VSG vs LapBand

[SpotOx 0]

I had decided to get the LapBand, but went to my doctor's seminar and heard more about VSG. It sounds a whole lot better, but I'm concerned about two things:

(1) It's not reversible - with the Lapband, if for some strange reason I decided to I could always go back. This probably wouldn't actually be a problem, but my gp doctor mentioned it so now I'm nervous.

(2) This is the issue that really has me wondering... The hormone that you lose with the VSG is supposed to regulate hunger. I'm wondering how this affected other people. Do you actually lose "hunger"? Did you miss being hungry? And it seems like we very often hear of medical issues that we thought were ok, but later learn they are not -- what's the probability of losing this hormone becoming a "whoops! - we shouldn't have done that" issue?

Right now I'm waiting to get approved by my insurance and schedule the procedure. Figured I'd use my time wisely while I wait and get as informed as possible.

My surgeon raves about VSG, but my gp doctor thinks LapBand is a better way to go.

Edited July 19, 2009 by SpotOx

[Malaika 50]

WELCOME SPOTOX to the forum - we're glad to have you join us and hope you find lots of information and answers to your questions.

I had decided to get the LapBand, but went to my doctor's seminar and heard more about VSG. It sounds a whole lot better, but I'm concerned about two things:

(1) It's not reversible - with the Lapband, if for some strange reason I decided to I could always go back. This probably wouldn't actually be a problem, but my gp doctor mentioned it so now I'm nervous.

While it is true that VSG is irreversible, with the lapband you have 2 foreign objects in your body - the band and the port ... to me that just seems to weird. And there are lots of people out there who have had a part of their stomach removed or even all of their stomach removed due to disease and they still function. I think Mac said her aunt had her entire stomach removed -- you can live with out a stomach, you just have to learn how to eat properly -- at least that is what I believe Mac said.

(2) This is the issue that really has be wondering. The hormone that you lose with the VSG is supposed to regulate hunger. I'm wondering how this affected other people. Do you actually lose "hunger"? Did you miss being hungry? And it seems like we very often hear of medical issues that we think are ok, but later learn they are not -- what's the probability of losing this hormone becoming a "whoops! - we shouldn't have done that"? I don't miss the feeling of being hungry. When I am truly hungry, I know it - like when I get up in the morning- I'm hungry and my stomach lets me know it! I've also heard that over time that your body will begin to produce the ghrelin hormone again ... not sure what the research on that is. With VSG they leave the pylori intact so there shouldn't be any "whoops" factor in removing the ghrelin hormone.

Right now I'm waiting to get approved by my insurance and schedule the procedure. Figured I'd use my time wisely while I wait and get as informed as possible.

My surgeon raves about VSG, my gp doctor thinks LapBand is a better way to go.

I never had the band; however there are LOTS of members who have had revision and they will tell you that the band is good for a little while and then you have nothing but trouble. With the sleeve, there's nothing to slip and no follow-up is needed -- you just have a smaller stomach and you can't eat as much. However, you can eat anything you want - unlike with the band, from everything I have read.

Good luck with your decision. I think I'd go with my surgeon's opinion over a GP -- my own personal opinion.

[*susan* 1,709]

Hi SpotOx, welcome to our forums! I am a band to sleeve revision and I have to tell you, the sleeve is so much better. With the band, you have issues of food getting stuck, being too tight, not tight enough, it is just a never ending battle. With the sleeve, you have the surgery, your tummy is smaller and your done. No getting stuck, no looking for proper restriction, no seeing your doctor every month or so for fills, you just concentrate on losing weight and feeling better.

Many people who get the band do so just for the reason you mentioned, it is reversible. My thought is, so what? I don't anticipate ever waking up and thinking "Hey, I want to be fat again, I wish my sleeve was reversible." I have a food addiction, band or no band, sleeve or no sleeve, I know I will always have that addiction. So, I want something permanent.

As for the ghrelin, I am told that eventually you do start producing it again. But, it is produced in much smaller quantities, more to the equivalent of that of a normal person.

[BobBayCityMI 111]

I had the same choice. At first I was gung-ho for the lap band. Then I did some more checking. Found out about the sliming, slippage and fill dilemmas; the removal of the "I am hungry" sensor; the success rates being so damn good; nothing plastic left in me (even if it can be removed); and fewer problems with malabsorbtion. I personally liked the permenance of it. The stomach is left with the toughest part of the belly, so less chance for stretching, unless I am really a doofus. All in all, I am very happy with my choice to go for the sleeve.

[SpotOx 0]

Wow! Thanks for the great responses. Sure gives me a lot to think about. I agree that my surgeon would probably be the better one to listen to (over the gp doctor) just because he's more experienced with it. But I am getting good support from the gp either way, which is nice.

