Revision from Band - Surgeon wants sleeve, I want bypass!

[Taunter 15]

I am 3 months into my 6 month pre-op period. I met with the surgeon on Tuesday because I currently have a lapband I want revised. Given my diabetes (diagnosed 10/1/2015), my severe obstructive sleep apnea and being morbidly obese (361 lbs on Tuesday), I've been focused on gastric bypass (RNY). I thought for sure my doctor would recommend that as well. But I could tell from our meeting that he advocates for the sleeve. He says nearly 90% of the surgeries he'll do this year will be sleeve and that sleeve patients are less likely to have future complications and that their labs are "boring" because they don't have nutrient malabsorption issues like bypass patients. Now I'm torn. He says it's up to me - that he'll do the bypass surgery. But I'm wondering if I'm being a polyanna in thinking I won't be one of the ones that has complications. I just feel like the sleeve is a fad - it's what everyone is doing now. But there are only 5 years of available data whereas bypass has been around for 20+.

Anyone else have a similar issue? I'm also concerned because I'm a revision patient. I lost about 30+ lbs with the lapband and have kept it off (which the surgeon says is actually successful!!) and I really don't want to do the sleeve and then find myself losing only a fraction of what I need to lose. Any other revision folks out there?

[Pinkgirl1234 761]

I just got revision from band to bypass .Post op 8 days...I couldn't be bothered with new "fad "" procedures that will evolve.I made the stupid mistake of "going with the less invasive procedure instead of the bypass back in 2004....major mistake...Bypass this time...so happy I finally got it right this time!!!!Bypass...the Gold Standard.

They like to push you into the sleeve...it's a cash cow fast procedure.

[Pinkgirl1234 761]

Do what you feel is best! I finally did my research and I am happy.

[sothankful 5]

I had lap band revision surgery to RNY Gastric Bypass on December 31, 2015. There is no other weight loss surgery better. All of the issues I had with the band are gone. I know several people who have the sleeve and have regained their weight. There is no way that I would let a doctor talk me into that mistake. Roux-en-Y Gastric Bypass is the best revision from lap band. I am a man - and have lost 10 pounds in 7 days. I encourage you to stick with your decision - if it means finding another surgeon.

[LilMissDiva Irene 3,281]

That is interesting... most Drs will stick to the Rny idea. He is leaving the choice up to you, so get what you want. I have the Bypass. I love it. You're on the right track though, and since you are diabetic, keep researching the Bypass. It really works.

[Notinks 91]

I chose to revise from band to bypass because 1) I had reflux from the band and that is also a more common complication of the sleeve 2) because I chose the latest/greatest with the band and didn't want to make that mistake again and 3) I liked the added malabsorption component of the bypass. If you are diligent about taking Vitamins, you shouldn't have any issues with malnutrition. When I first went to see my dr., it was his nurse who was talking sleeve, sleeve, sleeve. My dr. probably does more sleeves than bypass now too, but I am thrilled to have done the bypass instead.

[Djmohr 6,965]

I am 15 months RNY post op. I have now had 3 complete nutritional work ups. I take my Vitamins everyday and I make sure that I get my Protein and Water.

I had 1 abnormality on my tests results and it was caught and resolved immediately. I was taking too much B12 and was low on Thiamin. They had me hold B12 for 6 months and had me add B1. Just did a recheck of my B1, it's now perfect.

If you are someone who plans to not follow up or follow the plan, RNY is not the way to go. If you are like me and get regular checkups then bypass is absolutely the way to go!

People that struggle with malnourishment are the people that choose not to follow the eating plan nor do they follow up with their doctors regularly. Then they wonder why they are sick and blame it on bypass.

You should absolutely do your research and do not let someone talk you out of what you know is right. Bypass is definitely the gold standard in WLS. It has a proven track record.

It cured my type 2 diabetes and severe Gerd. It put my stage 3 kidney disease into remission.

[IrishGermanRN 151]

I personally am getting a little tired of a certain poster bashing the gastric sleeve when they have not had the procedure done themselves. Someone asks for advice it's always best to let them know to do their research and discuss with their doctor. To flat out say the gastric sleeve is a "fad" is wrong and not true. I'm glad you've found success with the RNY procedure but others have had great success with the sleeve as well.

Edited January 7, 2016 by IrishGermanRN

[Cervidae 2,389]

If the doctor can't give you a concrete medical reason that the sleeve would be better for you despite your desire for the RNY, I would be a little suspicious of his motives and skills. There are legitimate reasons some people should have the sleeve over the bypass but if he honestly can't give you any and is pushing something you don't want... I don't know if I would feel comfortable continuing at that office. This is your body and whichever procedure you get is going to change you and your life forever. It should be your decision if there are no medical reason's otherwise.

That being said, there are a lot of people who start at a high bmi and have a lot of success with the sleeve, from what I've seen. I personally chose the RNY because my weight when I started the program was about 400 pounds and I wanted the most bang for my buck. Not to mention, a LOT of people who get the sleeve eventually have to revise to bypass anyway. One major surgery is enough for me.

