Lap Band vs Sleeve

[MacMadame 81]

I'm so worried that if I get the sleeve and not the RNY that I won't have much success ( I say this because I'm self Pay)

My surgeon finds his sleeve patients do as well as his RnY patients initially and have less issues with regain. At least they have less issues with regain since they started using the 32 f boughie. When they used the 48 f, regain was a problem.

RnY is a very different surgery than VSG so it's not like it's just VSG plus malabsorption.

[attitudefree 2]

I am kinda disappointed. Two weeks ago I was told my insurance paid for either the band or the sleeve. So I read and researched and decided on the sleeve. Today I went to the Dr they said insurance "sometimes" payes for the sleeve but always payes for the band and gastric bypass. I just don't want the complications of the band, so keep your fingers crossed for my insurance coverage!!!

[Oregondaisy 2,021]

will keep fingers crossed. The band is just plain a bad idea for anyone. It may be great at first, but the complications always seem to come down the road.

[attitudefree 2]

My surgeon told me that gastric bypass and the sleeve were very similiar. In your opinion what are the problems with gastric bypass?

[Jaffa 5]

I can't speak from personal experience about the bypass. But, what I have learned, and what I don't like about bypass, is that it has a lot more follow up care. You are not removing the ghrelin producing part as much, even though there are studies that show it goes down for awhile. But, the biggest thing is regain. I think the regain is much more likely with bypass over sleeve. Mostly because of the stretchy nature of the stomach that is left, and I think the ghrelin returns or is left much stronger, making you want to over eat.

I'm not saying that it isn't right for the right person, but for most, I don't think it is really the best surgery.

I would get a sleeve, then later if I still need more help add the DS. But, I think that is rarely necessary?

[WASaBubbleButt 41]

My surgeon told me that gastric bypass and the sleeve were very similiar. In your opinion what are the problems with gastric bypass?

The bypass pouch is not very forgiving. Once you stretch it out your restriction is toast and there is no repair yet they have found that works. The sleeved stomach is made from the more muscular portion of the stomach. You use your pyloric valve where with bypass they make a stoma for you (looks like a paper punch at the bottom of the pouch that is essentially a drain). When that stretches you have no restriction and no "full" sensation.

People believe they malabsorb forever, they do not. Ever hear of the "honeymoon" period of bypass? That's when they are malabsorbing. Nutrition is always malabsorbed, calories are not.

Bypass carries a significant mortality rate. Leaks, obstructions, malnutrition, osteoporosis, strictures, anemia, bleeding, allllll kinds of complications can happen and not just out of surgery but for the rest of your life.

We overeat, it's what we do. Each time you overeat you stretch your pouch just a bit more. Since the pouch is made from the elastic portion of the stomach this is a problem. Can you stop overeating now? If not, do you think you could stop overeating later? Overeating is eating until you are full instead of satisfied. We don't do that well and that is what got us fat.

One in five fail bypass and I can see why, I probably would too. The sleeved stomach is much more forgiving than the bypassed pouch.

I honestly do not see how bypass and sleeves are the least bit similar. The sleeved stomach is made from the muscular portion of your stomach. The bypassed pouch is made from the elastic portion. The sleeved stomach uses the pyloric valve at the bottom of your stomach. The bypassed pouch has the valve stapled off and they make a stoma, or a drain at the bottom of your stomach. Sleeved people do not have any bypassed intestine. Bypassed people have 120-150cm of small intestine bypassed. Sleeved people do not malabsorb, bypassed folks do. Sleeved people do not have to take mega supplements for life, bypassed folks do. I can only guess that your doc is trying to give you a level of comfort with bypass by giving you the impression that sleeves and bypass are similar?

If you fail bypass your options for revision are extremely limited. If you fail a sleeve your options are open for a revision.

Edited June 12, 2009 by WASaBubbleButt

[Lisanne 5]

I considered the Band in the beginning, before I was introduced to the Sleeve. I read of too many people with complications with the Band, so I opted with the Sleeve. I know some people do well with the Band and Im happy for them, but as a nurse, I understand the anatomy and what the Band can do to cause problems. It just wasnt a risk that I was willing to take. However, any of the surgeries are a risk. You just have to research and choose the best one for you. I might think the Sleeve is the best surgery...but Im not going to say that its the best for everyone. That decision is up to you.

hugs 'n love,

Lisa

[Oregondaisy 2,021]

WasA explained it exactly right. I know many many people who have had gastric bypass and I can count the people on one hand who have not gained most or all of their weight back.