It does seem like it will be weird having this foreign object in my body for the rest of my life. Plus, I live a good 2-hour drive from my surgeon and not having to go back and forth for refills sounds really good. I had also heard that, with the band, sometimes the stomach actually grows so that if you do remove the band you've got more of a problem.

I'm leaning closer to the VSG, but am not there yet. I have been reading up on ghrelin, leptin and cortisol. Adding your comments to what I'm finding, I am feeling more comfortable with that issue. But I guess what's making me hesitate is that it's still new and we don't have years' of research on it yet. Wasn't ghrelin only discovered a couple of years ago? I keep thinking of phen-phen, sacarin (sp?), hormone replacement therapy, etc. - things we thought were great but then found out after a few years that it wasn't such a good thing to do because of side effects that took a while to show up.

I know my insurance will cover the band, but I don't know about the VSG. It may just come down to that and my decision will be made for me. Who knows - maybe insurance will cover the band now, and then later on down the road they will cover VSG and I can get a revision.

I think a good thing for me to do would be to write out all of my questions (so I don't get off-track and forget anything) and take them to the surgeon before making the final decision.

Argh! I tend to be a wishy-washy person, and I felt really good having made a decision about the band. Then they had to go and come up with this VSG and I have to think all over again.

Edited July 19, 2009 by SpotOx

[Jaffa 5]

Frankly, is your GP, referring you to someone for the lapband?

They make money on referrels you know.

[Oregondaisy 2,021]

I have nothing good to say about the band. It was very difficult for me to lose weight with the band. I felt like I was doing it with sheer willpower, and why did I pay 10 grand for that? Eventually, I got the restriction I was looking for , and started throwing up practically everything I ate. Then came the waking up from a sound sleep , choking and puking in my sleep. I could not get that band out of me fast enough.

The sleeve is great. I love never being hungry. With the band, I was not supposed to be hungry , but when you throw up what you eat, you're hungry again right away. You're supposed to drink liquids after you throw something up, because the vomiting causes swelling around the band. So, back on liquids AGAIN. Hunger, AGAIN.

The sleeve works the way the band is supposed to work, but it really does work, no fills, just surgery and you're done.

[SpotOx 0]

No, my gp isn't referring me. I researched and chose my surgeon (location, insurance, credentials - not necessarily in that order). The gp is just helping me make the decision and prove to my insurance that I need it.

This is really weird. I'm reading several posts on this website that say how bad the band is. Until now, the sites I had seen were mostly positive. My question is, if the band is so bad why is it being done so often and why are the percentage rates showing negative results so low? More questions for my surgeon....

[Jachut 487]

I have a perfectly functioning band and I'd have to say that I cope day to day with it brilliantly but it does involve multiple small discomforts and a bit of stress over eating in public. I can virtually guarantee I wont vomit in public but to achieve that I eat teeny tiny amounts and ever so carefully.

The band WONT last forever inside you, sooner or later, the balloon will wear out. I think if you get banded, you must expect a further surgery down the track.

Many dont agree, I know, but I think reversability is a valid advantage to some people. Some people really cant handle the deprivation and inability to eat and will try to eat around any surgery they have, at least with a band, if you decide you really cant take the lifestyle you must live to get the weight loss, then it can be taken out. I think that's very unlikely and would really only be an issue for a small percentage of people.

However the adjustability is a MAJOR bonus. You can work your band just how you need to at any given stage of life. Pregnant? You can loosen it off and eat a bit more. Running your first marathon? Loosen it off to fuel your training. No worries about how to maintain, if you're keeping on losing and dont want to, have some fill removed. Feel you need more oomph to keep your weight loss going. Have a small fill. When you're old and your appetite has faded to nothing anyway unfill the band or remove it entirely.

But all of that ONLY applies if your band functions well in your body, somethign that cant be guaranteed. Yes, the stats of erosions and slippages are low but as many here in this forum could tell you, sometimes people's bodies just plain dont like the band and they have all sorts of horrid everyday pain and problems that are not really reported in all the literature you'll find in your research.

[Bornagainbabe 4]

I am a band to sleeve revision, only being sleeved since last Monday, so I can't compare the two yet, but I can tell you of my experiences with the band.

I suffered two severe slippages during the two years I had it, neither of them caused by my not following the diet correctly. I suffered from horrendous indigestion and acid reflux (never suffered from them prior to banding) which did make me vomit a lot. It was truly awful. I was tired, dehydrated and in pain quite a lot of the time. A lot of foods just wouldn't go down at all and whilst I don't regret having it (I lost 105lbs in 12 months) I was absolutely desperate to get it out at the end. When my surgeon performed the revision he found the band to have slipped down to a third of my stomach.