[UsernameTaken 283]

I am 3 months into my 6 month pre-op period. I met with the surgeon on Tuesday because I currently have a lapband I want revised. Given my diabetes (diagnosed 10/1/2015), my severe obstructive sleep apnea and being morbidly obese (361 lbs on Tuesday), I've been focused on gastric bypass (RNY). I thought for sure my doctor would recommend that as well. But I could tell from our meeting that he advocates for the sleeve. He says nearly 90% of the surgeries he'll do this year will be sleeve and that sleeve patients are less likely to have future complications and that their labs are "boring" because they don't have nutrient malabsorption issues like bypass patients. Now I'm torn. He says it's up to me - that he'll do the bypass surgery. But I'm wondering if I'm being a polyanna in thinking I won't be one of the ones that has complications. I just feel like the sleeve is a fad - it's what everyone is doing now. But there are only 5 years of available data whereas bypass has been around for 20+.

Anyone else have a similar issue? I'm also concerned because I'm a revision patient. I lost about 30+ lbs with the lapband and have kept it off (which the surgeon says is actually successful!!) and I really don't want to do the sleeve and then find myself losing only a fraction of what I need to lose. Any other revision folks out there?

I am still in the process of fulfilling requirements for insurance submittal for revision to RNY. I have considered a sleeve, but after much research I have decided on RNY. I wish I had done it from the get go. I feel sleep and band are similar... I feel I have better chance at weight loss with RNY, as scared as I am to go through it... But I am soooo done with band!

[Pinkgirl1234 761]

I am 3 months into my 6 month pre-op period. I met with the surgeon on Tuesday because I currently have a lapband I want revised. Given my diabetes (diagnosed 10/1/2015), my severe obstructive sleep apnea and being morbidly obese (361 lbs on Tuesday), I've been focused on gastric bypass (RNY). I thought for sure my doctor would recommend that as well. But I could tell from our meeting that he advocates for the sleeve. He says nearly 90% of the surgeries he'll do this year will be sleeve and that sleeve patients are less likely to have future complications and that their labs are "boring" because they don't have nutrient malabsorption issues like bypass patients. Now I'm torn. He says it's up to me - that he'll do the bypass surgery. But I'm wondering if I'm being a polyanna in thinking I won't be one of the ones that has complications. I just feel like the sleeve is a fad - it's what everyone is doing now. But there are only 5 years of available data whereas bypass has been around for 20+.

Anyone else have a similar issue? I'm also concerned because I'm a revision patient. I lost about 30+ lbs with the lapband and have kept it off (which the surgeon says is actually successful!!) and I really don't want to do the sleeve and then find myself losing only a fraction of what I need to lose. Any other revision folks out there?

I am still in the process of fulfilling requirements for insurance submittal for revision to RNY. I have considered a sleeve, but after much research I have decided on RNY. I wish I had done it from the get go. I feel sleep and band are similar... I feel I have better chance at weight loss with RNY, as scared as I am to go through it... But I am soooo done with band!

Make sure you have a very experienced surgeon....revision surgeries are not easy.Dont be afraid to change.

[ocgirl15 667]

You are right to question and research! My surgeon is like yours.... Loves the sleeve. And that was fine for me with a lower BMI and no co-morbities (at least that insurance recognizes). But my support group friends with mult co-morbidities and much higher BMIs are also getting it. He gave them the "choice". If I was you I would be asking the same questions. Maybe get an opinion from another surgeon. I think it is awesome you are being an advocate for your health! Too many blindly think doctors are all knowing Gods!

[amyg80 45]

I had band to sleeve revision on 12/1, and have lost 20lbs so far. With the band I only lost 25lbs and then got preg and gained 50.

For me the sleeve was my personal choice and I couldn't be more pleased. I have about 95lbs total to go, but I think with any surgery/diet plan you have to be compliant. I know people who have had the bypass and 5yrs later are heavier then when they had surgery.

For me cutting out my stomach is drastic enough. I don't want to mess with my bowels. If this fails it's my own doing.

It's a personal choice, and one you need to decide after research and self analysis. You know what you can handle. No one else does. Good luck.

[Threetimesacharm 1,400]

Only time will tell how successful all of those who have had the sleeve will be. I personally don't think it will accomplish significant weight loss in those who have say more than 50 pounds to lose. I speak from experience; had the ridiculous lapband in 2007, partially successful with the sleeve in 2012 and reached my goal(2 more pounds to lose) with the bypass in 2015. I find I have a much better restriction with the bypass and have had zero issues with the bypass part. I too initially was worried about the intestinal bypass portion but some days I wonder if it actually was done!!('Cause I have no issues!). I too wish I had gone right to the bypass but I guess it just wasn't what I needed to do at the time. One other plus about the bypass is your inability or intentional support form your surgery to refrain from eating SUGAR and only eating complex carbs. I have a fear from what could happen if I have sugar so now sugary foods actually repulse me!! Who knew! I also have never had a dumping session and hope to never have one. You will do the best thing for you, good luck!

[UsernameTaken 283]

The points you mentions above are mainly my reasons with choosing to do RNY for my revision. Hopefully I will have no issues too