[MacMadame 81]

My surgeon told me that gastric bypass and the sleeve were very similiar. In your opinion what are the problems with gastric bypass?

I wonder what he meant by that because, they aren't very much alike at all mechanically. Weight loss is similar. But that's about it.

[Bornagainbabe 4]

I had nothing but problems with my band too. I am awaiting sleeve surgery so I can't make any comparisons yet but I suffered slippage twice, due to no fault of my own, horrendous acid reflux (I am right with you there on sleeping in a chair Elisabeth) from which I woke nightly choking and eventually vomiting up the contents of my pouch, what else? Pains in chest and back, indigestion, etc. etc. I lived with it as I was also losing a lot of weight in the process but I was tired and miserable all the time. I had to keep going for fills and would think I was well-restricted and then I would have to go back because I wasn't restricted enough and then I was over-restricted and slippage had occurred, and so on.....Plus the pain when something gets stuck is awful and different foods can have a different effect on different people so you can't really follow the band diet by the book so to speak. It can be a lot of trial and error and when you do a problem you really do have to find a toilet very quickly to be sick in. My band is not fully effective at the moment, but I was starving and shared soem fried chicken and chips at a motorway services last week with my daughter. Big mistake! I shovelled the food down and then regretted it as later on whilst driving down the motorway I had to pull over to be sick. I had had this nagging pain all the time I was driving and was writhing around. Only the coffee came up that time but 2 hours (!!!) later I had to pull over again and only had time to grab a tupperware box from out of the back into which I brought up all the chicken and chips. Nice! My daughter was not impressed at all. And I have had my band nearly 2 years so you would think I would know better....!

[WASaBubbleButt 41]

And I have had my band nearly 2 years so you would think I would know better....!

I relate to that. There were times that I knew something wasn't going to go down but I was hungry and decided "this" time would be different and it would magically go down. HA! No such luck!

I have a banded friend that pukes so much her 2 year old daughter thought it was a game. My friend would start to hurl and Ava would mimic her. That's when she made it a point not to hurl in front of Ava.

[Oregondaisy 2,021]

I certainly don't miss waking up from a sound sleep with my dinner from 5 pm in my throat.

And I am down another 2 lbs this am.

[Malaika 50]

I certainly don't miss waking up from a sound sleep with my dinner from 5 pm in my throat.

And I am down another 2 lbs this am.

Congratulations - that's great!

[AJW 18]

After reading these stories, I'm convinced that the sleeve is the right procedure. Either that or I can keep doing Medifast for another year to lose the 97 pounds I have left to go. I think it would be a real draw between losing weight with a band and staying Medifast; the end result would be about the same amount of loss. The thing is, I can't do Medifast for another year and as soon as you transition to normal food, the weight will come back.

I've been communicating with my band doctor's surgical consultant because he also does the sleeve procedure. I've asked for a quote because I'm pretty sure that my insurance (Healthnet PPO) will not pay for it, but of course I'll confirm that first. No one at the doc's office is getting back to me; I think they're too busy scheduling band patients to pay attention to me, which is weird. Yes, I could go to Mexico - I could drive down to Mexicali where Dr. Aceves is in about 4.5 hours. I'm still just "iffy" about the Mexico thing. I know those who went had good experiences, but I'm the type who gets nervous about getting blood taken, kwim? So going so far out of my comfort zone is rather scary to put it mildly. I always insist on Lidocaine before IV insertion, wonder if they'd coddle me like that down there, or is everything done their way or not at all? These are questions I wonder about. In the meantime am waiting for my ulcer to heal that was discovered on June 5th at EDG. Questions to mull over.:001_unsure:

[Malaika 50]

Eyfura has a fear of needles -- she would be able to tell you of her experience.

As for the IV - mine was put in in the OR and I wasn't "there" for it ... the pills they give you beforehand are very nice. I have no memory of any of it.

I will say that the gal who drew my blood did the best job of anyone who has ever taken blood -- I always bruise -- heck, after she took out the needle, you couldn't even see where the puncture was ... that was just amazing to me.