Okay, so I am starting to go to a new PCP, he has been doing my pre-ops for worker's comp case, and when I mentioned that my former PCP mentioned me getting a lap band, he said, you should have the sleeve gastrectomy, aslo he is going to get me the info on a doctor who does breast reductions...yippee! So my question is, what is the advantage or disadvantage of having the sleeve gastectomy over a lap band? :w00t:

I have the LapBand and my husband just had the sleeve done a month ago. I think the advantages of the sleeve is you don't have a foreign device or "hardware" inside you and you don't have to deal with fills. The disadvantage is it's a "one shot deal" meaning if you start to over eat and the pouch starts to stretch, over time you are at risk for gaining weight back. My husband is doing well and has great restriction. Sometimes I think "hmmm..I wish I had that". But I fully realize that the band was the right choice for me because it is a little more forgiving and I like the fact that it's adjustable. Most importantly, we are planning to try to get pregnant and the sleeve wouldn't work for me if I do!! If you have any more questions about the sleeve feel free to PM me. Good luck with your decision!

I researched this option in the beginning. The sleeve sounded better than lapband to me at first because of the elimination for the needs to fills and none of the usual lapband specific complications.

I did a lot more research because it was really diffficult for me to decide. I chose the lapband. I did this primarily for the following reasons:

* Eventhough getting fills may be a hassle and expense, I always can keep my lapband at just the right level for me. Some people with lapband never need a fill, some have had a dozen fills but the recurrent them is that there is no one size fits all. I have known people with R&Y who have regained weight and don't have simple options for an "adjustment."

* The sleeve is considered experimental and I could never find a lot of reliable study information related to how well it worked over the long term. Most statistics were short term. I didn't want to lose weight for a year or more but find that I am in the same position 5-10 years down the road.

* The deeper I looked I found mention of one primary failure of the sleeve is stretching. So what if my stomach stretches and it is no longer effective, do I turn to something like the lapband???

* FDA approval is important. It is not easy to get a drug or medical device to pass their specifications. An FDA stamp of approval indicates a higher likelihood of a quality procedure or device.

I too have done a large amount of research on the Sleeve vs. the lapBand. I had wanted the sleeve procedure for one main reason - it eliminates the Gherlin hormone that is released 4 times a day causing the cravings. It goes away because that part of the stomach that releases it is removed. I have spoken with several medical facilitites and most of the doctors who have performed them successfully (more than 75 operations), swear by them. They leave the intestines in place and the pylorus valve which regulates the release of food into the intestines. I will end up with the lap band because I refuse to get the Roux-N-Y as way to intrusive and the lap band is covered by my insurance.

I have a friend who had the lapband and went 345 to 245 in 5 months with no fills. Now he is getting a fill because he is platooing.

I'm not sure why, but I think it is the skill level of my doctor, I have not had one moment's hunger since I was banded three months ago. Not having hunger does bring a different set of challenges but one that I'm up to.

If I had it all to do over again, it would be a sleeve. Hands down, a sleeve.

Sleeves have far fewer complications long term than bands or bypass.

They have better and faster weight loss, no restriction issues, and I've heard of people losing their band but never their sleeve.

They used to save a more elastic portion of the stomach and it did stretch. Today they save a more muscular portion of the stomach and stretching isn't the issue it was in the 70s.

I'm going through the same dilemma. Plus, throw in the fact that insurance will pay for a band, but not for me to have a VSG. Right now, I am about ready to toss a coin......

So a Roux-N-Y is the same as a sleeve?

So a Roux-N-Y is the same as a sleeve?

Nooo, completely different. Sleeve is purely restrictive, RNY is restrictive and malabsorptive.

Bypass is bypassing intestine, there is no intestinal rerouting with a sleeve procedure.

I'm going through the same dilemma. Plus, throw in the fact that insurance will pay for a band, but not for me to have a VSG. Right now, I am about ready to toss a coin......

Laura, you have the same delema I have. I think the sleeve is better and according to the 2 yr. results, it works well. I'm a little worried about the issues I've heard about from different people regarding the eroding of the band. Since my insurance will only cover RNY or Band and not sleeve. I'll go with the band, but I'm going to ask the surgeon how many of his band patients band's have eroded or slipped. I guess the slipping is not as much as a problem because they stitch the stomach over the band ton hold it in place. The problem is if they perforate the stomach and the stomach acids hit the band I think this accelerates the eroding.

UHC says they won't cover the sleeve because there is little data as to it's effectiveness -- only one study of around 25 people that showed no weight loss at 3 years. That surprised me. So if you have a link to the study that shows good 2 year results, I'd really appreciate it.

Check out this site Laparoscopic Associates: Vertical Gastrectomy, Vertical Sleeve Gastrectomy, Sleeve Gastrectomy , You will see that it has been used for over 800 patients with very good success.

UHC says they won't cover the sleeve because there is little data as to it's effectiveness -- only one study of around 25 people that showed no weight loss at 3 years. That surprised me. So if you have a link to the study that shows good 2 year results, I'd really appreciate it.

I just got my revision from a band to sleeve a week ago. Clearly, I did a lot of research on it. The largest five year study is coming out in a few weeks. So far things look fantastic for sleeves.

I just got my revision from a band to sleeve a week ago. Clearly, I did a lot of research on it. The largest five year study is coming out in a few weeks. So far things look fantastic for sleeves.

I was re-reading their policy statement and this time I interpreted the text differently. It says something about "no weight loss reported at 3 years" and I first interpreted that as "no one had maintained their weight loss at 3 years" but I read it again and this time I interpreted it as "no study has reported on weight loss at the 3 year mark".

It's very confusing because the way they worded it really can be interpreted both ways. I'm guessing the meant the later though.

Why can't these medical people just say what they mean! :thumbs_up:

I was re-reading their policy statement and this time I interpreted the text differently. It says something about "no weight loss reported at 3 years" and I first interpreted that as "no one had maintained their weight loss at 3 years" but I read it again and this time I interpreted it as "no study has reported on weight loss at the 3 year mark".

It's very confusing because the way they worded it really can be interpreted both ways. I'm guessing the meant the later though.

Why can't these medical people just say what they mean! :thumbs_up:

Because they don't sound as smart when they do. If you have to stop and think about what they mean, they feel extra special. ;o)

Five year studies are coming out. Doc's already have access to them, the study is the largest study available so far. It is supposed to show that sleeves do not stretch like a banded pouch does, weight loss is better, it is faster (no bandster hell, no waiting for restriction), etc. This info is being given to bariatric docs first at various seminars throughout the country.

Banding:

1-2 pounds per week, 50-70% EWL

Sleeves:

2-3 pounds per week, 70-80% EWL

I don't put a lot of stock into the EWL, I think that is all very individual and I don't think it is tracked well over the patient's long term weight loss journey. But sleeves do afford better and faster weight loss with fewer complications. It's a matter of what works for each person.

I keep going back and forth. Plus I did a spreadsheet and if I switch insurance my out of pocket expenses will be double what they are now. If I don't switch, I have to self-pay and if I self-pay, then a sleeve seems like a better deal as I don't have to worry about erosion or slippage and having to pay again to take it out. But if I switch, the band will be paid for 90% after my deductible is met.

They also made some changes in the plan this year but won't post the Plan Summaries with all the exclusions.

Man, this insurance stuff is so complicated and unpleasant!