Why did you switch from band to VSG/choose VSG instead of the band?

[BlackBerryJuice 349]

So I was pretty set on getting the band, but as I called the Dr's office to book the surgery, they really encouraged me to get the sleeve. The sleeve costs more, so there's definitely some financial motivation in it for them. Plus it's a more invasive surgery, so I'm more concerned. I'm gonna list the reasons they gave me to go with the sleeve. Can someone comment on these/discuss their personal experience? Thanks.

1) Less ghrelin = less hunger

2) No post-op maintenance (repeated fills, etc) = no need to find bariatric surgeons (there are none in my immediate area) as you can just be cared for by any general surgeon

3) no leaks, slips, erosions or infections that can take place with the band, etc

4) Apparently, lower odds of regaining weight

[sbingram12 1]

I have the band right now and I just talked to my doctor yesterday about getting the revision to the vsg. I have PCOS and the band help me right after surgery, but now I'm a year out, doing the same exact things I was doing in the beginning - eating right, keeping calories low, and exercising - and I'm gaining weight. I'm so disgusted with myself, but I know that I'M doing everything right, and I that I shouldn't lose hope. I'm choosing the vsg because I know I won't gain weight after it's done, and since I'm a university student, I don't to worry about going back each month for a fill or a barium swallow to make sure everything is ok. I'M SO READY FOR THIS VSG!

[BlackBerryJuice 349]

Thanks for the response. I see you also bumped up another thread that addresses a lot of these issues. I'm 100% sure I'm getting the VSG. When/where are you doing yours? I plan to have mine done in the 2nd week of August in Mexico - here in Canada, the prices are outrageous, and I'm a student who's paying for this entirely with my line of credit, so saving $10,000 is definitely a big deal.

[sbingram12 1]

I live in the states and I'll be getting mine done in Fort Worth. Hopefully I'll be getting mine done in July, but I guess August would be fine with me as well lol. I just brought it up with my doctor yesterday (friday) and his nurse said that there wasn't a surgery opening until August, but I think she was just being facetious - or at least I hope so lol. Anyway, I meet with my doctor face to face on friday 2 July, so I'll know by then. I would just like to be at goal weight and feel good about myself (sorry, lol I know that was kind of a rant, but I feel like I just wasted a year and a half on this lap band and I want this vsg to happen NOW lol). I'll keep you updated on when I get it done!

[MINI-Me 196]

I have 3 friends with bands. I have watched them all struggle with complications and none have made goal in 2+ years. I have 2 friends with VSG - no issues and 1 made goal in 6 months and the other is well on her way. I am so happy with my choice - in 5 months, I am close to what I weighed in high school. My health has improved, I get around better, I feel comfortable in my own skin ... VSG was definitely the right choice for me!

[want2lose 1]

My husband and I went to a meeting that discussed the different ways to lose weight. They actually preferred the VSG also. He said one thing with the band was that sometimes it doesn't help. We are taught to chew our food well. One thing he mentioned was that with the band, the more you chew, the more food that passes through to your stomach. I had VSG May 14th in Mexico and feel the best I've felt in a long time.

I had gained over 30 pounds in the last two years because of a thyroid problem. The medication can make you gain weight. Since the surgery I have lost 32 pounds! I am very happy with the choice we made. Best wishes for your surgery!

[Tiffykins 673]

I've had the band, and over a 2 year period the band is more expensive than the sleeve due to follow up appointments, fills/unfills, and the other issues with the band. With the reoperation rate of the band, it's actually way more expensive than the sleeve. Hug your doctor, and thank them for being honest and giving you an option. Some surgeons prefer the band because it's the real money maker of the bariatric surgeries.

I've had both the band and the sleeve, and my personal opinion is that the sleeve is superior over the band for several reasons. The band has the lowest and slowest loss stats, highest rate of long term complications even outdoing RNY with the exception of Vitamin deficiencies. The food restrictions alone with the band are horrific. I couldn't eat meat, any type of breads, lettuce, raw veggies, and most fruits caused major issues.

