Does anyone know what the success rate is of patients who have the gastric sleeve done? I have read many posts of people who don't lose weight with the lap band and was wondering if there are the same issues with the sleeve?

I don't know it is still kind of new here. I have been doing a bite of reseach on it. It seems everyone you talk to has a diffrent story. Some people are getting them once they reach their goal with the band. Some bandster are giving up on the band and going with the sleeve. One doc said that the band and the sleeve are only half the solution that neither of them work as well as the mini bypass which is the sleeve and a smaller bypass. I think the verdick is still out on that one. I think they are all tools and which ever one you choose you have to learn to make it work for you.

A mini-bypass (aka as the "loop" bypass) is a dangerous operation that isn't recognized by the American Society of Metabolic and Bariatric Surgeons. IMO you should RUN from any surgeon who thinks it's a good idea.

Anyway, if you want some hard data, the LapSF guys have recently published their 5 year data which includes results for over 750 patients.

What they have found is that when they first started doing the procedure, initial weight loss was excellent. However, at around the 2-3 year point, regain became a problem. So now they do the sleeves with a 32f boughie and regain is not an issue.

Average EWL is around what you get with a bypass and regain stats are actually better ... around 20-25% of bypass patients regain a significant amount of weight. But only about 10% of their sleeve patients have this problems and their average regain is not as significant.

The LapBand has the lowest average EWL stats of any of the four WLS recognized by the ASMBS. Duodenal Switch has the best average EWL. Bypass and sleeve are in the middle.

However, the lower your starting BMI, the better you are going to do with any surgery. Plus averages are just averages. You need to match the surgery type with your food issues to get the best results. If you do that, you'll be one of the above average people instead of the below average people.

What they have found is that when they first started doing the procedure, initial weight loss was excellent. However, at around the 2-3 year point, regain became a problem. So now they do the sleeves with a 32f boughie and regain is not an issue.

How many years have docs been performing the sleeve with the 32f boughie? What is the rate of mortality for the sleeve or is it per MD rate that I should be concerned with? I am almost positive I am switching from the lap band to the sleeve but just want to be reassured.

My surgeon has been doing sleeves for 7 years. Most surgeons have been doing them for about 3-4 or even less. In their 5 year study, they only had 3 years of data with the 32f. However, data falls behind reality and I think the practice has more like 5 years of experience with that size.

With most WLS, regain happens around the 2-3 year mark. That's when the hunger comes back for everyone (though usually not like before), when everything is at its max stretched out, when the patient is most likely to ease up with the rules, etc.

With some of the older surgeries, regain would happen farther down due to failure of the procedure -- at about 5 years out. But the VSG is the stomach portion of the DS and that procedure has been done for around 20 years with no failures like that. Plus partial gastrectomies (of which the VSG is a subset) have been done for decades. So we know what happens with this kind of operation long term and we know there is nothing that is going to fail.

For some people, the lack of data is a sticking point with this procedure. They want a surgery that's been around for 20 years too. I can understand that, but it wasn't for me because I believe the operation is sound from a engineering point of view. There is no stoma or pouch to enlarge like with bypass. There is nothing to grow back together like with VBG or bypass. There is nothing mechanical in there that can fail like with a band.

Plus my aunt battles stomach cancer and has lived most of the time I have known her with a partial gastrectomy so I have personal knowledge that people can have good lives with part of their stomach missing.

dear neworleanslady: I have seen a few posts about the sleeve, and wondered more about it. Actually, I wanted to know the very same thing you asked. May I ask you why you are thinking of switching from the band to the sleeve? I had asked someone else on here once, and her reason was because she was on maintenance. However, I have not been successful with the band, but don't know much about the sleeve. Any advice you can offer would be greatly appreciated (that goes for anyone reading this post). thanking you in advance

I was sure I was getting the lap band until a few days ago when I started reading that many people are unsuccessful with it. I wanted the safest procedure possible and thought that the band was it.

I read on some of the sites that people could eat two pieces of pizza (after lap band) and others replied that just b/c she could eat it doesn't mean she should eat it. That is worrisome for me b/c if I had the will power to say no to food I wouldn't be having WLS in the first place. Also, I am making a loan to pay for my surgery so I really need to find the safest surgery but with the highest success rate. I can't afford to have another surgery in a few years if this one fails. Especially if I am still paying on my 3 year loan for this surgery.

