The ultimate battle RNY vs lap band vs sleeve?

[ThruChristICan 27]

I know this question will be redundant for many of you but forgive me. I have researched all 3 but I'm still undecided which route to take. I'm aware is my choice but my question is: which surgery did you choose and were the deciding factor (s) for you? I'm about to schedule my informational meeting through Kiaser in southern California. So prior to me going I'm trying to be as knowledgeable as possible but I do realize how important personal experience is! Thanks and be blessed

[Djmohr 6,965]

This topic comes up just about every day on this site. You can search for it and fine hundreds if not thousands of posts that should help you.

For me, the band was never an option to consider. My surgeon feels unless you have really great exercise habits in place, the band will not succeed long term. Banders had to work even harder. Given I have psoriatic arthritis and degenerative spine disease, we felt that was not going to be as successful for me.

So my decision was between the sleeve and RNY gastric bypass. We then had to take my health concerns into account. I suffered from a lot of things, high blood pressure, high cholesterol, reflux/herd, diabetes and stage 3 kidney disease. As soon as my surgeon realized that I suffered from reflux, he immediately recommended that I go with RNY. I was devastated. I had my heart set on going with the sleeve. I was told the sleeve can make reflux much worse and that many folks will go the sleeve route and then have to get it revised to RNY anyway. I got a second opinion from my gastroenterologist and he immediately confirmed for me that RNY was the way to go.

I had RNY on 9/29/14. It is the best thing I ever did. I am down 95lbs, all of my issues: high blood pressure, diabetes, reflux/gerd, high cholesterol and even my kidney disease have resolved.

When you go for your consultation, they should go through your medical history and that should really help with your decision.

Good luck to you!

[gowalking 10,790]

@@ThruChristICan, it's not a battle but a choice. Do your homework, talk to your medical professional about your situation, and what you are most comfortable with, and then make the choice that is best for you. The most important decision you made was to look at the option of WLS, whichever one you decide on. Good luck.

[KateP 359]

You have to decide which lifestyle suits you. Do you need malabsorption to help you? Do you need to take NSAIDs?

Please bear in mind that I am a very happy and very successful bandit now 9 years post-op. I do not regret my band, would do it all over again and if I ever have to have it removed, I would hope to have a replacement.

When I was banded in 2006, it was a miracle surgery. And for some people, who accept that they will still have to work hard, it is just that. It was and still is for me. But over the years it has become clear that serious complications necessitating further surgery are much more common than originally thought, some of these are avoidable by careful eating and by not keeping the band tight; unfortunately others are beyond our control.

We used to be warned about band slips, leaks and about ( very rare) erosion into the stomach tissue but it turns out that a build up of scar tissue round the band (causing it to tighten) is quite common. It can be very difficult to get the right level of restriction and some people are tempted to keep it tight enough to physically limit food, in fact it was once thought this was how it should be. But this causes food to back up into the oesophagus and that risks problems such as oesophageal dysmotility which may be irreversible. It can also damage the vagus nerve.

Quite a number of doctors have stopped implanting bands as they found the removal rate was unacceptably high and it was too easy not to lose enough weight. Revision from band to sleeve is not uncommon!

We still need lots of will power. The band makes it easier by dimming hunger, but it does nothing for head hunger and, contrary to popular opinion, it does not and should not physically stop us eating. If it does it is too tight!

Having said all that, I love my band, I know many successful long term bandits in real life. My own experience has been good and so has that of almost all those I actually know and have met.

Equally, I know people who have had major successes AND serious complications with both sleeve and rny. But I haven't had those surgeries myself so will not speak for them!

[IcanMakeit 1,318]

Each of us can only tell you how our surgeries worked for us, not how well it would work for you. My advice is to talk to and read lots of posts from people who had different surgeries, paying close attention to the ones who are similar to you. You will get a pretty good idea of what is common for all the different surgeries and then you can make an informed choice.

[ThruChristICan 27]

This topic comes up just about every day on this site. You can search for it and fine hundreds if not thousands of posts that should help you.

