Deciding between lap band & gastric bypass

[Rhonda17601 0]

Hi. I've got most of my pre-op appts taken care of, and hope to meet with the surgeon in a few weeks to schedule surgery. I'm having difficulty deciding between lap band and gastric bypass. I'm 45, 5' 5", and weigh 262. If anyone can tell me the reason they chose lap band over any other surgery, I would appreciate any and all input. Thanks!

-Rhonda

[sweetkc85 0]

Hi, i think you should consider the lapband, but in the end it's ur decision... I am 25, 5'5" 1/2, n i weigh 300lbs, i will be getting the lapband done... i chose this because i have 150 to lose, maybe if i were 400lbs or more i would do gastric, but lapband is much safer, and a more healthier way to lose weight.. just my opinion!

[JudyDF 0]

I am a nurse and have seen quite a few patients that have had many serious problems from the gastric bypass. Also the lap band is reversible. But really your surgeon is the one who should be telling you what the best procedure would be for you. I had the lap band done on March 30th and I only wish I had done it sooner! So far no probems and I have lost about 35 lbs. Good luck to you in whatever you decide to do!

[waynooo 1]

REVERSIBLE! the main reason, the second is it seems that gastric bypass is so intrusive. They reroute your intestines and make you a little tummy. I am very happy and satisfied with my choice. Armed with the knowledge that it was not something that will just happen and that I have to contribute to the weight loss has helped me become a better person. I am forced to make better food choices or I wont lose. I am also exercising and feel like a new man. The best of luck in your decision, to me it was a no brainer!

[abracadabra 0]

Rhonda,

Your decision should be made between you and your surgeon and some self-reflection.

I am 4 mos out now and feel great with my decision and my weight loss. That said, my surgeon was very clear with me that if I could not commit to regular exercise I would probably lose 20-40# tops! I am in the gym 5-7days every week since a month after surgery.

For me, I had lost weight before I considered surgery. I know I can lose it and have the right mindset to succeed and keep it off. Also, I had made many lifestyle changes prior to surgery. I am young and otherwise very healthy aside from a back injury. At this point, I didn't feel I needed to go the more drastic route of RNY. I like that I am responsible for my weight loss. I have some restriction now, but I still have more control over my choices than bypass patients do. In 4 mos postop and a little over a year since starting this process I am now down almost 90# and down 6 dress sizes. So it can be done, but takes A LOT of dedication.

If you are able and willing to commit to regular cardio and strength training as well as make the changes in your diet, then the band may be right for you. However, choosing the bypass is a great option as well. You will lose weight faster, but there are other possible complications and longer recovery. You can dump post bypass but not post band. With either surgery, vomiting and PB'ing can happen. Since bypass is malabsorptive, you can have Vitamin and mineral deficits, but these issues can happen after the band too, if you make poor choices.

Also, do not look at the band as reversible because it should not be removed except in the extreme case of severe complications. The band is placed to help you manage your weight over time. Just because you lose X pounds doesn't mean then the band can come out. Both surgeries are major abdominal procedures and are permanent except in the rare case. RNY is more drastic and requires a lot of cutting and stapling while the band involves some internal sutures around the device. Both surgeries have been proven to be safe and effective. Remember, RNY is still considered the gold standard for WLS.

In the end, both surgeries require you to exercise in order to keep the weight off. The bypass just shortens the weight loss phase. I know many people who have chosen both surgeries and each has been successful and healthy.

The choice is yours, but I encourage you to be honest with yourself- your comittment, expectations, and lifestyle. Talk to your surgeon and others who have had surgery.

Best of luck! I'm sure you'll come to the right decision for you. I wouldn't change my decision for anything!!

Edited June 17, 2010 by abracadabra

[Spartan 4]

I have to give Abracadabra a LOT of credit. Until today, I have only seen two people on this forum who ever really understood the bypass, and I’m one of them!

Abracadabra seems to “get” it. I always appreciate posts by people who are happy with what they have decided, but do not feel the need to bash other procedures.

The RNY is a very viable procedure that has been successfully performed for over 50 years. If the patient is compliant, and the surgeon is competent, the outcome can be quite easily predicted….much more so than the band, in fact.

