Hello all,

I am scheduled to have lapband surgery on 2-6-09 and now I may be

having cold feet. Does anyone know if the sleeve is better than the

band? I have been reading and doing alot of research and just cant

decide. I like that the band is ajustable but I also like that the

sleeve requires little maintenance. I am cash pay so I have to make the

right decision the first time. I am also worried about something

happening to the band and needing to have it removed, since I am cash

pay this would be terrible for me. I just need a few words of wisdom if

any of you could spare a few it would be appriciated.

Thanks,

Ann

It's normal to have cold feet close to your surgery. I think you need to think about the reasons you decided to have a band in the beginning and the reasons you think a sleeve might be better now and then do a Pros & Cons list to clarify your thinking.

For myself, I started out wanting a band because all I knew was band and bypass. When I heard about the sleeve, my immediate reaction was that it was too permanent. I liked the fact that you could take the band out if something went wrong.

But over time, as I did my research, I came to realize that *all* WLS is permanent, even the band. I also came to realize that people only get bands taken out when the bands do bad things -- things that other surgeries don't have to deal with because there is no mechanical device implanted in your body.

In the meantime, it became clear that insurance would not pay for my surgery. As a self-pay, the idea of having to pay for a band and then pay to take it out and then pay for a different surgery was too scary.

Unfortunately, the odds of this happening were too high for me to think "oh that will never happen to ME". Recently released figures show that anywhere from 25-40% of people with bands end up with a re-surgery. They don't all end up losing or replacing their bands, but a lot of them do. Those odds are too high for me to be comfortable with.

So I gave the sleeve a second look and, when I learned more about it, I was sold.

Advantages I see for the sleeve:

-Removes the part of the stomach that makes ghrelin, the hunger hormone (so you don't have a ravenous appetite)

-Removes the stretchy part of the stomach so regain due to the stomach getting too big over time is not an issue

-Stomach is fully functional, so no dumping as with bypass, and Vitamin supplementing is not as critical (though you still need to do some, particularly calcium). Also, there is no stoma so food doesn't get "stuck" per se (as it does with lap-band and bypass)

-Long-term risks are minimal; much less than lap-band.

-True restriction from day one - no living in Bandster's Hell while trying to find your sweet spot, no getting your sweet spot and then losing it, no never finding the sweet spot so you are basically just dieting (which you can do without a band)

-Better average excess weight loss than the band, similar to bypass

Advantages to the band:

-Adjustable (if your sleeve is too small or too big, oh well)

-Less short-term risk (no risk of leaks or strictures in the first 3 months)

Hope that helps!

Well, it definitely made me feel better. Thanks.

The only reason you would need to have the band removed would be if it was medically necessary. When I had to have mine removed due to infection my insurance covered it 100%. If the doctor reports it as medically necessary, it is covered even if your plan does not cover bariatric surgery, like mine does not. When I got sick I was scared to death that the removal surgery would not be covered, but my new doctor reassured me it would be covered.

As far as your choice, if I were young and planning to have children in the future, I would factor that into the equation and discuss it with my doctor.

I too chose the band, because the only other alternate at the time was bypass.

I had my band done with 8 of my coworkers and none of the others have had any problems. I am the only one who picked up a staph infection and we all saw the same doctor for the surgery and the fills (except for one).

Of course, at this point because of my problems, I can only recommend the sleeve.