success. Adapting your life to the post op protocol.

I see too many people getting creative with their post op care and that drives the complication and failure rates up with ALL surgeries.

Really quick the staples they use for sleeve are so small you more than likely wont even see them when you poop them out! Gross but true!

Really quick the staples they use for sleeve are so small you more than likely wont even see them when you poop them out! Gross but true!

The titanium staples are permanent girl, they are in for good. They get covered with scar tissue and thats that. They don't get in the way of MRIs or airport metal detectors! :)

Sleeve Gastrectomy FAQ's

Can the staples tear out?

No. Once you have recovered from the surgery, your body's own scar tissue heals the stomach tissue together, just as your skin stays healed long after sutures or staples are removed. Staples are made of titanium. You can have an MRI scan, and you can go through the detectors at the airport without any problems.

What are the advantages of the operation over gastric bypass?

There is no rerouting of the intestines, and no new connections need to be made. This makes it safer, easier, and faster to perform. The lack of rerouting eliminates the late risk of bowel obstruction from internal hernia that comes with the gastric bypass operation. Finally, the lack of rerouting also reduces the risk of Vitamin and mineral deficiencies.

What are the disadvantages as compared to gastric bypass?

The main disadvantage is that we don't have long-term data to document that weight loss will be maintained. A disadvantage is that the operation is not reversible, in that part of the stomach is removed and thrown away. It can never be replaced. (On the other hand, there should be no reason to want to put it back).

What are the advantages of the sleeve over the gastric band?

With the sleeve there is no foreign body to break, slip, or erode. There is nothing to be adjusted. Reoperation rate for these complications is therefore eliminated. Weight loss is faster and more reliable with the sleeve. The feeling of fullness that you get from the sleeve is much more satisfying than the feeling of obstruction or discomfort that you get with the gastric band. Few patients vomit after the sleeve, while many patients continue to have vomiting episodes long after they have their gastric bands placed.

What are the disadvantages as compared to the gastric band?

The band is reversible; the sleeve is not. Unfortunately this turns out not to be much of an advantage of the band, as the only reason to remove a band is for complications.

Is removing the stomach safe?

This type of stomach removal has been performed with the Duodenal Switch procedure since the mid-1980s. It does involve stapling, just like gastric bypass, and has similar risks.

How much weight will I lose?

This is obviously a key question. Unfortunately, there is no long term data to give us a good answer. Preliminary data suggests that weight loss may be similar to that attained with Roux-en-Y gastric bypass.

With the added plication to my band, I feel that I got the best of both worlds, without permanence. My stomach volume has been dramatically reduced (shape and size like the sleeve), and the band on top signals satiety on very small portions. I was concerned about having plication because of the lack of long term studies, but I'm glad I did it. If I have a bad day & try & overeat, it gives me secondary restriction. And there was never any concern about leaky staples, and me losing my entire business :unsure:

Allow me to change the subject somewhat and ask a question of the sleeve folks? Plication? It appears that plication is similar to the sleeve in that it reduces the size of the stomach, however, without the removal of 80% of the stomach. Did anyone consider plication?

And I only ask because of my ignorance of both procedures. I know how the surgeries are performed thanks to youtube but it seems like they're somewhat similar? Wrong?

The band forum has a few bands with plication and seems like these folks need fewer fills or no fills and feel satiety easier than just the bandsters. I admit I feel a little envy at times!

tmf

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