Lap Band vs Gastric Sleeve

[Guest idgett@LBT]

I am self pay and of course been searching ways to save money. I had made a decision to have it at this one place here in Houston, for 12,900. Well today I was approached by someone pitching me the gastric sleeve, and how much better it was than lap band. I know this procedure is newer than lap band, but that doesn't mean it is better. She was mainly telling the bad things about lap band like erosion and such. Has anyone else checked into the sleeve? Is there somewhere I can review pro's and con's of both surgeries? Just as I had finally made up my mind I am getting confussed again. HELP:eek:

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[Guest Sue Magoo@LBT]

There's someone on this site that has had lap band and recently got the sleeve. I think it might be wasabubblebut. You might want to direct this question to her.

Good luck.

Sue

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[Guest gregvd@LBT]

I ask my nurse before I had the Lap-Band, about the gastric sleeve. She went on and on about the negative. Stick with the lap-Band. I sure am glad I did. It's working like a charm.

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[Guest BethO@LBT]

I was also told by my doctor about the sleeve, But the thought of removing most of my stomach scared me. I chose to stick with the lap band because it is the best fit for me. I would just research both and decided what the best option is for you. :smile2:

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[Guest Brian@LBT]

Hi, I think all of us looking at the LB, get antsy about making the "right decision". Other than a general internet search, I have no specific sites to recommend, but I'll give you my impressions. The VGB is a nifty procedure because it does not create the malabsoption syndrome of the RNY. It is however a permanent surgical procedure and has only been out in US since 2002. There are surgical side effects; it is not benign therapy. There are very few physicians that do the procedure. It was popularized in the UK, etc. etc. just as you can read on the Internet. For me, my medical co-morbities and BMI just don't warrant that option. My specific problems with it: I am not willing to undergo such surgery, RNY, VGB, etc. There is, for me, a much better alternate, the LB. My health insurance does not cover any WLS and more importantly costs of complications. I am willing to take the small bites, the chewing, the reduced food choices, PB, etc. As a pre-banded person, let me say the lapband it is not an elegant solution to weight loss. It will be a hard task-master. Indeed, it is rather "crude". And you know, if it doesn't for some reason, work for me, it will come out. Maybe some day there will be a magic pill. But if the banding is "crude" and inelegant, the surgery is drastic, however you cut it.

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[Guest katandcharlie@LBT]

Beth, I was all set to get a lap band but because of my health history (colo-rectal cancer along with several other cancers) my oncologist and my WLS surgeon strongly recommended I go with the sleeve. Mine is probably a unique situation and if it were not for my cancer history I would have done the band. I am now three weeks out from having the sleeve and doing great. I continue to pop in on this board and have a look-see as so many of the members are positive and helpful. Whatever your choice, please investigate and research what is best for you, ask lots and lots of questions and be positive. Good luck in your journey.

Katherine in New Mexico

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[Guest idgett@LBT]

Your right about being popular elsewhere. The person who was pitching me was for doctors in Mexico, and Michigan. As I said I live in Houston Texas, and you see ads for Lap Band where ever you go, and all over local TV. I sure haven't heard much about the gastric sleeve. Which tells me it is not as tried and true as lap band.

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[Guest HeatherO@LBT]

I am happy I went with the band because it is adjustable. I was worried about taking a one size fits all solution and not making my personal goals. Some people say that this adjustability through the need for fills makes the sleeve a better option (less aftercare), but I like being able to make sure that it is working just right for me.

Complications like erosion and slippage are serious and something to consider with the band. However, I thought the possible complications from having a more serious procedure such as the sleeve or R&Y were much scarier to me.

I also chose it because it is less invasive and I would like to have another child in the near future. It was just the right fit for me.

There are lots of other discussion threads on this topic. You should do a search on the forum and read through some other responses as well.

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[Guest MacMadame@LBT]

I came here because I was intent on getting a band. I only knew about the band and RnY and I do not believe in malabsorption procedures on principle -- I don't want something that allows me to eat more food than my body needs; I want something that allows me to eat regular portions and feel satiety.

Anyway, then I found out about all sorts of other options like DS, sleeve, VBLOC. It was confusing at first, but I've recently decided that a sleeve is a better option for me.