For me, the band was never an option to consider. My surgeon feels unless you have really great exercise habits in place, the band will not succeed long term. Banders had to work even harder. Given I have psoriatic arthritis and degenerative spine disease, we felt that was not going to be as successful for me.

So my decision was between the sleeve and RNY gastric bypass. We then had to take my health concerns into account. I suffered from a lot of things, high blood pressure, high cholesterol, reflux/herd, diabetes and stage 3 kidney disease. As soon as my surgeon realized that I suffered from reflux, he immediately recommended that I go with RNY. I was devastated. I had my heart set on going with the sleeve. I was told the sleeve can make reflux much worse and that many folks will go the sleeve route and then have to get it revised to RNY anyway. I got a second opinion from my gastroenterologist and he immediately confirmed for me that RNY was the way to go.

I had RNY on 9/29/14. It is the best thing I ever did. I am down 95lbs, all of my issues: high blood pressure, diabetes, reflux/gerd, high cholesterol and even my kidney disease have resolved.

When you go for your consultation, they should go through your medical history and that should really help with your decision.

Good luck to you!

I appreciate your response ok great I look forward to that consultation. I thought maybe I was the only one who hadn't decided which method I was gonna take.

[ThruChristICan 27]

I totally agree, that's why I joined this site to find out from everyone else personal experience and then continue to research , etc...

[Miss Mac 6,261]

I chose the sleeve because I did not want my plumbing re-routed and I did not want a port.

[ThruChristICan 27]

I chose the sleeve because I did not want my plumbing re-routed and I did not want a port.

thanks I've been recently doing more research on the sleeve my issue with it is that it's still relatively new and there is not enough long term research on it

[blashlee 509]

When I started my research I was interested in the band because I thought it was a less invasive and easier to manage option. That's not true. It's still a hospital stay and is still required a pretty major surgery. I also wasn't comfortable with the port in my skin and a foreign object in my body long term.

I wasn't really sure about the sleeve because it was fairly new and I didn't want parts of my stomach removed from my body. My surgeon doesn't perform the sleeve and doesn't believe there's enough long term data yet to know exactly how successful it is.

The gastric bypass has been performed for decade and is the gold standard in weight loss surgery. While it seemed a bit more extreme than the band I was originally interested in, I did a little soul searching and realized that in spite of potential complications and in spite of the potential for malabsorption and not being able to tolerate certain foods, it was the best option for me. Maybe not being able to eat whatever I want is a good thing. Being able to eat what I wanted in any amount is what led to my obesity to begin with. Taking Vitamins sucks but it helps me establish routine. I wake up and take the same vitamins at the same time throughout the day and I keep track of how much I eat and drink all day. I wouldn't ever do that if I didn't HAVE to.

Do your homework. Write down pros and cons. Really self analyze what your pitfall is when it comes to your weight and diet and exercise and see which surgery and subsequent program seems to be the best fit for you. Sleeve patients love their sleeve, bandits love their band and bypassers love our pouches. You have to kind of determine on your own and with your doctor which one you think will be best. Every body is different.

[CowgirlJane 14,259]

We all have biases - so frankly our voices are just the "knowledge" of ourselves. I am strongly biased but I recognize that there are very many people who have a different story to tell and i greatly respect their successes too!

I had the lapband for 10 years. While there are many success stories, I would try to talk anybody out of it for a couple of primary reasons.

#1 the "complication" rate is understated - I thought it was the least risky surgery but it was actually fraught with complications for me. Many people do great at first, but the complications over the long haul impact a high number of people. I personally think the primary reason for that is that many needed a fairly tight fill to restrict food and that leads to problems. I found out that "restriction" alone does not work for me.

#2 OMG, my life was hell due to the vomiting. enuf said

#3 If you are high BMI, it is not likely the best choice since high BMI people tend to need a little "something more"

I revised to the sleeve over 3 years ago and have been maintaining a normal size/weight which I never attained with the band. the sleeve is also mentioned as "restriction only" but there is definately more to it then that. It reduced my hunger from an all consuming 24/7 obsession to something I can manage. It restricted how much I eat, not by vomiting, but by reducing my drive to eat.