Also fills, defills and finding your 'sweet spot' are a pain. You can easily find yourself too tight, not even being able to get liquids down and then you really are in trouble, especially if you have to find someone to perform a defill for you as an emergency procedure.

I had the band for the exact reason that it was reversible but even after two years I still need restriction. I have had weight issues for nearly all my life and they are not going to be resolved in the space of 2 years. I needed the permanence of the sleeve for my future health.

I don't know much about the long-term issues of sleeving but my husband's grandmother had most of her stomach removed, for different medical reasons when she was young, and lived until she was 87 (dying from unrelated causes) so I am not too concerned about that. Diabetes could hit me quicker and be more of a risk to my health.

Keep researching and ensure you make an informed and educated choice.

Good luck,

Helen xxx

[Oregondaisy 2,021]

The reason doctors are still pushing the band is that it's an easy money maker. besides the surgery being easy, a lot of them get money every time someone needs a fill or an unfill. There are not a lot of places that gives you fills free forever. Fills can also be very expensive, and so are the tests to find out why you are having problems.

[Ruthi 60]

Just to keep you more informed. Many people with the band have had some intense complications with it and have almost died as a result. I am one of those ppl. I heard about the complications and said to myself, "it wont happen to me" but guess what? If anyone gave me the option now to have insurance pay for another band or have a sleeve and pay for it yourself, I would be asking where to borrow the money. BELIEVE ME when I tell you, you do NOT want the band.

[Jaffa 5]

I think in answer to your question about why so much positive information versus negative information about the band?

Well, I am very happy with my band. But, I think most people are in the beginning. I'm 6 months out....and doing great. But, frankly, so are most people at my point. I think it is much more intrusive in your daily life then you might think, and people are just willing to live with it, because it is worth it to lose the weight. People like to post when things are going great, they don't like to post as much when things aren't so great.

It seems to me that most people start to develop trouble at about the 3 year point. Of course some have trouble from the very beginning and others have trouble later. The sleeve definitely tends to be less trouble long term. Where the band tends to be less trouble short term. So, people post and talk in the short term, but long term they become less interested (obsessed) with it and don't care to post.

I can see why people want a band, because most people like to think that the troubles are rare. Well, if you quit tracking the statistics at about the time your product tends to go up in problems, then yes it looks better.

What I don't buy in to, and you shouldn't either are the marketing gimics with the band.

Adjustable

Reversible

Less invasive

These aren't truly advantages except in very rare cases.

Adjustable. Well, yes, it is adjustable, but in reality your trying to adjust it to get to the sweet spot....many times difficult for people. The only other time adjustable is used is to empty it, when you have something go wrong with it. Well, that is a nice spin. Your band has slipped, well thank god we can empty it and see if it goes back in place....put into context it doesn't really seem like a positive does it?

Reversible. Well yes, technically it can be removed, but why would you want to remove it, unless it was causing a problem? So again a problem is being spun to a positive.

Less invasive. Well yes, it is in the sugery portion. But, from that point on it isn't really any less invasive, and some people would argue it is actually more invasive. You absolutely, have to think every time you eat, to make sure you don't get stuck, and even then sometimes you will get stuck. Also, your stomach is being smashed and the scar tissue is ongoing and developing.

[Oregondaisy 2,021]

Also, your stomach is being smashed and the scar tissue is ongoing and developing.

That is a really good point. That whole idea really scared me when I started throwing up in my sleep. I got to wondering what was going on inside that I could not see. I got to thinking about putting a rubber band around my finger and leaving it there for 3 years and how my finger would look after that.

LapBandTalk Click to visit the largest Lap-Band community online!

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[MacMadame 81]

This is really weird. I'm reading several posts on this website that say how bad the band is. Until now, the sites I had seen were mostly positive. My question is, if the band is so bad why is it being done so often and why are the percentage rates showing negative results so low? More questions for my surgeon....

Most people love their WLS in the first year... that's true for all the surgeries including the sleeve. To get a more full picture, you need to hunt around for people who have had the surgery longer. You can find lots of unhappy people if you go to more established websites with revision sections, too. You also need to lurk on the boards for a while to get a true picture.

I spent several months on LapBandTalk and during that time I slowly found people who were raving about their bands when I first got there having problems. It was scary, quite frankly.

But in terms of statistics, there are a number of studies coming out about how the long-term complication rate of the band and they are not pretty. They show anywhere from a 25 to a 40% re-surgery rate for people with bands by the 10 year mark.

These studies are a large part of why I don't have a band. Between that and the people who did everything right but still couldn't get restriction, I realized that the lap band is the least effective of the surgeries and had a unacceptable (to me) complication rate.