Lap Band vs. the Sleeve

[dani_nyc 224]

3 words to remember

Adjustable... Replaceable... Removable

And

No matter which WLS surgery you have. If you do not follow a good diet and do the work.. You will gain the weight back!

[d9leigh 31]

Doctors have been doing plication surgery for many many years.. But for other reasons. They find it gives almost the same effect as sleeve surgery + lap band and cuts down on hunger after surgery. Also they are not cutting into your Stomach. They fold it Into 1/3 and put sutures in .. This is always reversible.

[☠carolinagirl☠ 18,721]

which ever you get, please keep in mind that it is not a miracle and just having the surgery wont make anyone lose weight..complete mental changes must be made...my surgery saved my life..i hope it saves yours also..

[Baba Wawa 543]

Thanks for the study!! I guess I am just so nervous about gaining the weight back. I found out I have Hoshimotos (autoimmune disorder that attacks the thyroid) gained 93lbs in a year and have been trying to loose it ever since. I was able to loose 30, but I ended up gaining it all back after my grandmother died last year because of helping my mom with all of the stress/stuff that comes with that... What would you say is key after getting banded to keep the weight off? I'm not a huge fan of support groups (no reason, just not). Obviously the exercise and diet is a huge factor, but anything else? Maybe some good questions I should ask the surgeon when I see him? I am a teacher so I'd like to have the surgery over the summer when I'll know I'll have plenty of time off.

Autoimmune disorders are not compatible with the gastric band, per Allergan's own disclaimer. The sleeve will work similarly to the band (portion control) but won't fire up your hashimoto disease.

Someone said they didn't want to give up ice cream for life? I assume it was due to dumping? It's pretty unusual for a sleeve to cause dumping. It's not nearly as severe as with RNY and for most, diminishes with time.

[DELETE THIS ACCOUNT! 12,703]

Autoimmune disorders are not compatible with the gastric band, per Allergan's own disclaimer. The sleeve will work similarly to the band (portion control) but won't fire up your hashimoto disease.

Someone said they didn't want to give up ice cream for life? I assume it was due to dumping? It's pretty unusual for a sleeve to cause dumping. It's not nearly as severe as with RNY and for most, diminishes with time.

There are many people with autoimmune diseases and the band with zero problems- including myself.

The contradictions that Allergan list are no different than any other drug or device on the market. They have to list all the possible issues to save themselves from lawsuits.

It's no different than the birth control not be recommended for women over age 35. Hundreds of thousands of women over 35 take the pill without a problem but they have to list it in the warning for their own protection.

[Baba Wawa 543]

Actually, I've been told by my band doctor and GI doctor that they will not recommend banding for those with autoimmune disorders. There are so many Lapband patients whose conditions flare up or who are developing them post band that they just don't see that the risk outweighs the benefits.

The support groups for those with failed bands are full of people with long term problems due to their body rejecting the band.

[DELETE THIS ACCOUNT! 12,703]

Actually, I've been told by my band doctor and GI doctor that they will not recommend banding for those with autoimmune disorders. There are so many Lapband patients whose conditions flare up or who are developing them post band that they just don't see that the risk outweighs the benefits.

The support groups for those with failed bands are full of people with long term problems due to their body rejecting the band.

Ok I am copy/pasting exactly what I put on your other thread. It is NOT all autoimmune diseases so please stop incorrectly telling people that;

---------------------------------------------------------------------

Again, that's not true. It doesn't say ALL autoimmune diseases, it says connective tissue diseases.

Directly from your link:

"You or someone in your family has an autoimmune connective tissue disease. That might be a disease such as systemic lupus erythematosus or scleroderma"

Not all autoimmune diseases are connective tissue diseases, in fact the majority of them are not. Their warning does not cover all autoimmune diseases.

[Bibliophile 2]

In some ways, this is like asking people - "who belongs to the best church?" Unless you've directly experienced a negative outcome, you're inclined to shout-out the benefits.

I have had the band a little over 3 months and I am still on the fence ---- however, I will say it has not worked the way I expected it to and I am now looking at a possible complication. The complication rates were downplayed (as they often are on this board) to me. The only true way to know is to look at the peer-reviewed, scientific studies (not the studies supported by those profiting by the band). Go to the PubMed site and search for terms like "gastric band" and "complications" "weight loss" "effective" etc.. Here are two I recently found:

Surg Clin North Am. 2011 Dec;91(6):1249-64, ix. doi: 10.1016/j.suc.2011.08.008.

