Newbie - How do I choose?

[bikrchk 1,313]

The band may sound less risky, but if you look at the actual complication rate of band vs sleeve and the long term results, I think you'll find the sleeve has less risk and better outcomes. I'm obviously biased as a successful sleeve, but know several people personally who've had the band and either didn't have good long term results, couldn't follow the prescribed diet because all dense Protein came back up, or had complications with the band in general... prolapse to outright rejection and it had to come out. Of most of the folks I know where it had to come out, one had so much damage her only choice was revision to bypass, one just had it removed and has maintained the weight loss on her own so far, and many have revised to the sleeve with much better results.

[Bandista 7,466]

I chose Lapband because I was not prepared to anything more drastic than that. There are lots and lots of successful banders. The founder of this site is a bander. Band requires followup with the surgeon -- 11 visits in the first year was what was put forward to me. Personally I liked that -- for the accountability and for the personal attention to what I was experiencing. Many surgeons don't want that much patient contact and hospital administrators and insurance companies sure as hell don't. What was I experiencing? A dimmed appetite and consistent weight loss. The main thing is that whatever you decide you have already decided to do something -- you are choosing yourself and your healthy future first and that is so important. Weight loss surgery is amazing. For me, the band has been amazing and I am very grateful. I was 52 and had never been an overnight patient in the hospital before. I am not some one who would ever co sides plastic surgery, for example. That's why the band was as far as I wanted to go. I already ate really well but just too much. The band dims my appetite so I don't do that anymore. There are two links in my signature that helped me understand how it works. Maybe they will help you, too. Also I don't know what all this foreign object talk is about. Yes, I have a silicone band and if anything goes wrong I can have it taken out or replaced. I was not able to get my head around the other surgeries so I think I was probably lucky to be so sure of the one right path FOR ME. We can only speak to our individual experiences here. Best wishes for smooth sailing and once again congratulations on deciding to turn your life around.

[MrsSugarbabe 727]

I concur with @@ShrinkingPeach and the others who are saying "do the research." I would also add to your research watching a YouTube video of each procedure. Those videos are very enlightening and helpful in understanding exactly what's taking place during the surgery.

I considered all my options, ruled out lap band early on, my surgeon was strongly recommending RNY, but in the end the sleeve made the most sense to me and for me. I work with several people who have had WLS - band, RNY, & sleeve - and I spoke to all of them prior to making my decision. Every one of them said the same thing at the end of our conversations - regardless of any issues they had following surgery (some had some, others had none), they all said they would do it all over again. My surgeon felt the RNY was the better option because he felt I'd have a better chance at losing the 100 lbs. with it than with the sleeve. Fortunately, I found BP sometime before surgery and discovered a world of people who have been sleeved who have lost 100 plus pounds so I'm planning to prove my surgeon wrong on that topic.

Good luck to you and we'll see you on the losers bench!!

[Graciesmom04 184]

Initially, I had my mind made up I was going to do the lap-band. Thinking it was a mild procedure, nothing would be cut or removed....sounded great. I went to the WLS meeting and instantly changed my mind. I did not want to have to run to the Dr (75miles away) every month, or more to have a checkup and change the band, if needed. I opted to go with the sleeve. Yes, it's permanent, but the more I thought about it, I felt it was a better choice. I had horrible GERD before the procedure and since having it done, have not had one issue of reflux or heartburn. I have had no complications from the sleeve, just trying to learn what I can and can't eat yet, even after 3 mo's out. I carefully went through all my options before surgery to determine which was best for me. And being a nurse, and seeing knowing which ones had more complications, that helped as well.

Good luck in your decision!

[Dancing Fool 29]

I started out thinking I wanted the sleeve, but switched to a band after my surgeon consultation. Sleeve has a lower complication rate, but the complications that occur are more likely to be serious (as in, ICU and PICC lines) than lap band complications.

Basically, both procedures are safe, but my temperament could more easily accept a greater risk of a less catastrophic complication than a smaller risk of something really awful happening. This is more a matter of feelings and temperament than a rational computation.

