I'm back from getting my sleeve. The operation went well. I don't have a *lot* of pain but I am also taking all my painkillers quite faithfully. My hospital stay was like something out of a Fellini film though. You can read about it on my blog. I won't even try to summarize here. It's just too weird.

Hi. I will be going to Mexico on Oct 19th, with Dr. Aceves. Surgery will be on the 20th. I was banded in 2006. I will be having a revision surgery from band to sleeve. I will be getting a complete unfill this morning and going on liquids for 3 weeks preop. That's a little scary :biggrin:. My weight is 125 (up from lowest of 115). I hope to lose the 10 lbs and then maintain. I hope the sleeve will help with that.

Congrats, Mac!! I hope you have a wonderful recovery! Take care!

What is a sleeve? Please compare it to the lapband.

Sure.

Lap band and Vertical Sleeve Gastrectomy are both restriction-only surgeries. No intestinal re-routing. No malabsorption.

Lap band works by making a pouch aka a pre-stomach that is similar to the gastric bypass pouch. When it fills up with a small amount of food, the pouch stretches a bit, and that sends a signal to the stomach that you are full. However, you don't normally get this until you get to your "sweet spot" which is the spot where you have enough restriction to get the signal but not so much you can't keep anything down.

The sleeve works by removing most of the stomach including the fundus and all of the stretchy part. It also sends a signal to your brain when the sleeve fills up. But because the fundus is removed, you also get a big reduction in production of ghrelin, the hormone that stimulates your appetite.

The stomach that remains is shaped like a sleeve -- hence the name -- and is about the size of a man's index finger. It is a fully functional stomach with a pylorus valve, unlike with bypass.

In terms of weight loss, the averages are around the same as bypass, whereas with lap band, they aren't quite as good. However, with lap band, you have no "window". Your band works forever as long as you keep up with fills. With a sleeve, your intestines do figure out how to make more ghrelin eventually. It never goes back to pre-op levels, but you do start to feel hungry more than in the beginning and that's when regain is an issue. But since the really stretchy part of the stomach is gone, it's not as big an issue as it is with bypass.

In terms of complications, they are similar. The sleeve is riskier in the first few weeks post-op. Along with all the things you can get with a band, like a blood clot or pneumonia, you can also get a leak or a stricture. Leaks are VERY serious. However, the farther out you get, the safer the sleeve is. Complications past 3 months post-op are unheard of. This is not true of the band which can slip or erode at any time.

The cost is similar. Sleeves tend to cost a few thousand more, but not what bypass or DS costs. Insurance companies are only just starting to pay for them though so many more of us are self-pay.

Feel free to ask more questions. I tried to hit the highlights.

Congrats!

I hope I get sleeved soon too!

I hope I get sleeved soon too!

Good luck to you.

Congrats Mac, you seem to have been waiting a long time for this. You'll be a shadow of your former self before you know it!

You'll be a shadow of your former self before you know it!

And I can't wait!