First, I've come to terms with the whole surgery thing. At first, I was freaked out by something *permanent* but it's not like having a lap band is like wearing a belt with your slacks. It's a surgery and it adheres to your stomach with scars -- scars that are probably permanent. The reasons you would want to take one out are because of erosion or slippage or other damage that the lap band caused. So if you don't get one, you don't need to undo it.

I do like the adjustability of the band. I like the idea of being able to eat most things by not being super tight. But will I be able to get to that elusive "sweet spot" where I feel satiety when I eat normally but can still eat most foods if I chew well enough? After hanging out here for a 4 months, I see that it's not a given. Plus what really bugs is that many of the foods you can't get down because of a band are good for you. Plus even if you find your sweet spot, the band can be fickle -- tight certain times of day, loose at others -- tight certain TOM or after flying or when you are under stress. So you can be at the sweet spot then lose it over and over again.

Another reason for getting a band is that you can get an unfill if you need more nutrition, say when you get pregnant. I'm past the age of getting pregnant. I may get cancer, but my understanding is that most people with cancer have problems with nutrition because they are too sick to eat. Unfilling the band may help, but it's not going to make you want to eat.

Finally, there is the matter of costs. The band is cheaper in the short run, but adjustments can drive up costs. WLS is not covered under my insurance so not only would I have to pay to put it in, but if something happened and it had to be taken out, I'd have to pay for that. With a sleeve, you get it and that's it. So it's a one-time cost.

The sleeve works by making your stomach smaller but, unlike with a lap band, there is no stoma so you have a much smaller chance of getting stuck. It also removes the portion of your stomach that produces ghrelin, the hunger hormone, so that you don't feel hungry. Most of my overeating comes from hunger issues so something that definitely controls hunger is a good choice for me.

This particular operation has been done for reasons other than weight loss since the 80s. It has been done as a two-part operation for DS patients who were too sick to get DS for a while too. It has only been done as a stand-alone operation since around 2001 (and contrary to the info on the intranet, was not started in the UK ). This is also the year the Lap band was approved for use in the US so, in fact, it's been done in the US as long as bands have been done here.

Not that it matters: don't go by what is popular in the US or common in the US -- we really out of step with the rest of the world when it comes to WLS.

The bad parts of the sleeve, to me, are:

Not a lot of data on long term results. There is one published 3 year study and one getting ready for publishing 5 year study. The results of that study are promising. It seems unlikely that the sleeve will expand that much over time. Plus, while your stomach does figure out how to make ghrelin after a few years, it doesn't make it at the levels that it used to (morbidly obese people have about 10x the ghrelin as normal). But only two studies is a bit scary. The 1 and 2 year studies show that weight loss is similar to bypass with safety similar to lap band, however. So those are promising.

Not a lot of doctors do them. Now I live in a major metropolitan area and I know of at least 6 surgeons who do them including some who have done them since 2001, but most people won't find that.

Insurance won't pay for it yet. But my insurance doesn't pay for WLS at all. Plus, there are ways to get around the "no sleeve" limitation... it is approved as a 2-part operation after all. :cool2:

I think there is no one right WLS for everyone. The sleeve appeals to me for a number of reasons, but it's not going to appeal to everyone. OTOH, it's definitely not some fly-by-night, unsafe surgery that has no track record what-so-ever and I do think a few posts in this thread gave that impression whether intentionally or not.

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[Guest hollynn@LBT]

excellent post.

at the end you said there are ways around non-coverage ...i.e. 1st step in two step procedures. It is important to read your policy very closely because many insurance policies that specifically cover BPD-DS (bileopancreatic diversion/duodenal switch) also specifically state that it is only covered as a single stage operation and specifically don't cover the sleeve. So, be careful.

For the most part, at least around where I live in Louisville, it is only a self-pay surgery.

holly

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[Guest MacMadame@LBT]

It is important to read your policy very closely because many insurance policies that specifically cover BPD-DS (bileopancreatic diversion/duodenal switch) also specifically state that it is only covered as a single stage operation and specifically don't cover the sleeve. So, be careful.

Definitely. And if you call your insurance company and they say something, get it writing or call back and see if the answer is the same the second time.

I've been told the wrong info twice now and it's really aggravating.

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