But on the more rational side, I figured that it makes most sense to get the least invasive/lowest risk procedure that will still get the job done. Taking into account my starting weight and food behaviors, this was the lap band for me.

Other people have reached a different conclusion and had a wonderful experience with the sleeve.

One thing to consider about the lap band: it requires a lot of follow-up over a long stretch of time. If your surgeon does not offer good follow-up, or you would not financially able to afford the follow-up should your insurance change or if you are self-pay, then it may not be the best choice.

[TexCntryBoy 34]

I researched it pretty heavy. I went into the the process pretty convinced that I was going to do the lap band because I wanted minimally invasive. I never seriously considered the bypass for the same reason. After research and talking to people I found out that the maintenance on the lap band is much more time consuming with all the "fills" then I found out that the lap band is slower than a sleeve. Then I began to hear horror stories about lap band failures that required a revision to a sleeve. I am now post op 3 weeks. I started at 502 two weeks before surgery. I am down 73#s already with no real pain or strain (except the clear liquid diet which got easier after 3 or 4 days).

[VDB 800]

One of the reasons for WLS is to deal with chronic diabetes, certainly was for me. I had read articles citing gastric bypass as having 25% greater results with putting diabetes in remission than did the sleeve, and the band had much lower than either method. This was the reason I went with bypass. I left the hospital on no diabetes meds, but will likely be back on one soon, which I may need for a few months until more weight comes off. My office no longer does the lapband due to problems including mechanical breakdown. It is no longer used in most of Europe for this reason.

[NewNewMe 277]

I got a band in 2005. I lost 85lbs and then started getting horrible reflux. They finally took most of the Fluid out and I yoyo dieted for 8 years. I finally decided to have it taken out and get the sleeve. The doctor said my stomach was getting pushed up through my band and was close to closing off. I had no idea. I am so glad I decided to do this and didn't end up with emergency surgery. I am now two weeks post op and I can tell you already the sleeve is leagues better than the band. I wish I did this instead of the band back then. I feel so much better with that thing gone!

[Smye 695]

@@Shakti, I'm with wannabthinsoon on this one. I can try to find you the research jennifer Minton mentioned if you like.

[Shakti 55]

I'm so happy I found this forum - thank you to all for your caring responses. It is a huge help and I must admit I felt kind of lonely when I finally made my decision to have surgery, as I know so many people who think it's a cop-out and all I need is diet and willpower. If that were the case would have already been successful at losing!

I look forward to being armed with more information once I meet with the surgeon next Friday.

[wannaBthinsoon 1,634]

@@Smye if you can find that info I would love to read it. Thanks.

[Alex Brecher 10,516]

Shakti,

You’ve gotten a lot of good advice here. As the others have said, there is no single right answer for everyone – do your research and make the decision that seems right to you.

For me, I chose the lap-band and am completely happy. It worked for me. I learned about it because it was working for my friend. I chose it because it seemed less invasive than bypass. Sleeve wasn’t common at the time. I didn’t like the idea of rearranging my insides, although I can understand the perspective of people who don’t like the idea of having a foreign object (the band) permanently placed in their insides. I also like the adjustability. I only felt like I needed the restriction, and didn’t feel like I needed the malabsorption like you get with bypass.

Of course, the band means more trips to your surgeon. You need to go after surgery at least a few times to get it filled and probably adjusted. If you go on vacation, you should always know where you could go if necessary if you have a band emergency. In that sense, the band’s a little more labor intensive.

Also, keep in mind you may want – or need – to consider the financial aspects. Your health insurance plan may not cover all of the different surgeries – some health insurance plans still consider the sleeve to be experimental and therefore not reimbursable.

Good luck with your decision!

[BLERDgirl 6,417]

@@Shakti - It's a matter of knowing your body. Acknowledging what your limitations are, doing your research to find a good doctor.

For me I knew chances were my body would not react well to the re-routing and dumping syndrome that comes with bypass. I also knew I was ready and committed to eating better and exercising regularly, not a diet, but a change in my relationship with food. I needed a tool like the sleeve that would give me a boost to get on track. I never did a bunch of fad diets. I did weight watchers and had some limited success. I lost weight and kept it off for about a year. My love for healthy foods and fresh veg was just as strong as my love for all things chocolate. I just needed a way to stay balanced. The sleeve was perfect for me.