I haven't heard of people gaining significant amounts of weight back with the sleeve. And it seems to be a safer procedure than the bypass. I do plan on doing everything I can to eat sensibly but I know how weak I can get when it comes to food. I hope this answers your question and I didn't ramble on too much. How long has it been since you had the lap band done? And why do you think it is not working for you? I just want as much as info as possible to be sure I make the right decision. Thanks.

I had asked someone else on here once, and her reason was because she was on maintenance.

I think you may have misunderstood. No reputable surgeon is going to take out a functioning band and replace it with a sleeve for no reason.

As an example, there is a lady in my support group whose surgeon suggested she get a sleeve because of how much weight she has to lose. She opted for the band instead, but now is sorry. But she's losing just fine -- has lost over 200 lb! -- and her surgeon has said she needs to keep plugging away with the band until it stops working for her.

There are a few people on this forum who have had band to sleeve revisions. None of them got them "because they were on maintenance" though a few of them were at goal when it happened. In every case, they had problems with the band. In some cases it slipped or eroded. In others they had esophaegal spasms and couldn't keep down solid food. IOW, they had medical reasons for doing a revision. The rest got the sleeve because they weren't losing weight with the band.

Also, I am making a loan to pay for my surgery so I really need to find the safest surgery but with the highest success rate. I can't afford to have another surgery in a few years if this one fails.

One of the reasons I went with the sleeve is because I was self-pay. I think the sleeve makes the most sense for a self-pay. My surgeon will tell self-pays who want bypass to go for the sleeve instead because it's cheaper but just as effective.

this is to neworleanslady and MacMadame: Apparently I didn't give enough of my background the first time. So, here it goes... I have had my band since May 2007 - 19 months-I have not lost a single pound since the day I left the hospital! I lost about 10 or 12 pounds on the PRE-op diet/phase, but NOTHING since surgery. Although, I will be the first to admit that I have not followed all the band rules. I have made poor food choices and haven't exercised like I should. However, I do feel that despite that, my portions have been cut drastically, such that I should have had SOME weight loss by now. This is very upsetting, disappointing, depressing, and frustrating - to say the least. I now have 2.5 cc in my 4 cc band. I was supposed to have 4 cc in it, but lost restriction, so I had all the fluid withdrawn and measured, and lo and behold, there was only 1.5 cc in the band. Not sure yet if there is a leak or if it was just a careless fill. I'm to go back to the dr on 1/7 to have the fluid measured again. The PA I seen doesn't think there is a leak, though, because she had good "vacuum" as she was drawing the fluid out. Apparently, if the fills are given carelessly, fluid is allowed to leak out as the needle is being withdrawn from the port - which may be the case. I'm hoping for the best, but I am here to tell you that WLS is a big step, a big decision, and one that I thought I made correctly. However, it is a lot to sacrifice to wind up with no success. That being said, I know a lot of people on this site have had huge successes and I applaud each and every one of them, as the band DOES NOT WORK ALONE, you have to put forth a lot of effort as well, and that's tough (as we all know). I think it's safe for me to say that the band was not the right WLS for me - it doesn't work for everyone, and as much as I wanted to be one that it works for, I'm afraid I'm not. Granted, I have not had any terrible side effects that some have had (reflux,slippage,eroding,flipped port), and for that I'm thankful. Good luck on your decision. And, please, don't let my experience scare you away from the band, because like I've said, I am in the minority here. Thanks for your advice and any other info would be helpful.

I appreciate you sharing your info with me. Are you able to eat larger quantities of food than you expected? There seems to be a wide array of answers to that question. Is it that you are hungry or just the habits of any overweight person where we eat just because, I know I am guilty of that. I know that you are not trying to make me decide against the lap band but hearing of stories like yours and knowing how I am I really think the sleeve is my best option. I see a NP on Jan 9 and will get things started. I will keep you posted on how I do with the sleeve and such.

To Macmadame,

What do you think is a good number of sleeve surgeries or years of performing them? Also, my surgeon just calls if the "Gastric Sleeve" not the vertical gastric sleeve. I would think it is the same surgery but I guess I will double check. Are they all laproscopic procedures?

