Lapbanding vrs Gastric Bypass

[flexible 0]

This is my first post. I am housesitting for someone who told me she had Gastric Bypass Surgery. She showed me her before and after pictures. I went to see her surgeon. I was favorably impress with her surgeon.

I began the discussion saying that from what I've read online, it seems like lapbanding would be a good choice. He seemed adamant against it. He said it is an easier surgery and he has done it in the past. (He has been doing weight loss surgery for 15 years.)

If I remember correctly he said it only had a 50% success rate. That many lapbanded patients don't eat correctly afterwards. And they get lots of adjustments. That the band costs about 5K and it makes more sense to go with gastric bypass.

I am 5 feet 4 inches and weigh 235-240. I was just under 200 until I moved to the Seattle area in 1999. I lived in Southern California before that and swam outside a lot and roller bladed or biked along the beach. I didn't get as much exercise in the Seattle area.

I travel a lot as a researcher. While overseas this year I stayed at some hostels and to my horror realized I snore quite loudly. I have been told this is a result of being this obese.

If I am understanding correctly, lapbanding requires less 'follow up' visits. For gastric bypass this surgeon requires the patient to attend his pre-op support group, a pre-op class at the hospital, 2 more pre-op appointments, then 2 nights in the hospital for the surgery, then visits once a week for 3 weeks, once a month for 3 months, then every 3 months for 3 years, then annually. All the 'follow up' care needs to be paid in full before the surgery.

Given my family history of obesity, strokes, diabetes, etc - I'm 99% sure I want to follow through with at least lapbanding. I'm only 75% sure that gastric bypass would be the better alternative.

I'm thinking of 'settling down' in the Las Vegas area because condos/apartments might still be reasonably priced and I can swim outdoors year round. I figure subletting a Las Vegas place would be easier when I later travel.

Any advice on how to move forward would be appreciated.

[tomorrowsdream 0]

Gastric bypass is a very invasive surgery where your intestines are re-routed, and often with problems such as major leaks. The surgery is far more risky then the more non-invasive lap banding. Everyone on here seems to be losing weight fantastically. I would never even consider gastric bypass, and my doctors would never allow me too, but they will allow me to have lap banding. Always remember lap banding can be reversed and adjusted...there is no adjustment possible with gastric bypass. My daughter had it 3 years ago. She suffers from "dumping syndrome" among other things. Everything she eats goes right through her, because of the intestinal re-routing.

I would think long and hard before I ever opted for gastric bypass. Talk to some of the bandsters on here. They seem very happy with their choice, and I think it has far more success than 50%. A lot is right there in your mindset I think.

Good luck to you.

Lots of dr's. that do gastric bypass do NOT know how to do the lapbanding procedure. It's not uncommon to find that lap band dr's. do not do gastric bypass either. My surgeon does not do gastric bypass at all. They are surely going to try and swing you to their way of thinking if all they do is gastric bypass.

[Alexandra 55]

Hi Flexible,

Welcome to LBT! You've come to a place where just about everyone decided in favor of banding over bypass, so keep that in mind. Your surgeon is looking at the two procedures from HIS point of view, with his results-oriented view of many patients having both procedures. Statistically what he says may very well be true.

But when I went into this, the statistics people threw at me went right over my head. I just didn't listen. I don't care about statistics, I cared about ME and what my life would be like post-operatively. My goal was and is to reduce my excess weight by at least 50% and to KEEP IT OFF permanently. It was not to lose 100% of my excess weight and set some sort of speed record doing it.

Banding does indeed require more attention to work correctly. But I don't see that as a negative--I need to continually be mindful of this lifelong project I'm engaged in and band adjustments go a long way in that direction. Behavior modification is a HUGE part of any weight loss program and occasional refreshers help a lot.