The less ghrelin thing is true. Just because you fill up your little pouch with the band doesn't mean you are satisfied. That hunger is still there, and once the food slips through, you'll be hungry again, and really aren't supposed to eat because you're on a forced diet.

The maintenance thing is true. You don't even need to go to a general surgeon. Your family doctor or primary care doctor can pull your labs, and monitor your levels.

This is a post I share often when people ask about VSG vs. Band, or VSG vs. RNY, or VSG for a revision from band vs. band to band revision. At the very bottom, you'll find some research links that I enjoyed reading for research purposes. Hope this helps.

This is directly from the band manufacturer so there is no skewing facts or stats here. This is their own study.

http://www.lapband.com/en/learn_about_lapband/safety_informa tion/

Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. In the United States clinical study, with 3-year follow-up reported, 88% of the 299 patients had one or more adverse events, ranging from mild, moderate, to severe. Nausea and vomiting (51%), gastroesophageal reflux (regurgitation) (34%), band slippage/pouch dilatation (24%) and stoma obstruction (stomach-band outlet blockage) (14%) were the most common post-operative complications. In the study, 25% of the patients had their band systems removed, two-thirds of which were following adverse events. Esophageal dilatation or dysmotility (poor esophageal function) occurred in 11% of patients, the long-term effects of which are currently unknown. Constipation, diarrhea and dysphagia (difficulty swallowing) occurred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. The access port design has been improved. Four out of 299 patients (1.3%) had their bands erode into their stomachs. These bands needed to be removed in a second operation. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications.

Adverse events that were considered to be non-serious, and which occurred in less than 1% of the patients, included: esophagitis (inflammation of the esophagus), gastritis (inflammation of the stomach), hiatal hernia (some stomach above the diaphragm), pancreatitis (inflammation of the pancreas), abdominal pain, hernia, incisional hernia, infection, redundant skin, dehydration, diarrhea (frequent semi-solid bowel movements), abnormal stools, constipation, flatulence (gas), dyspepsia (upset stomach), eructation (belching), cardiospasm (an obstruction of passage of food through the bottom of the esophagus), hematemsis (vomiting of blood), asthenia (fatigue), fever, chest pain, incision pain, contact dermatitis (rash), abnormal healing, edema (swelling), paresthesia (abnormal sensation of burning, prickly, or tingling), dysmenorrhea (difficult periods), hypochromic anemia (low oxygen carrying part of blood), band system leak, cholecystitis (gall stones), esophageal ulcer (sore), port displacement, port site pain, spleen injury, and wound infection. Be sure to ask your surgeon about these possible complications and any of these medical terms that you dont understand.

Back to Top What are the specific risks and possible complications?

Talk to your doctor about all of the following risks and complications:

• Ulceration
  
• Gastritis (irritated stomach tissue)
  
• Gastroesophageal reflux (regurgitation)
  
• Heartburn
  
• Gas bloat
  
• Dysphagia (difficulty swallowing)
  
• Dehydration
  
• Constipation
  
• Weight regain
  
• Death
  

Laparoscopic surgery has its own set of possible problems. They include:

• Spleen or liver damage (sometimes requiring spleen removal)
  
• Damage to major blood vessels
  
• Lung problems
  
• Thrombosis (blood clots)
  
• Rupture of the wound
  
• Perforation of the stomach or esophagus during surgery
  

Laparoscopic surgery is not always possible. The surgeon may need to switch to an "open" method due to some of the reasons mentioned here. This happened in about 5% of the cases in the U.S. Clinical Study.

There are also problems that can occur that are directly related to the LAP-BAND? System:

• The band can spontaneously deflate because of leakage. That leakage can come from the band, the reservoir, or the tubing that connects them.
  
