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Why Lapband? Why Not The Sleeve?



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  1. I work in HR in the medical field. 2 years ago When I was doing my research and making my decision I asked every one I knew who worked in patient care and also in medical records to get an informal opinion poll on band vs bypass. I am not a Dr and have no medical training and have no scientific proof but .... it was overwhelming in support of the band.

    The sleeve wasnt in the discussion as I believe it was too new then but the bypass apsorption problems seemed to be the most common... lots of follow up and treatment and a lifetime of medications for many.

    Just wanted to share....

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I must admit the idea of a sleeve leakage really puts me in a quandry. I wonder if pliction instead would be the thing . they get the reduction of the stomach by folding then suture. Then Id worry about stff getting caught in the crease, and infectio. AHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH! So many CHOICES, WHAT TO DO!

wahhhh too. Sandy

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I personally couldn't justify re-routing my internal organs or hacking off 2/3 of my healthy stomach without trying some less drastic first. In my mind, the Lap Band seemed like the best starting point in the natural progression. I figured if the band didn't work then I'd consider the Sleeve.

Considering I've lost almost 160 pounds in 10 months, the band definitely works for me. I love it and getting the band was best decision I've ever made in my life.

It's important to remember that whatever you choose, WLS is just a tool, not a magic fix for fat. Be it Gastric Bypass, the Sleeve, or Lap Band the work will always be yours to do. How successful you are is dependent entirely on you- not the surgery.

Best wishes on whichever you decide.

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I was originally banded in 2008 right after my insurance started covering it. The sleeve was still experimental. This summer my band was replaced due to a leak. My doc recommended changing to a sleeve and I was supportive' date=' but insurance would would not cover a different type of weight loss surgery "one type per lifetime". Heck, I had to fight them for four months to even replace the defect. Originally they only agree to take out the defect.

I originally picked the band over bypass for the same reasons as most--reversible, to rerouting, etc. However, if I was starting new today, I would choose the sleeve over band because of the lack of follow-up fills, unfills, 40%+ failure or replacement rate over time. The sleeve is a compromise between the band and bypass and gets a weight loss rate close to the bypass.[/quote']

Just to clarify, the band is "removable" not reversible, since it does cause a lot of scar tissue and many have issues long after its removal. I'm glad I got the band, but wish the sleeve had been available to me when I had my surgery.

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Missy, you've done awesome, and represent the lapband very well. I guess I want my "first try" to be my "only try". I wouldn't do the gastric bypass because I wouldn't want to reroute my organs either. But for some reason I'm ok with cutting away half of my stomach...LOL. I also like the fact that it removes the part of your stomach that produces ghrelin, which is the hormone that stimulates appetite. Yes, I totally understand that these are all "tools" to help you in your weight loss journey, and that they all take work to make them work. The sleeve is a couple of days in the hospital and more recovery time than the band. Anybody know the price difference?

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Introducing Laparoscopic Gastric Plication

A promising - less invasive - weight loss procedure

There are several types of bariatric (surgical weight loss) procedures. Some procedures like laparoscopic gastric bypass and laparoscopic sleeve gastrectomy restrict the amount of food that can be eaten at one time and others bypass segments of the intestines to limit the absorption of calories like Roux-en-y gastric bypass. Laparoscopic Gastric Plication is a restrictive procedure that reduces the size of the stomach and limits food intake. This procedure is also referred to as Laparoscopic Greater Curvature Plication (LGCP).

Laparscopic Gastric Plication for Treatment of Severe Obesity

Stacy A. Brethauer M.D., Jason L. Harris Ph.D., Matthew Kroh M.D. and <a name="au0020">Philip R. Schauer M.D.

How Is Gastric Plication Performed?

We perform the Gastric Plication as a laparoscopic procedure. This involves making five or six small incisions in the abdomen and performing the procedure using a video camera (laparoscope) and long instruments that are placed through these small incisions.

Laparoscopic Gastric Plication, involves sewing one or more large folds in your stomach. During the Laparoscopic Gastric Plication the stomach volume is reduced about 70% which makes the stomach able to hold less and may help you eat less. There is no cutting, stapling, or removal of the stomach or intestines during the Gastric Plicaiton. The Gastric Plication may potentially be reversed or converted to another procedure if needed.

The Gastric Plication procedure is minimally invasive and takes approximately one to two hours to complete. Most patients stay in the hospital for 1-2 days after the procedure.

How Does Gastric Plication Cause Weight Loss?

Gastric Plication is a restrictive procedure. It greatly reduces the size of your stomach and limits the amount of food that can be eaten at one time. It does not cause decreased absorption of nutrients or bypass your intestines. After eating a small amount of food, you will feel full very quickly and continue to feel full for several hours. Gastric Plication may also cause a decrease in appetite.

GastricPlication1_1_1_1.jpgGastricPlication2_2_2_1.jpgGastric Plication : Reducing stomach volume by folding in the stomach wall Stiches are placed in the stomach to secure the folded stomach wall.

Who is a candidate for Laparoscopic Gastric Plication?

The Laparoscopic Gastric Plication procedure is relatively new, and considered investigational as a primary procedure for weight loss. The Gastric Plication is being offered to patients at the Cleveland Clinic as part of a clinical trial that will better define short and long-term benefits of the procedure. Currently, insurance companies do not cover the Gastric Plication Procedure. Therefore, patients are required to self-pay for the procedure. A financial coordinator from the Bariatric and Metabolic Institute will be available to discuss payment options with you.

What Are The Risks Of Laparoscopic Gastric Plication?

There are risks that are common to any laparoscopic procedure such as bleeding, infection, injury to other organs, or the need to convert to an open procedure. There is also a small risk of a leak from the suture line used to imbricate/plicate ("fold") the stomach. These problems are rare and major complications occur less than 1% of the time.

What Are The benefits Of Laparoscopic Gastric Plication?

Depending on their pre-operative weight, patients can expect to lose between 40% to 70% of their excess body weight in the first year after surgery. Many obesity-related comorbidities improve or resolve after bariatric surgery. Diabetes, hypertension, obstructive sleep apnea and abnormal cholesterol levels are improved in more than 75% of patients undergoing a bariatric procedure. Though long-term studies are not yet available, the weight loss that occurs after Gastric Plication results in significant improvement in these medical conditions in the first year after surgery.

Is Laparoscopic Gastric Plication A Good Choice For Me?

Your surgeon may talk to you about Gastric Plication as an option if you have a BMI over 27 with one or more significant co-morbid medical conditions which are generally expected to be improved, reversed, or resolved by weight loss. You should discuss all of the available surgical procedures with your surgeon and determine which procedure is best for you.

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i think im gonna take my time deciding what to do, and try to follow a 6 month diet in the mean time. this looks interesting tho, the plication as a wls in and of itself. i WONDERED why plication alone wouldnt work and now I know. it can. Sandy

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yes the plication does work, but you still have to eat proper Proteins and the allotted amounts. in combined with my band, i am doing well and it gave me back my life.

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