On the other hand my surgeon did bypass for a friend of mine a year before he did my surgery. That was also perfect for her and she remains successful 3 years out.

[pink dahlia 2,513]

I was banded just over 3 years ago at age 54. I didnt look at anything besides the band because I didn't want my insides rerouted. From surgery day to now, it has been very easy without a single complication. No more sleep apnea, digestive problems or anything else. I look and feel better than I have in years. Yes , I have to choose my food a little more carefully, eat slower, chew well etc but the 5% n inconvenience of being banded is NOTHING like the 100% inconvenience of being obese. Best decision ever ! Good luck !!

[samuelsmom 670]

@Shakti As you can see from all the posts this is a personal decision. For me, the idea of possibly having to have the band removed was enough to steer me towards the sleeve. Every surgery has risks and it gets more dangerous the older we get. Also, research is not supporting the band as a great long term option. None of that means that you personally will have a problem- but the risk is there.

Below I have pasted an abstract from a long term study. There are some other studies also linked there which you may find interesting. Good Luck on this journey!

Long-term results after laparoscopic adjustable gastric banding: a mean fourteen year follow-up study

• E.O. Aarts, M.D.^, ,
• K. Dogan, M.D.,
• P. Koehestanie, M.D.,
• Th.J. Aufenacker, M.D., Ph.D.,
• I.M.C. Janssen, M.D.,
• F.J. Berends, M.D., Ph.D.

• Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.

Received 30 May 2010, Accepted 3 March 2014, Available online 5 April 2014

Show more Show less

doi:10.1016/j.soard.2014.03.019 Get rights and content

S1550728914001427

Refers To

• Allen F. Browne
• Paired Editorial to SOARD-10-151
• Surgery for Obesity and Related Diseases, Volume 10, Issue 4, July–August 2014, Page 640
• • PDF (47 K)

Referred to by

• Allen F. Browne
• Paired Editorial to SOARD-10-151
• Surgery for Obesity and Related Diseases, Volume 10, Issue 4, July–August 2014, Page 640
• • PDF (47 K)

Abstract Background

For over a decade, the laparoscopic adjustable gastric band (LAGB) was 1 of the most performed bariatric procedures in Europe. This study is a retrospective analysis with prospectively collected data of the experience in 1 specialized Dutch center with the adjustable gastric band over 14 years.

Methods

Between 1995 and 2003, 201 patients underwent an LAGB for morbid obesity in our hospital. Data on preoperative clinical characteristic, postoperative outcome and weight loss patterns, and co-morbidities for up to 18 years are presented and evaluated using the Bariatric Analysis and Reporting Outcome System (BAROS).

Results

Average follow-up was 13.6 (±2.0) years (163 mo) and 99% of patients with complete follow-up. Two thirds of patients reached an excess weight loss (EWL)>50% at some point after LAGB placement. However, due to insufficient weight loss or complications in 53% of patients, the LAGB had to be removed or converted to a Roux-en-Y gastric bypass. Additionally, half of the remaining patients had disappointing results according to the BAROS score. In total, less than one quarter (22%) of patients had a functioning band with a good result after the follow-up period. Although initially the number of patients experiencing co-morbidities was reduced, most of them returned and a large number of patients developed new co-morbidities. Complications, other than weight regain, were numerous as 47% of patients experienced at least 1. In total, 204 reoperations were performed in 137 (68%) patients. Furthermore, patients who were lost to follow-up did almost twice as bad in terms of EWL compared to patients who had regular follow-up.

Conclusion

Morbid obesity is a chronic disease that can be resolved with bariatric surgery. One of the treatment options is the LAGB, which in the short term shows good results in terms of EWL and co-morbidity reduction. In the long term, however, EWL and co-morbidity reduction are disappointing, and the LAGB does not seem to live up to expectations. Besides the decrease in EWL over time, the number of reoperations required is alarming. In total, less than a quarter of patients still had a functioning band after a mean 14 years of follow-up.