Hi everyone. Today I got the final approval for bariatric surgery from my insurance company. For the last 2 months I've been certain that I want to go w the lap band. When I was meeting w the committee today they recommended the sleeve and said I will have a better quality of life afterwards. I've done a of research and I still think I'm going to go with the band. Can some of you tell me why you chose the band over the sleeve. Thank you.

For me, I liked that it wasn't completely permanent. This was really one of my first major surgeries ever. You can get the band adjusted / filled up or down however you need it. My plan was to use this tool to lose weight to get pregnant. If I get too nauseated, I can have it unfilled. The band allows your body to still fully absorb the nutrients of the food where, from my understanding, you can have malnutrition issues with the sleeve - things pass too quickly. The sleeve you can really stretch out and there's not much you can do. With the band, if you eat too much you'll get a negative response from the body. If you happen to stretch out your pouch, you can get another fill and start the 'diet' over again. The band is still reversible but the sleeve is not. I'm an engineer, so I look at failure mechanisms first and this seemed the 'safer' route to me.

I read that people with the sleeve have a tendency to have a lot of heartburn. Being that I had a hiatal hernia which was repaired during banding, and I lived with reflux/GERD for over 10 years, this was something I wanted to get away from almost as much as the extra pounds. I also had plication which is a modified version of the sleeve (they don't cut the stomach away, just stitch it). So, I feel I got the best of both worlds. Like somebody said, 2 tools instead of 1.

Either surgery is good. The sleeve was never mentioned prior to my surgery and if it was, it was glossed right over. I've done some reading on the sleeve forum and both surgeries have their issues.

Sleevers don't want the hassle of going back for fills or dealing with a slightly higher re-surgery rate we bandster's deal with. For me, it would have been the finality of removing 85% of my stomach. Barring any kind of extreme problems with being banded, I feel like I can always revise to a sleeve or bypass if that becomes necessary.

With any other surgery, you have few choices once the knife cuts the stomach. With the band, I still have many choices including removal and returning to my prior obese state.

tmf

Thanks. I totally agree with what everyone said. I have my surgery set for jan 22.

Shelly like so many others have said, it was a decision I made to get healthier.. I did not want the dumping syndrome and malnutrition issues associated with the bypass or sleeve... The band was a easier surgery, in and out.. I had very little recuperation time.. it's not permenant so if something happens I can get it removed or replaced.. once your stomach is gone it's gone... I don't find the fills that big of a deal.. I enjoy seeing my surgeon and it keeps me motivated to check in with him .. I did have to realize that I would eat differently and have a slower loss but I have not regretted my decision at all...

I hope you will do what is best for you and will be totally successful...

I researched all the options for a long time before finally deciding on the band. For me, the other options were just too invasive. I also liked that the band is removable if absolutely necessary, and I can have it adjusted as needed for the rest of my life. With the sleeve/bypass, if you stretch your stomach back out there's no simple adjustment to fix that, and once you're insides are cut out/ and or rerouted, you can't just put that back.

It's obviously a very personal decision for each individual. Just keep doing your research to find which tool you feel will work best for you...for both the short and long term.

Wishing you the best of luck with your decision!

Shelly, go look at all the patients revising from the band to the sleeve on the sleeve forums. The band simply isn't as successful for people, as a whole. This is why the Mayo Clinic no longer offers it, and Allergan is trying to sell their own product (the LapBand.) I'd gently suggest the sleeve, personally. I'm a week out from being sleeved and feeling great. Good luck with your decision.

Edited December 30, 201312 yr by sleevethefatbehind

Heres some food for thought....I copied and pasted from an earlier post. YMMV.....

DO THE MATH

164 Studies,
161,756 Patients
Over Nearly 10 Years:
What Does This Add Up To?

BARIATRIC AND METABOLIC SURGERY IS EVEN MORE EFFECTIVE THAN PREVIOUSLY REPORTED AND GETTING SAFER!

A new meta-analysis of studies carried out between 2003 and 2012 shows higher remission rates of diabetes and high blood pressure and a lower mortality rate than previously reported. The study, published online in JAMA Surgery, is an update to a meta-analysis of studies conducted between 1990 and 2003 and published in the Journal of the American Medical Association (JAMA, Buchwald et. al.) back in October 2004.

Researchers from Washington University School of Medicine in St. Louis reviewed outcomes from nearly 162,000 patients in 164 studies (37 randomized clinical trials and 127 observational studies), over almost 10 years.