Complications of adjustable gastric banding.

Snow JM, Severson PA. Source: Minnesota Institute for Minimally Invasive Surgery, MIMIS Weight Loss Center, 320 East Main Street, Crosby, MN 56441, USA.

Abstract: Adjustable gastric banding (AGB) has become increasingly used by bariatric surgeons and their patients as the surgical weight loss procedure of choice. The popularity of this procedure is in large part a result of the remarkable safety profile and low initial complication rate. Complications of AGB were initially believed to be minor and infrequent, but longer-term studies have increasingly described complications that lead to revisional surgery. In addition, a larger fraction of patients fail to lose weight than with other surgical weight loss procedures, frequently necessitating conversion to these other options.

Obes Surg. 2010 Sep;20(9):1206-14. doi: 10.1007/s11695-010-0205-0.

Graft survival and complications after laparoscopic gastric banding for morbid obesity--lessons learned from a 12-year experience.

Naef M, Mouton WG, Naef U, Kummer O, Muggli B, Wagner HE.

Source: Department of Surgery, Spital STS AG Thun, 3600, Thun, Switzerland.

" ... In the present long-term high-participation follow-up study, LAGB is a safe and effective surgical treatment for morbid obesity. However, the high complication, re-operation, and long-term failure rates lead to the conclusion that LAGB should be performed in selected cases only, until reliable criteria for patients at low risk for long-term complications are developed."

[Frederic 500]

First off' date=' congratulations on really weighing your options! Here are some of the pros and cons of each. Both surgeries are done in the less invasive laparoscopic procedure. In both surgeries there is cutting of tissue. One implants a device, which can fail. In VSG, the fundus of the stomach is removed.

Lap Band cons: long term complications are becoming more and more frequent, and per their own website for professionals, http://www.lapband.com/hcp/en/risk_information/

25% of bands needed to be removed.

More and more, motility disorders, auto-immune disorders and nerve damage are occurring. This is information that you won't find in a study, but all over other WLS sites and on FB pages dedicated to assisting and supporting Lapband pts with complications.

VSG: true, the immediate post-op period is a bit riskier than with Lapband, but the re operation rate is so much less. The biggest risk is a leak on the staple line (1%).

The recovery from VSG is longer. Bear in mind that most of the 25% of band pts who have their band removed, revise to VSG. Why not just get the VSG in the first place?

There are some who will tell you that if you follow all the "rules" you won't have complications. It's simply not true, you can do everything right and still fail. There are too many variables with banding. Things like surgical skill, individual anatomy, post op diet protocol, pt compliance, and the skill with which fills are given are all factors all factor into how you'll do. You only control ONE aspect of your experience...compliance.

Resources:

https://www.facebook.com/groups/FailedBands/

https://www.facebook.com/groups/548645781829528/

https://www.facebook.com/groups/ResearchingLapBand/

[/quote']

I understand this is an attempt to be objective but these are not good research points. The trouble with Facebook is that by the nature of it's alogirythyms it self reinforces viewpoints. You can get a much better sample for comparing surgeries by dong a google search for "WLS surgery comparisons" and skipping an study appearing on a website by a manufacturer or surgical group. In my research I've fond the success rate and overall weightloss between all of the procedures is about the same at 3 years post op.

So considering those details I decided I'd prefer lap band because it is less invasive, it's dietary guidelines were most inline with my existing habits, and it is the only reversible option.

Regarding the sleeve specifically my research showed it was often only a first surgery and a second more invasive surgery was performed once sufficient weight was lost.

[Lori123 170]

I realize this is a lap Band forum' date=' but I was curious as to how you were able to make your decision to have the lap band done and not the vertical sleeve. I have been researching things for a year and I still can't decide. I am young (24) and would still like to have kids, but I can not see any more pros or cons for either. I would LOVE your advice/opinions. I chickened out and got cold feet last April because I couldn't decide and now I have an appointment on the 29th and I find myself in the same situation. Please help!![/quote']

Remember the sleeve is permanent- they CUT away some of your stomach. The band isn't permanent if you don't want it to be and they don't cut anything away. Any WLS requires work on your part but I would much rather try the less invasive first

[Frederic 500]

Thanks for the study!! I guess I am just so nervous about gaining the weight back. I found out I have Hoshimotos (autoimmune disorder that attacks the thyroid) gained 93lbs in a year and have been trying to loose it ever since. I was able to loose 30' date=' but I ended up gaining it all back after my grandmother died last year because of helping my mom with all of the stress/stuff that comes with that... What would you say is key after getting banded to keep the weight off? I'm not a huge fan of support groups (no reason, just not). Obviously the exercise and diet is a huge factor, but anything else? Maybe some good questions I should ask the surgeon when I see him? I am a teacher so I'd like to have the surgery over the summer when I'll know I'll have plenty of time off.[/quote']

The most common factor I see among failed WLS is the patient was unprepared for the needed behavior changes after the surgery. Just as important as looking at how the surgeries work is learning about he Long term diet and activity changes. Try to follow those guidelines before you make your decision to see how easily you can adapt to them.

