I have had a lapband for almost 3 years. During that time, I have lost 120 pounds. Last summer my band slipped and was replaced in the same surgery. I had a miserable 4 months of pbing and vomiting before I finally realized that the problems weren't me and something was wrong with my band (I'm a slow learner). Since getting my new band I have had a lot of nausea. ALOT! It doesn't seem that the new band had ever reallly worked well, but I have had some restriction and been able to maintain my weight. I just found out Wednesday that my band has slipped again! All the fluid has been taken out of the band and I find that my appetite has really picked up. I'm so afraid of gaining weight back. My doctor has suggested the vertical gastric sleeve and I am seriously considering it. It seems like a drastic move, but the anxiety of gaining weight is very strong. I'm wondering if those that have had the band removed have been able to maintain and or lose weight, if they had an alternative surgery or they wish they had had an alternative surgery? I would appreciate any and all feedback. My doctor is willing to do the revision for free. Just not sure what is the best thing to do. Thanks!

Esmeralda: My band has to come out and I will still have to pay the hospital, etc. just like I did this summer. Unfortunately, my lapband has been a very expensive propostion for my family.

Dr. Pleatman: Is that what you charge when you have to remove a lap band also? Doesn't the company that makes the lap band do anything for the patient when their band fails? Is this why my doc says he'll do the surgery for "free?" I did check out your website and I was impressed. Also watched a video on U Tube where you are demonstrating a sleeve procedure. It was very interesting. If I had complications you would be a long ways from me, but it sounds tempting.

It costs $2000 more if your old band is being removed at the same time. The company that makes the LapBand will only pay if you can prove that the band was defective. Slipped or eroded bands wouldn't be covered. Leaking bands generally leak because they were punctured by a needle during implantation. Basically you are out of luck.

Taking out a band is a trivial procedure; converting to a sleeve is not. It is a tragedy for the patient to remove the band; that's why I always recommend conversion to sleeve or bypass.

By the way, someone asked if business is slow. Happily, it is not. I would just like to get the word out that the band is a dying operation, and will probably go away in the next few years. I am saddened every time I get a call from a patient who just came back from Mexico, asking to have their band adjusted by me. Rarely have they even HEARD OF sleeve gastectomy.

Today I was chatting with the company rep from Covidien, who partners with Allergan, makers of LapBand. Even she said that they are predicting that the LapBAND will soon be obsolete!

Mark Pleatman MD

It costs $2000 more if your old band is being removed at the same time. The company that makes the LapBand will only pay if you can prove that the band was defective. Slipped or eroded bands wouldn't be covered. Leaking bands generally leak because they were punctured by a needle during implantation. Basically you are out of luck.

Taking out a band is a trivial procedure; converting to a sleeve is not. It is a tragedy for the patient to remove the band; that's why I always recommend conversion to sleeve or bypass.

By the way, someone asked if business is slow. Happily, it is not. I would just like to get the word out that the band is a dying operation, and will probably go away in the next few years. I am saddened every time I get a call from a patient who just came back from Mexico, asking to have their band adjusted by me. Rarely have they even HEARD OF sleeve gastectomy.

Today I was chatting with the company rep from Covidien, who partners with Allergan, makers of LapBand. Even she said that they are predicting that the LapBAND will soon be obsolete!

Mark Pleatman MD

How odd.... when you look at the boards most posting here were banded in the US and they have never heard of the sleeve. I question why you always try to get your digs in for Mexican doctors?

I think one of the big problems in the US is that there aren't many "good" sleeve surgeons. Most surgeons do bands or bands and bypass only. They don't tell patients about the sleeve because they don't DO the sleeve. They aren't going to push a procedure they don't do. Since most bariatric doctors in the US are holding the seminars that US patients are going to during their research, I question why the US folks are not educated when they get to MX for their surgery. So when you infer that it is just the Mexican banded patients that don't know about the sleeve, aren't you really knocking US surgeons? I don't know, I'm looking through the boards now and US patients banded or not do not know about the sleeve. Your digs to MX surgeons are not very professional as a bariatric surgeon.

I just saw my doc in Mexico recently when I went to him with a friend for her band fill. I asked him how many bands vs. sleeves he's doing. He's doing mostly sleeves and very few bands. Only for those that insist on a band. Lucky for us (those who had surgery in MX) all the better MX surgeons have always done bands, sleeves, and bypass. It just wasn't popular until Cirangle's studies came out.

Some of the MX surgeons are extremely good, my doctor has done over 500 sleeves and hasn't had a leak yet, how many have you done and how many leaks have you had?

Two of the mods here on LBT were revised (one yesterday and one today) and another next month... they are all getting band to sleeve revisions by the same doc I went to. There are several excellent band/sleeve/bypass surgeons in MX. Considering the type of sugery most don't really want this procedure done on an outpatient basis or one night in the hospital. They want 3 nights in a hospital, they want the leak tests, they don't want to cut corners.

I'm glad Allergan realizes that the band isn't working well. First the mesh band, then the non adjustable band, then the small adjustable band, now the mega big adjustable band... for 40 years medicine has been trying to find one that works. Finally they are catching on that it's a sinking ship.

I appologize if it sounded as if I was criticizing only Mexican surgeons; US surgeons are probably just as guilty. The fact is that I don't generally see band patients from other US surgeons.

I agree with you that there are many excellent Mexican surgeons. The surgeon who trained me in LapBand is from Mexico! I've been to his clinic, and have done surgery at his hospital.

Finally you ask about leaks. I've had a few. You say your surgeon has done more than 500 sleeve gastrectomies and has never had a leak. If he's telling the truth, that's great.

Mark Pleatman MD

I appologize if it sounded as if I was criticizing only Mexican surgeons; US surgeons are probably just as guilty. The fact is that I don't generally see band patients from other US surgeons.

I agree with you that there are many excellent Mexican surgeons. The surgeon who trained me in LapBand is from Mexico! I've been to his clinic, and have done surgery at his hospital.

Finally you ask about leaks. I've had a few. You say your surgeon has done more than 500 sleeve gastrectomies and has never had a leak. If he's telling the truth, that's great.

Mark Pleatman MD

Yes, Dr. Pleatman, he's telling the truth. Most of his patients post on his own e-group following surgery. We all discuss the good and bad of surgery, surgeon, hospital, risks, complications, etc. Never has a sleeve patient of his ever told of a leak on his own board, OH, here, or anywhere else. I know, I researched the heck out of it before my own revision from band to sleeve. More support for his stats. Considering the type of affiliations he has he would be a fool to lie about such a thing.

Something I have noticed is that only the bad surgeons lie about their stats. The better surgeons really don't have a need to lie.

I do wish all surgeons would tell people of their options. But, they don't. That is sad.