Does anyone know what the success rate is of patients who have the gastric sleeve done? I have read many posts of people who don't lose weight with the lap band and was wondering if there are the same issues with the sleeve?

Weight loss is better and faster with a sleeve per stats.

I had a band and couldn't stand it anymore. I absolutely hated my band. I tried and tried to make it work but after 4 months on liquids I couldn't do it anymore. I was getting very sick and I was getting sick enough that I wouldn't have been safe to have surgery... meaning, to remove the band. So I finally got a sleeve.

Now, i was sleeved at goal so I can't tell you personal examples of weight loss with the sleeve but I can tell you that I maintain without any effort whatsoever at a size 4/6.

anillacookie:

One doc said that the band and the sleeve are only half the solution that neither of them work as well as the mini bypass which is the sleeve and a smaller bypass. I think the verdick is still out on that one. I think they are all tools and which ever one you choose you have to learn to make it work for you.

The verdict isn't out on MGB at all. NO good surgeon will even do that surgery, only the money grubbing idiots who have a focus on income vs. patient safety will do that procedure. Only the crap surgeons such as Ruttledge (sp?) will do it. There are a few dirtbags in MX that will do it but honestly, none of the better quality and skilled surgeons with good reps will even discuss the issue.

I had a band and couldn't stand it anymore. I absolutely hated my band. I tried and tried to make it work but after 4 months on liquids I couldn't do it anymore. I was getting very sick and I was getting sick enough that I wouldn't have been safe to have surgery... meaning, to remove the band. So I finally got a sleeve.

Now, i was sleeved at goal so I can't tell you personal examples of weight loss with the sleeve but I can tell you that I maintain without any effort whatsoever at a size 4/6.

That is incredible! I can't wait to have the surgery done. How was the recovery from the lap band to the sleeve?

I had a band and couldn't stand it anymore. I absolutely hated my band. I tried and tried to make it work but after 4 months on liquids I couldn't do it anymore. I was getting very sick and I was getting sick enough that I wouldn't have been safe to have surgery... meaning, to remove the band. So I finally got a sleeve.

Now, i was sleeved at goal so I can't tell you personal examples of weight loss with the sleeve but I can tell you that I maintain without any effort whatsoever at a size 4/6.

That is incredible! I can't wait to have the surgery done. How was the recovery from the lap band to the sleeve?

Not as bad as I thought. The worst part was port location, removing the port is what hurt the most in the following two weeks. I think anyone that has a band removed will tell you that was the worst.

Other than that, it's hard to tell. I was pretty sick at the time I had my revision so I don't really know how it would compare in an otherwise healthy person.

What do you think is a good number of sleeve surgeries or years of performing them? Also, my surgeon just calls if the "Gastric Sleeve" not the vertical gastric sleeve. I would think it is the same surgery but I guess I will double check. Are they all laproscopic procedures?

It's the same procedure. People just have different names for it, probably because it's new. My surgeon calls it a veritcal gastrectomy and no sleeve in there at all.

These procedures should *always* be done lap, if at all possible. If you find someone who says they "prefer" to do them open, RUN. That means they aren't skilled enough to do them lap.

Now, you may have unique things about you that require you to be done open, but the good surgeons always start out lap and only open up if they run into situations that call for it.

How many they should have done is more what you feel comfortable with. I went to the guy who had done the most in the US (or at least the West Coast -- it's not like they have an offiical scorekeeper so maybe Gagner, on the East Coast, has done more than him, but probably not). So obviously, experience was very, very important to me. :laugh:

Your surgeon should have done AT LEAST 250 bariatric procedures. That's actually been documented -- that there is a big learning curve and it takes about 250 to get the hang of bariatric surgery.

If you are going for a sleeve, I would want him to have done 250 sleeves or 250 bypasses or 250 combination of the two, at a minimum. 250 lap-bands would not reassure me. I'd want him to have experience with staple lines and bands don't have staple lines. I also woudn't go to someone who only did bands and is now adding in the sleeve. I want someone who can do something harder than what he's going to do to me and not someone who I'm his hardest patient.

If you find someone you love, with good stats, and they have been doing bypass for years, but have just started doing the sleeve, you are going to get a decent operation, most likely. I know plenty of people who have gone to guys like that and been their 3rd or 4th sleeve and they've been happy.