I chose sleeve over bypass frankly because I was freaked out about the bypass at the time. I think I had negative views about it due to someone I knew that did it in 1994 - open procedure and her recovery was hellish. I have a much more open mind about it now as I am more educated. I think it is a good choice too.

i think education is key. I strongly encourage that you not only speak to surgeons and get educated but also GO TO SUPPORT GROUPS AND MEET REAL PATIENTS! You can do that prior to your surgery!

My basic plan was to get the sleeve and if that wasn't enough, do step two and get the DS. (Reduced stomach, the sleeve, was stage one of the DS for many years. For very high BMI people it was too risky to do it all at once). Due to hard work, great surgeon, and good luck, I didn't need DS as i have been maintaining a normal weight/size for a couple of years now.

I lost over half my body weight. I spent most of my life morbidly obese, or super morbidly obese and to be just normal is a dream come true.

[Elizabeth21 175]

I chose the sleeve because I did not want my plumbing re-routed and I did not want a port.

thanks I've been recently doing more research on the sleeve my issue with it is that it's still relatively new and there is not enough long term research on it

What are your "long term" concerns? There is actually more long term data about the gastric sleeve than people realize. This procedure was done as part one of a two step procedure for years, and, eventually it was discovered that the success rate with just doing part one was enough that step two (re-routing intestines) was unnecessary. Furthermore people have had to have stomach reduction surgery for various reasons over the years for ulcers and cancer. Long term, people have done fine in terms of health. If your concern is about long term maintenance of weight loss the numbers for the sleeve are pretty competitive to RnY and better than the lap band.

For me, the deciding factors included this: 1) the sleeve does not require as extensive surgery as RnY nor the need for supplements due to malabsorption and 2) the sleeve removes the part of the stomach that affects the production of key hormones and metabolic control so that your hunger is reduced and your metabolism can reset. The second factor was very important to me in terms of my ability to maintain the weight loss.

I agree with the others. Continue your research and make the choice that best fits you.

Good luck!

[ThruChristICan 27]

I chose the sleeve because I did not want my plumbing re-routed and I did not want a port.

thanks I've been recently doing more research on the sleeve my issue with it is that it's still relatively new and there is not enough long term research on it

What are your "long term" concerns? There is actually more long term data about the gastric sleeve than people realize. This procedure was done as part one of a two step procedure for years, and, eventually it was discovered that the success rate with just doing part one was enough that step two (re-routing intestines) was unnecessary. Furthermore people have had to have stomach reduction surgery for various reasons over the years for ulcers and cancer. Long term, people have done fine in terms of health. If your concern is about long term maintenance of weight loss the numbers for the sleeve are pretty competitive to RnY and better than the lap band.

For me, the deciding factors included this: 1) the sleeve does not require as extensive surgery as RnY nor the need for supplements due to malabsorption and 2) the sleeve removes the part of the stomach that affects the production of key hormones and metabolic control so that your hunger is reduced and your metabolism can reset. The second factor was very important to me in terms of my ability to maintain the weight loss.

I agree with the others. Continue your research and make the choice that best fits you.

Good luck!

Thank you for your informative response. It's responses like yours that give me a little more insight than what's in the research. So that's why I'm asking, I want to find out as much as I can to make a decision that will ultimately change my life. I'm not sure if I mentioned but I'm just beginning the research and joining message boards so my information is coming from various sources. This weekend alone I've been dedicating my research on the sleeve. I must say I do find it's information and benefits favorable more than the others. I initially thought I'd do the lap band but all the side effects from people's experience is not something I'd like to deal with, not to mention other factors like the longest term weight loss. Thanks for your help

[maark 1]

• Hi ThruChristICan,

There are many similarities between the lapband and the bypass diet for the first few weeks, It is good that you're asking questions and doing your research to make the best decision for yourself.

Check out the forums for the Sleeve and Lap-Band. Read the posts and post questions that you have so members can provide you with additional information.

[VSGAnn2014 12,992]

You're getting good advice.

The right choice for me doesn't mean that it would be the right choice for you.

None of us has identical physical, mental and emotional resources and challenges.

Therefore, if you were to be more specific about your own resources and challenges, that might help us respond more specifically to your situation, based on our experiences.