Please help! I went to the dr. today to set up lap band procedure. I need to loose about 80-90 pounds. Since I am self-pay he suggested the gastric sleeve. Can anyone give me advice on this? My research says that it is generally used on people who have 500lbs or so to loose and is part one of a two part process. He said his suggestion for this was based on the fact that I don't have insurance and if the lapband slipped then I would have to pay to have surgery redone. Can anyone give me advice?

Please help! I went to the dr. today to set up lap band procedure. I need to loose about 80-90 pounds. Since I am self-pay he suggested the gastric sleeve. Can anyone give me advice on this? My research says that it is generally used on people who have 500lbs or so to loose and is part one of a two part process. He said his suggestion for this was based on the fact that I don't have insurance and if the lapband slipped then I would have to pay to have surgery redone. Can anyone give me advice?

What is the link where it said you should have 500lbs to lose to get a sleeve?

It's a good option. I think you are confusing your research of sleeve vs. bypass. A sleeve is the first half of bypass, just no malabsorption and no rerouting of intestine. But the sleeve is quite effective and something I would do if I had it to do all over again.

Gastric Sleeve Operation (link)

The gastric sleeve operation is available as a gastric restrictive procedure and has all the disadvantages of such procedures, in that it only restricts solid foods to some extent and not liquids. The stomach remaining will gradually stretch and permit larger meals. In addition there is no band or other permanently restrictive device.

For these reasons it should probably be reserved for the treatment of truly massive individuals (500 to 600 lbs. or more) as a first stage of a BPD (bilio-pancreatic diversion) or its modification, the duodenal switch, or possibly a gastric by-pass, in cases where it would be too dangerous or difficult to perform the secondary or main operation in one stage. For experienced bariatric surgeons it should rarely be necessary to perform a gastric bypass in 2 stages.

This is old information.

When they first did bypass some people were so large that they could not safely do the entire procedure. This is when they were doing it open vs. lap. So the procedure was pretty long, extensive, and dangerous.

They started doing just a sleeve until the person lost a significant amount of weight so the remaining part of the procedure could be done safely at a smaller BMI.

Well, they found that people did really well with the sleeve alone so now it is done that way for many people.

The technique has also changed a bit so it is even more effective.

That is quite interesting. Something my parents always taught me about doctors. Get a second opinion! Try and find another doctor in your city who does Lapband surgeries and see if he suggests the same thing, without mentioning that you spoke to another doctor. Just to see if he arrives to the same conclusion. If he does not mention it, ask him about the "sleeve" procedure for informational purposes.

At the end of the day you must be comfortable with what you are doing, your doctor's advice is just that advice that you need to weigh.

Personally, I know paying for yourself is a great cost, but the reversible nature of the band gives me peace of mind.