I’m going paste a post I made here a few months ago that sums up my feelings on the Bypass, and answers most of the usual incorrect information posted by people who really do not understand the procedure:

Here it is:

The Band vs Bypass debate rears it’s ugly (and misunderstood) head once again.

Loads of baloney from all sides. So, here are a few comments on things that have been said on this thread.

And, if someone suggests that I have a Bypass Bias of some sort…that would be incorrect. Both Surgeries are quite viable, but they are meant for different classes of people. People just love to “defend” their own surgery, which is detrimental to other people who are still trying to make the decision as to what is right for them.

“The Lap-band®® is less invasive than gastric bypass surgery.”

This quote is right out of a LAP-BAND® brochure. This seems to be one of a couple of phrases that are continually regurgitated whenever the subject of Band vs. Bypass comes up. The Procedure is DIFFERENT. But this whole concept of “invasion” is pretty absurd. It is NO different than many other surgeries and procedures that are performed to correct a deficiency or malfunction in some area. We have appendixes removed, gall Bladders removed, Heart bypass surgeries, and on and on and on….we have TONS of plastic surgeries. I find it amusing that so many of the people who chose LAP-BAND® over Bypass because it’s “less invasive” are planning to have tummy tucks, facelifts….whole big pieces of skin (an organ) removed. Plastic surgery probably carries as much if not MORE risk than a GB. Not to mention all of the piercings and tattoos we have and don’t even think twice about. But a gastric Bypass? An effective surgery that has been successfully performed for nearly half a century and has benefitted hundreds of thousands of patients? Hell no! it’s too…”invasive”….funny stuff.

“Gastric bypass is physically altering your stomach forever.”

The old “irreversible” argument…..wrong again. It is, in fact, reversible. It is not something that is done very often, because it does not NEED to be performed very often. The vast majority of Gastric Bypass patients have their surgery, lose the weight they need, and continue on to live happy, productive, and HEALTHY lives. You hear of some adverse outcomes, but in virtually EVERY case, the problems occur as a result of patient non-compliance or Surgeon inexperience or incompetence. But the notion that the bypass is irreversible is NOT true. Doctors do not “advertise” the fact that it is reversible, because they do not want patients to consider it to be a temporary procedure. But it can be reversed. It’s not all that easy, but it is performed quite regularly on those who need it….which is not a lot of people.

“Gastric bypass surgery does cause you to lose more rapidly, increasing the chance of hanging loose skin... yeah I'd love to have all my weight melt off in a few months, but the idea of looking like the saggy-baggy elephant afterwards... not so appealing.”

Again…not the case in most circumstances. In many instances it depends on how much weight you have to lose. If you have 150 pounds to lose, you are going to have saggy skin regardless of what procedure you have. And, even THAT is dependant upon some very individual circumstances, such are your age, skin elasticity, etc. Also….if this element is of great concern, you do not HAVE to lose weight quickly post-bypass. You do have a LOT control over your weight loss.

“You CAN eat sugar with gastric bypass, I work with 2 people that have had it done in the past 6 months.”

This is one area where you are partially correct. I have watched this argument come and go for years on this (and other) forums. The facts are that a percentage of GB patients do experience a reaction to certain types of high-fat and sugary foods. It is what is called the “dumping syndrome”. As is the case with virtually all WLS procedures, there are no solid stats, but experienced surgeons will tell you that Dumping occurs in roughly 15 to 30 percent of GB patients. If they consume enough concentrated sugar (and in some cases that would be an astronomical amount), ALL GB patients will experience it because of the inherent mechanism by which the GB functions. And, the severity of the Dumping varies dramatically. For some patients, it is a mildly uncomfortable sensation. For others, it is more severe. MOST people who experience dumping are grateful for it.

“Even for those that get dumping syndrome, though, it goes away within two years. So, eventually, all sugar addicts have to deal w/moderating sugar (without the help of dumping).”

Not necessarily. For SOME patients, it diminishes somewhat over time, but in virtually ALL cases where dumping was present to begin with, it does continue, but, again, it CAN diminish somewhat.