They discovered 92 percent of patients in randomized clinical trials experienced diabetes remission after surgery, slightly higher than the 86 percent remission rate found in observational studies, but significantly higher than the 76.8 percent remission rate found in the 2004 JAMA study.

Remission rates for hypertension were about 75 percent in both the randomized clinical trials and observational studies, while the remission rate in 2004 was 61.7 percent. Body Mass Index (BMI) loss five years after surgery ranged from 12 to 17 in the new study. Before surgery, patients had an average BMI
of 45.62.

"With the 2004 study, we now have 22 years worth of data from over 180,000 patients and 300 studies," said study co-author J. Esteban Varela, MD, MPH, MBA, Fellow of the ASMBS. "The data continues to prove bariatric surgery is not only safe and effective in providing significant and sustainable weight loss, but is the most effective treatment today for diabetes, hypertension and an array of other diseases and conditions in people with obesity."

In the new study, 30-day mortality rate was 0.08 percent, down from the 0.3 percent reported in 2004. Complication rates ranged from 10 to 17 percent and the reoperation rate was about 7 percent. Complication and reoperation rates were not reported in the previous
meta-analysis.

By procedure, gastric bypass and sleeve gastrectomy resulted in the greatest weight loss, but had a higher rate of complications and mortality than adjustable gastric banding. Gastric banding had the highest reoperation rate (12% in randomized trials), while gastric bypass had the lowest at 3 percent, followed by sleeve gastrectomy, which had a reoperation rate of 9 percent. The new meta-analysis included sleeve gastrectomy, which was not available in the 1990s. Of note, sleeve gastrectomy had comparable weight loss to that of gastric bypass at 5 years.

"This is but the latest study to validate the high degree of safety and effectiveness of bariatric surgery," said Ninh T. Nguyen, MD, FACS, President of the American Society for Metabolic and Bariatric Surgery (ASMBS) and Vice-Chair of the Department of Surgery at UC Irvine School of Medicine. "Today we are performing operations that are as safe or safer than gallbladder and hernia repair surgery."

According to the Centers of Disease Control and Prevention (CDC), more than 78 million adults were obese in 2011–2012.¹ The ASMBS estimates about 24 million people have severe or morbid obesity. Individuals with a BMI greater than 30 have a 50 to 100 percent increased risk of premature death compared to healthy weight individuals as well as an increased risk of developing more than 40 obesity-related diseases and conditions including type 2 diabetes, heart disease and cancer.^2,3

Hi everyone. Today I got the final approval for bariatric surgery from my insurance company. For the last 2 months I've been certain that I want to go w the lap band. When I was meeting w the committee today they recommended the sleeve and said I will have a better quality of life afterwards. I've done a of research and I still think I'm going to go with the band. Can some of you tell me why you chose the band over the sleeve. Thank you.

There are some pre-existing medical conditions which can rule out having the sleeve done, just the same for the band.

Because of my prior medical history, I am not an acceptable candidate for the sleeve. My bariatric surgeon did not inform me of this, however thankfully my PCP did.

I would ask every question you can of the surgeon. I am aware of the trend to phase out the band by many physicians, however in the case of my original "Center of Excellence" surgeon, I believe that he no longer wanted to provide the medically necessary aftercare to band patients. The "big money" was in the new patients who were having either gastric bypass or the sleeve done.

Just my opinion, and others mileage may vary...but this is your body. So be informed!

Good luck to you whatever path you choose.

I started this thread a while back as to help settle some of the questions and false truths that were floating around.

http://www.bariatricpal.com/topic/288795-out-on-the-table/

I absolutely love my band but it is more involved than the sleeve for sure. It's that involvement though that I think gives the band a leg up over the sleeve for me because I have an actual "tool" to work and can make tweaks and adjustments to dial things in just right for me. There are days that I wish I had done the sleeve for the simplicity of just being done with the process but then again the process is what gives me strength to make my band work for me and helps me to not give up on my new lifestyle. It's so easy to revert back to old ways and having follow ups and fills keeps me right in line and helps me mentally not fall off the band wagon. I don't think you would regret either choice but instead of trying to decide which surgery is right for you, I would suggest you decide which lifestyle suits your personality the best because both surgeries do offer different lifestyles.

Thank you everyone for your opinions and information. For me I feel like the sleeve would be easier but the band will be more of a life commitment to staying healthy. It's scary to think of thinking of foods I love disagreeing with me but its also scary to have part of my stomach cut off. I've also read that surgery is much more risky then the band. And I also like that the band is reversible/removable. I'm mixed but I think that I will go with the band. Sorry if I'm ranting. Just writing my thoughts. It's so hard to know which will be right for me.