OTOH, there are pitfalls. Some things to consider:

Do they understand how important it is to use a small boughie or are they going to use the same size as the DSers get? Do they understand how to deal with some of the weirdnesses that pop up? Is their after-care all bypass oriented and they are going to tell you not to eat things bypass patients can't have or not to use NSAIDs or other stuff that doesn't apply for sleeves? Do they get good results with their sleeves?

As an example, I know someone who went to a guy local to me who had a good rep as a surgeon (not as a person, but as a surgeon) and that person had some weird scar tissue on the tummy so he made her sleeve shaped like a femur and not a banana. Um, bad idea. Her stomach immediately twisted in on itself. In the end, he told her that he had to revise her to a bypass or she'd die. So now she has a bypass. Is it a coincidence that this doctor doesn't really believe in the sleeve and hadn't done too many of them? I think not.

Also, if you go to the surgeon and they tell you they haven't had as good a result with the sleeve as with bypass, that's a sign -- something about their technique or their after-care program doesn't work as well for the sleeve as it should.

It's the same procedure. People just have different names for it, probably because it's new. My surgeon calls it a veritcal gastrectomy and no sleeve in there at all.

These procedures should *always* be done lap, if at all possible. If you find someone who says they "prefer" to do them open, RUN. That means they aren't skilled enough to do them lap.

Now, you may have unique things about you that require you to be done open, but the good surgeons always start out lap and only open up if they run into situations that call for it.

How many they should have done is more what you feel comfortable with. I went to the guy who had done the most in the US (or at least the West Coast -- it's not like they have an offiical scorekeeper so maybe Gagner, on the East Coast, has done more than him, but probably not). So obviously, experience was very, very important to me. :laugh:

Your surgeon should have done AT LEAST 250 bariatric procedures. That's actually been documented -- that there is a big learning curve and it takes about 250 to get the hang of bariatric surgery.

If you are going for a sleeve, I would want him to have done 250 sleeves or 250 bypasses or 250 combination of the two, at a minimum. 250 lap-bands would not reassure me. I'd want him to have experience with staple lines and bands don't have staple lines. I also woudn't go to someone who only did bands and is now adding in the sleeve. I want someone who can do something harder than what he's going to do to me and not someone who I'm his hardest patient.

If you find someone you love, with good stats, and they have been doing bypass for years, but have just started doing the sleeve, you are going to get a decent operation, most likely. I know plenty of people who have gone to guys like that and been their 3rd or 4th sleeve and they've been happy.

OTOH, there are pitfalls. Some things to consider:

Do they understand how important it is to use a small boughie or are they going to use the same size as the DSers get? Do they understand how to deal with some of the weirdnesses that pop up? Is their after-care all bypass oriented and they are going to tell you not to eat things bypass patients can't have or not to use NSAIDs or other stuff that doesn't apply for sleeves? Do they get good results with their sleeves?

As an example, I know someone who went to a guy local to me who had a good rep as a surgeon (not as a person, but as a surgeon) and that person had some weird scar tissue on the tummy so he made her sleeve shaped like a femur and not a banana. Um, bad idea. Her stomach immediately twisted in on itself. In the end, he told her that he had to revise her to a bypass or she'd die. So now she has a bypass. Is it a coincidence that this doctor doesn't really believe in the sleeve and hadn't done too many of them? I think not.

Also, if you go to the surgeon and they tell you they haven't had as good a result with the sleeve as with bypass, that's a sign -- something about their technique or their after-care program doesn't work as well for the sleeve as it should.

Me... personally... I wouldn't go to anyone with less than 250 sleeves AND 250 bypass procedures. I wanted someone with a LOT of staple line experience.

Something you will hear sleeved people discuss a great deal is that if a surgeon isn't skilled enough to do the more difficult bypass staple lines, they won't be doing any staple lines on the majority of us. If they can only do an easy staple line, that's a concern. What if the person has a weird shaped stomach or they find a leak during surgery? I want someone that has already dealt with this previously and knows how to fix it before they wake me up.

I know your doc doesn't do any leak tests and while I agree it comes down to personal opinion, I wouldn't go to anyone that doesn't do leak tests. Mine does three leak tests and that's what I wanted. Many of us travel for surgery and some leaks won't show up immediately. I didn't want to get home and THEN discover there was a problem. With three leak tests I knew there was no leak and I was comfortable about going home.