“Bypass is a great surgery for some people. But it causes significant lifelong malabsorption of nutrients--which is something we are thankfully spared.”

Some nutrients are not absorbed properly post bypass. That IS one of the mechanisms of the procedure. But…..much of the BAD stuff is not absorbed as well. That is why it works. The solution to this problem is quite simple: Take your Vitamins. Period. If you take your supplements, there will almost NEVER be nutritional deficiencies. And please note: You need to take supplements post-LAP-BAND® as well. The NEED to take Supplements post Band Surgery is not quite as critical as it Post GB, but you still need to. For most GB Patients, the Supplements are a non-issue. They take them and they are just fine. No Problem. Again: Patient Compliance is key. A few Vitamins a day is a small price to pay for the benefits offered by a GB.

“And once the initial honeymoon period, the rate of weight loss success generally equalizes with ours---at a far greater lifestyle and health cost, IMO.”

Wrong again. The LAP-BAND® faction of the WLS industry loves to toss this one out with great regularity, but as presented here, it is quite incorrect. Of course, as I have stated before, there are NO solid, quantifiable research statistics on this, but most experienced, long-term Bariatric Surgeons (and not the batch of surgical clowns that have jumped on board the LAP-BAND® Gravy Train in the last few years) will tell you that the vast majority (around 85-90% by some estimations) of GB patients take the weight off, and KEEP it off, given some minor, normal weight fluctuation as age increases and time passes.

“From what I've observed, dumping makes stuck look like a walk in the park.”

Most GB patients would disagree with that, particularly those who have experienced both. Dumping is usually a mild to medium discomfort, and NOT the gut-blasting makes-you-wanna-shove-your-fist-down-your-throat-and-rip-out-your-esophagus experience that characterizes the LAP-BAND® “stuck” experience. SOME Dumping episodes can be difficult, but to suggest that Dumping “makes stuck look like a walk in the park” is ludicrous, at best.

“Don't bypass folk get food stuck from time to time? My PCP had bypass and we were talking about getting food stuck. He spoke of some incidents he'd had with chicken.”

CocoaBean, that is partly correct. What a lot of people are unaware of about the GB is that restriction is ALSO a component of this procedure. Malabsorption is the primary and fundamental mechanism that makes the GB work, but on very, very rare occasions, you can get “stuck”. MOST commonly, this occurs in the presence of a “stricture”, where the channel leading into the stoma is not wide enough, and eating without chewing properly can lead to a LAP-BAND®-like “stuck” feeling. It does not happen very often, and the stricture can be very easily corrected. However….many patients do not WANT it to be corrected….it provides another level of “forced compliance”, kind of along the lines of the LAP-BAND®. It does not happen often, but it is one of the things that CAN occur….but again, it is quite easily corrected, in a few minutes, actually. And yes, Chicken…..evil stuff…. J. Also the nature of the “sticking” is different. With the LAP-BAND®, almost anything can get stuck, it seems. And things get stuck on one day and not another. With the Bypass, the experience is very consistent, in the rare event that it does happen. And it is ALWAYS because you haven’t chewed properly or it is something you just should not have eaten.

“I registered to the site just so I could post on this thread. I just wanted to point out that my best friend had a gastric bypass 6 years ago. One of the first things she ate post-op was a slurpee. (full of sugar) To this day, she has no issues eating sugar or candy. She only got dumping at the VERY beginning. Also, she is always getting food "stuck" and trying to either get it to come back up or go down. One of the very reasons I am not a big proponent of gastric bypass is having watched her and others who have gone through one. She doesn't eat right, and im worried for her in the long term as far as nutrients and vitamins are concerned. She lost a lot of weight, yes, and she's very happy and consideres it the best decision she's ever made. Im happy for her, but I just wanted to point out that she can eat sugar and gets things stuck..................

“

With all due respect, you have a very Stupid friend. Ultimately, it is likely that her Bypass will fail. PATIENT COMPLIANCE is KEY, with the band AND the Bypass….and the Sleeve, DS, FP, and all the other more obscure procedures. And from day one, she broke the rules. But guess what: The band wouldn’t work for her either. She would have the SAME problems, and would not have lost any weight, because of the ease with which one can eat “around” the band. For some people, NO Surgery will work long-term. Your friend needs the kind of help that no surgery offers.