[Bibliophile 2]

The most common factor I see among failed WLS is the patient was unprepared for the needed behavior changes after the surgery. Just as important as looking at how the surgeries work is learning about he Long term diet and activity changes.

Just curious because I've often mused on this ------ shouldn't the effectiveness of a WLS be judged overall and independantly of individual "effort?"

I've wondered about this because if a major criteria for success is to be able to follow a diet and exercise program, WLS would rarely be needed.

[DELETE THIS ACCOUNT! 12,703]

Just curious because I've often mused on this ------ shouldn't the effectiveness of a WLS be judged overall and independantly of individual "effort?"

I've wondered about this because if a major criteria for success is to be able to follow a diet and exercise program, WLS would rarely be needed.

I think it has to be judged on individual effort because there's so many variables based strictly on patient compliance and behavior. You can meet one person who lost 100% of their excess weight because they did everything they were supposed do and another who lost only 20% of their excess weight because they simply didn't make the necessary changes.

I think this is why I get upset when I hear "statistically speaking, band patients will lose 50% of their excess weight". That statistic is trying to take an average between the successes and failures, which quite honestly I don't think is fair and gives people falsely low expectations of the band. You can lose 100% of your excess weight just like you can also 100% fail- and both outcomes are largely in your hands to control and decide.

The majority of your success, or failure, with any WLS is in the patient's control.

[Frederic 500]

Just curious because I've often mused on this ------ shouldn't the effectiveness of a WLS be judged overall and independantly of individual "effort?"

I've wondered about this because if a major criteria for success is to be able to follow a diet and exercise program' date=' WLS would rarely be needed.[/quote']

That is a horrible misconception rooted in our poor understanding of how human nutrition works. Only in the last decade have we started to understand the connection between metabolism and the satiety response. It's not a matter of just Portion Control and exercise our bodies respond to complex chemicals in our food by releasing other complex chemicals. We have not evolved as quickly as our diets have changed so while some of our metabolism a are ideally suited for specific diets and climates are lifestyles and nutrion profiles don't match that anymore. Arguably the reason WLS is so effective at addressing diabetes is the improved satiation reduces insulin resistance which heightens metabolism. So not only do you eat less but your body actually digests the food better and exercise is more effective. This is possibly a reason Lap band is even more effective with Diabetics since it doesn't include malabsorption.

[Baba Wawa 543]

I understand this is an attempt to be objective but these are not good research points. The trouble with Facebook is that by the nature of it's alogirythyms it self reinforces viewpoints. You can get a much better sample for comparing surgeries by dong a google search for "WLS surgery comparisons" and skipping an study appearing on a website by a manufacturer or surgical group. In my research I've fond the success rate and overall weightloss between all of the procedures is about the same at 3 years post op.

So considering those details I decided I'd prefer lap band because it is less invasive, it's dietary guidelines were most inline with my existing habits, and it is the only reversible option.

Regarding the sleeve specifically my research showed it was often only a first surgery and a second more invasive surgery was performed once sufficient weight was lost.

So all of these real people's experiences are discredited because they've posted them on Facebook?

As far as the two stage VSG/DS point. It was that way early on and still is for super MO folks in some situations. What they found doing the 2 stage DS is that many people lost successfully on the first surgery, VSG, and there was no need to do the second, malabsorptive procedure to revise to DS. Also, partial gastrectomy has been done since the late 1800's to treat cancer, ulcers etc and those people have lived normal lives with just part of their stomach.

Bear in mind, I'm not "anti-band", I have one and have lost 90 lbs. BUT, as a person with a pre-existing inflammatory GI disease aggravated by the band and facing removal/revision, I would not make the decision to get one today. I love that my band has helped me to lose and maintain the loss, restored my mobility and improved my overall quality of life, but my GI tract is truly not functioning as it should and this makes life pretty miserable a lot of the time.