Shelly, go look at all the patients revising from the band to the sleeve on the sleeve forums. The band simply isn't as successful for people, as a whole. This is why the Mayo Clinic no longer offers it, and Allergan is trying to sell their own product (the LapBand.) I'd gently suggest the sleeve, personally. I'm a week out from being sleeved and feeling great. Good luck with your decision.

I would suggest your conclusions are based on nothing but hearsay and rumor. You don't offer any documentation as to why the Mayo Clinic does not offer banding?

Allergan sold the lapband division earlier this month and businesses selling off divisions of their own companies is not a rarity. For all you know they made a profit? So please stick to the facts when posting.

And, you won't see anyone revising from the sleeve to back to normal(or the band) now will you?

Edited December 30, 201312 yr by 2muchfun

Hi Shelly, good for you for writing out all your thoughts and collecting as much information as possible. I chose the band because I wanted the least-invasive surgery possible and I liked the idea that if ever necessary it can be removed easily. The band requires quite a bit of followup in the first year but I like that -- it keeps me accountable and we are getting the band to the right adjustment for me as an individual. It's a partnership with the surgeon. Some hospitals are no longer offering Lapband because they want their surgeons in the operating room, not doing extensive patient followup. Let's face it, it's the insurance companies that are making our health decisions for us these days. Whatever you and your doctor decide is the best surgery for you, know that you are making a big life change -- you are choosing a healthy future for yourself. Yippee!

Speaking for myself only here....

When I started researching the Sleeve was the newest kid on the block and my Surgeon's practice hadn't yet started offering it so my option was limited Band or Bypass.

I decided to go with the band because I did not want my plumbing re-routed. I also figured I would have a better chance at 480+ pounds to survive Band surgery then full on bypass.

Some may say the band requires a lot more work in a sense of maintenance, follow up (fills) and such looking for that green zone and the weight loss is slower.

I have insurance that covers my follow up appointments along with fills 100% so those appointments to me are no big deal. I found having to do the constant follow ups and fill appointments only helped me in my journey as far as staying focused.

If the Sleeve had been available to me I still think I would have chosen the band option only because of the cutting. However, if my band needed replacing today I would not rule out the Sleeve. I would seek out other Sleevers for some insight and talk it over with my Doctor and Wife.

Which ever option you decide I wish you all the best and much success!!

While it's true that the sleeve is easier for some because it doesn't require adjustments (fills and unfills, I don't agree that it provides a better quality of life post-op. I revised from band to sleeve in August 2012 and in the 16 months since then have experienced complications that required more tests, procedures, treatments, time off work, and general misery than I ever experienced in 5 years with my band or even for decades before that. I'm happy with my weight loss, of course, but nothing else about my sleeve is easy to live with on a daily basis.

I wrote in some detail about my band-sleeve experience in a blog post here: http://jean-onthebandwagon.blogspot.com/2013/03/a-lot-of-people-especially-those.html

One of the unexpected (to me) aspects of sleeve gastrectomy is that, contrary to popular opinion, it does indeed cause the micro- and macro-nutrient malabsorption that made me decide against RNY. So I'm dealing with a variety of Vitamin and mineral deficiencies, supplements to compensate for all that, and unintentional weight loss. I'm 18 pounds below my goal weight and still losing.

I don't dwell on my dissatisfaction with my sleeve because there's really nothing I can do about it. Most of my stomach is gone forever, so all I can do for the rest of my life is make the best of the situation.

Quality of life is a very individual thing, hard to quantify, and unless the members of whatever committee you met with have had weight loss surgery, I doubt they're able to give you any accurate reasoning, data or scientific evidence to back up their claim that the sleeve offers a better quality of life. If you want anecdotal evidence about that, I suggest that you visit the sleeve forum. And keep in mind that band-to-sleeve revision members who post there may be delighted with their improved quality of life because their band side effects and complications were so awful that just removing their bands was a relief, not because the sleeve is superior to the band.

The bottom line is that there is no such thing as a perfect, risk-free, easy success weight loss surgery. All you can do is do your research, pick the procedure that feels right to you, and move on.

I'll close this message now because I'm tired, don't feel well, and have too much to do today, including picking up a prescription for injectable B12 and syringes and making an appointment with my gastro-enterologist about starting Iron infusions to deal with my post-sleeve anemia.

Jean

Edited December 30, 201312 yr by Jean McMillan