This whole debate over which procedure is better is pretty useless. The simple fact is that one of the procedures is better for someone than another. They are different procedures that work in different ways. One is Malabsorptive in nature, with some restriction; the other is almost entirely restriction. They are meant for DIFFERENT people with DIFFERENT eating and/or metabolic disorders. There is a certain segment of the obese population for which either one WOULD work reasonably well….But….ONE of them would be better. It is not a matter of simply picking the one that appeals to you….at least not if you want REAL success. It takes an experienced and skilled bariatric specialist to be able to help you sort out which one would be the most successful for you.

There are a number of things that make the GB a preferable surgery for many people. It’s been around a LONG time, nearly 50 years. The procedure has been refined over and over. The advent of Laparoscopic technology in the last decade has made the procedure incredibly safe. As one very experienced Bariatric Surgeon said: “If the Patient is reasonably compliant, then we can predict pretty much exactly what is going to happen…the surgery is that reliable”.

Finally, to the Original poster I would have this to say. It is difficult to know from what you have said if the Bypass would have been a better procedure for you. A “sweet tooth” is not always a specific indicator of the need for a GB, but it is a “clue”. I think that at this point in time, it would be wise for you to work with what you HAVE, rather than spend any time thinking about what you “should” have done. “Buyers remorse” is very, very common among WLS patients in the first couple of months post-op. Regardless of the surgery, most Patients will end up saying to themselves “what have I done to my body?” at some point. But, that will pass. It almost always does.

Many people have a rocky start with the LAP-BAND®. One person on this board, Erin18, I believe, had a LOT of problems at the beginning. She was quite the topic of conversation here last year because she was posting every day, if not several times a day, complaining about the difficulty she was having. But, she has gone on to lose quite a bit weight. She is one example of people who had a lot of problems initially but went on to some success.

If you do not find success with the LAP-BAND®, there are the other options. But you absolutely have to give the LAP-BAND® every chance to work. It sometimes takes a LONG time to find that “zone” where it starts working. Some people never do, but you have to give it your best shot before you start thinking about alternative procedures. It IS “doable”. It just takes time, effort, commitment….and COMPLIANCE.

S.

Edited June 17, 2010 by Spartan

[Amanda.Root 3]

There is already alot of information in this thread but here's my two cents.

I met with my surgeon recently and he spoke about upcoming weightloss technology that requires your stomach to be intact. This cemented my decision to get the LapBand. The thought of no longer having an intact stomach creeped me out. I believe all the parts of the stomach are there for a reason and it's not a good idea to mess with that.

However, my surgeon also told me that if I had more weight to lose than I do (80-100) he would've suggest bypass instead. Have you talked one-on-one with your surgeon?

[tinksmom 0]

I think when people here are talking about non-invasive surgery we are talking about not cutting into/altering/or rerouting organs. Cosmetic surgery may at times be dangerous but also does not alter organs.

One of the things mentioned about the lapband is that it leaves you pretty intact and can be reversed or revised to another type of surgery if it is not tolerated or working. I consider that it is permanent but one never knows. Surgeons here have some people who cannot lose enough and are doing vertical gastric bypasses or R-en-Y, in some cases leaving the band in place. I just never wanted to jump into more radical surgery without trying the band. I also can, if my appetite is not nagging me, control my portions and keep track of Protein and carbs. I am not a compulsive eater and seldom eat emotionally (at least not unhealthily so). So we all decided the band would most likely work. I have a friend whose husband is wanting to get the band but he has no interest whatsoever in sticking to or even planning a diet. He would probably do best with a bypass. Another thing that was brought up is that if...and I realize this is a long shot...but if I needed testing on my gastro-intestinal track it is possible with the band and gastric sleeve, but not with the roux-en-Y. My family has a history of ulcers and stomach cancer so that fact had some weight. You need to think seriously about the options. Make a list of pros and cons for each. It took me over a year to decide to go ahead with the surgery and I am comfortable with the decision. If I didn't think as much about options I would feel far less secure and in control now.