Your surgeon's office may have fewer surgical followup visits recommended for band patients, because the surgery itself is vastly safer and has changed nothing about your digestive system. You will not suffer malnutrition and so you don't need to be watched as closely for problems. But that's not to say you just have surgery and walk away, expecting it to work, YOU will need to schedule adjustments as needed, perhaps up to five times or more. Everyone is different in that regard. But without close attention to followup care and the correct adjustment levels you will not be as successful as you might otherwise be losing weight with the band.

[flexible 0]

Thanks for both of your replies. I can understand that the surgeon I met would be prejudiced to his preferred operation. I think the problems he encountered were with patients that weren't as committed to post -op requirements.

The surgeon did mention requirements such as a comprehensive/medical/cardiac evaluation by a primary care physician or internist that includes at minimum:

Chest X-Ray

EKG

CBC, Chem 25, ferritin, Iron, TSH, H.Pylori Screen

B12 level

Cardiac Stress Test (done by PCP or Cardiologist)

Are similar tests required from lapbanding surgeons? If so, maybe I should go ahead and have them done and have copy of the results when I meet with a lapbanding surgeon?

I did have extensive labs and tests done from 1996-1998 when I had excellent insurance. And I've had two surgeries: septoplasty and liposuction. So I am familiar with the hospital wanting some lab work done within a day or so before an operation.

[pamela 10]

Hi Flexible!

I was just banded 2 weeks ago. I made the decision to go with the band for several reasons. It's less invasive, and I have a very good friend who had gastric bypass and has had some major problems because of it. Plus, she has gained 60 lbs back since losing 150 lbs. Of course, she is able to eat anything at this point. I thought the band would give me more control, what with the fills and all. It's also reversible, just in case...

I thought long and hard about this. At one point, I was ready to go with the Bypass, but after some long soul searching, I think the band was definately the right decision for me.

Good luck!

[tomorrowsdream 0]

I have been getting all my lab work done before hand. It requires a sleep study, which has taken me a mo. to complete. It might be a good thing to get out of the way as it is a requirement. The lab testing is the same I think, so if you want to start out getting them done, that's the way I did it. I haven't been banded yet, but only have the psych eval. to get through now.

[flexible 0]

Are sleep studies a standard requirement for lapbanding? Or is it because you have sleep apnea.

I had a sleep study in 1997 which showed I had 'restless legs syndrome.' This was shortly before I had a septoplasty to open my breathing. The neurologist who evaluated the sleep study suggested I have chin liposuction at the same time as the excess fat in the chin could be adding to my problems. So I had that.

When I was in the Mid West recently during ragweed allergy season I went to a ENT. He ordered a CT Scan of my sinuses. The nurse later read that report on the phone and gave me the impression it didn't indicate sinus surgery.

One of my concerns about all the testing and labs before lapbanding is the 'co-pay' costs and time to get everything done.

Were other people on this forum required to do a sleep study? Or only if you snore etc?

["with the band" 1]

Please - please - consider lap-banding over the gastric bypass. You are the perfect candidate at your height and weight.

If you hang around the boards here and look at the people's posts and their weight losses and starting points - you would see that you have a great chance with the band.

You would be better off with the band than any other treatment. From all of my research - I knew that was best for me.

Take care - nancy

[Thinjen 0]

Never ask a barber if he thinks you need a haircut.

[seehawksimms 0]

It appears that for most of us here at LapbandTalk. Gastric bypass was too radical and irreversible. No Malnutrition with excellent weight loss results. Since I have been doing my research, I have ran across a number of posts from people who had some form of bypass and followed up with a lapband. It ain't magic. It's a tool. You can succeed or fail on either course but for me, the thought of permanently altering my ability to absorb nutrients via gastric bypass, the longer recovery time, the higher death rate, and the fact you can stretch your remodeled stomach out again turned me against the bypass. Actually, I never considered the bypass since I have only the same 80 or so pounds to lose for the umpteenth time and the bypass scared the crap out of me. The lapband seems like a walk in the park. I am a newbie but have read just about everything I could get my hands on re:Lapband and to me it represented hope withot the giant risk of bypass. I am only sorry I didn't hear about it earlier in my life. I like to move forward fast and was just banded on 10/22/05. Was off work only 1 day and feel terrific. Little itchy on the port site but everything else is healed.

dd

[flexible 0]

I've pretty much decided Lapbanding will be my choice.

The surgeon I met has a support group of gastric bypass patients. Are the procedures so different that there is little of any value to attend?

Or is nutrition post-op similar? And maybe I could learn a little about that.

p.s. to seahawksimms. I have a timeshare with a nice property in Puerta Vallarta. But I've hesitated to go because of my weight. Do you go there regularly? And do you go back for fills?

[seehawksimms 0]

Wow.. too bad. PV was very nice although I didn't see much of it. I will go back for a fill when 6 weeks post op. Only 2weeks out now.

Next time I go, I am taking my clubs and spending a few days. I stayed at the Krystal which was very nice. Not 5 star but very adequate and well run. Great pool and poolside restaurant.

Dr.Joya was nice and he operates in a hospital rather than a clinic which I thought was a bonus if there were unforeseen complications with the surgery. Something that would require intensive care for example. Total fee, airfare hotel, hospital was $8K. I had zero complications other than nausea from the general anesthetic which I have had before. Surgery takes less than an hour. Hospital small and clean.

[tomorrowsdream 0]

I attended the seminar (which by the way is the first step) and got an application and the labs, etc. that were required. A sleep test was a requirement. That's why I went ahead and got one scheduled. Never thought a thing about it, and it turns out I have severe sleep apnea. I go next Sat. night again to get put on the C-pap overnight to find how much I should be on. My dr. requires you go into surgery with the C-pap. This, or any surgery, is extremely dangerous if you have sleep apnea. It is very common with people that are overweight, and lots don't know they have it. You can stop breathing under anesthesia if you have sleep apnea and are not being treated. That doesn't sound like a very good alternative to me. I'm darned glad I found out beforehand I had it. However, I may have to see an ENT anyway because I'm not breathing very well out of one nostril. It seems like it is one thing after another...but I'm sure the day will come when I will have the surgery.

I think the choice between gastric bypass and lap banding is truly a no brainer when you consider the complications that are involved with the gastric bypass. I'm not big on having my intestines cut and re-routed. Good luck to you.

[flexible 0]

I was in Ohio in September. I'd been to Ohio many times before but not in September. Apparently 'ragweed allergies' are prevalent in the MidWest. It might be called 'seasonal allergies.'

When I was in grade school weight was not a problem. I would nearly faint when our school would be inside an unairconditioned church in Florida. About 15 minutes before the end of the services I had to walk out. My friends thought it was a prank. But the nuns probably knew it was breathing issues.

I rarely recall breathing out of both nostrils at the same time. When I took a yoga class in 1997, the yoga instructor asked why I wasn't breathing out of both nostrils. When I told her I rarely did, she told me to tell my doctor. That led to the septoplasty to open the breathing. I felt like a new person when I woke.

I've heard the 'polyps' can grow back in the sinuses and the sinus surgery can need to be done. Not sure if I understand that right.

I went to a ENT in Ohio this September. He explained that these are separate and distinct problems:

1) allergies to things like ragweed

2) sinus problems

3) sleep apnea

I can't remember all of what he said right now, but it crystalized that I had lumped the problems and their solutions together before.

I had thorough allergy testing done in 1997 in Southern California but since I moved away and have been traveling frequently, he suggested I wait until I know where I'll settle before getting allergy tested again.

He ordered a CT Scan of the sinuses. The nurse read the report to me. I'm waiting to get a copy mailed to me.

You are right that sleep apnea is frequently associated with obesity.

Anyways, I wrote all this so you might research sinus issues or breathing issues.

[PinkMary 3]

my surgeon husband (urologist) is against Gastric ByPass and he wouldn't let me do it

.. he is calling GB as permanent disability, irrepealable operation.. etc