• The band can slip
  
• There can be stomach slippage
  
• The stomach pouch can enlarge
  
• The stoma (stomach outlet) can be blocked
  
• The band can erode into the stomach
  

Obstruction of the stomach can be caused by:

• Food
  
• Swelling
  
• Improper placement of the band
  
• The band being over-inflated
  
• Band or stomach slippage
  
• Stomach pouch twisting
  
• Stomach pouch enlargement
  

There have been some reports that the esophagus has stretched or dilated in some patients. This could be caused by:

• Improper placement of the band
  
• The band being tightened too much
  
• Stoma obstruction
  
• Binge eating
  
• Excessive vomiting
  

Patients with a weaker esophagus may be more likely to have this problem. A weaker esophagus is one that is not good at pushing food through to your stomach. Tell your surgeon if you have difficulty swallowing. Then your surgeon can evaluate this.

Weight loss with the LAP-BAND? System is typically slower and more gradual than with some other weight loss surgeries. Tightening the band too fast or too much to try to speed up weight loss should be avoided. The stomach pouch and/or esophagus can become enlarged as a result. You need to learn how to use your band as a tool that can help you reduce the amount you eat.

Infection is possible. Also, the band can erode into the stomach. This can happen right after surgery or years later, although this rarely happens.

Complications can cause reduced weight loss. They can also cause weight gain. Other complications can result that require more surgery to remove, reposition, or replace the band.

Some patients have more nausea and vomiting than others. You should see your physician at once if vomiting persists.

Rapid weight loss may lead to symptoms of:

• Malnutrition
  
• Anemia
  
• Related complications
  

It is possible you may not lose much weight or any weight at all. You could also have complications related to obesity.

If any complications occur, you may need to stay in the hospital longer. You may also need to return to the hospital later. A number of less serious complications can also occur. These may have little effect on how long it takes you to recover from surgery.

If you have existing problems, such as diabetes, a large hiatal hernia (part of the stomach in the chest cavity), Barretts esophagus (severe, chronic inflammation of the lower esophagus), or emotional or psychological problems, you may have more complications. Your surgeon will consider how bad your symptoms are, and if you are a good candidate for the LAP-BAND? System surgery. You also have more risk of complications if you've had a surgery before in the same area. If the procedure is not done laparoscopically by an experienced surgeon, you may have more risk of complications.

Anti-inflammatory drugs that may irritate the stomach, such as aspirin and NSAIDs, should be used with caution.

Some people need folate and Vitamin B12 supplements to maintain normal homocycteine levels. Elevated homocycteine levels can increase risks to your heart and the risk of spinal birth defects.

You can develop gallstones after a rapid weight loss. This can make it necessary to remove your gallbladder.

There have been no reports of autoimmune disease with the use of the LAP-BAND? System. Autoimmune diseases and connective tissue disorders, though, have been reported after long-term implantation of other silicone devices. These problems can include systemic lupus erythematosus and scleroderma. At this time, there is no conclusive clinical evidence that supports a relationship between connective-tissue disorders and silicone implants. Long-term studies to further evaluate this possibility are still being done. You should know, though, that if autoimmune symptoms develop after the band is in place, you may need treatment. The band may also need to be removed. Talk with your surgeon about this possibility. Also, if you have symptoms of autoimmune disease now, the LAP-BAND? System may not be right for you.

Back to Top Removing the LAP-BAND? System

If the LAP-BAND? System has been placed laparoscopically, it may be possible to remove it the same way. This is an advantage of the LAP-BAND? System. However, an "open" procedure may be necessary to remove a band. In the U.S. Clinical Study, 60% of the bands that were removed were done laparoscopically. Surgeons report that after the band is removed, the stomach returns to essentially a normal state.

At this time, there are no known reasons to suggest that the band should be replaced or removed at some point unless a complication occurs or you do not lose weight. It is difficult, though, to say whether the band will stay in place for the rest of your life. It may need to be removed or replaced at some point. Removing the device requires a surgical procedure. That procedure will have all the related risks and possible complications that come with surgery. The risk of some complications, such as erosions and infection, increase with any added procedure.

LapSf Study that I swiped from MacMadame's profile

LapSF Educational presentation to FACS - includes some 2 year results

LapSF Two Year Study

LapSF Five Year Study - abstract only

LapSF Five Year Study - presentation (requires Windows to play)

Literature review on the sleeve - requires $$ to get the full text unfortunately

Sleeve best for over 50 crowd

Video of a sleeve with lots of education discussion

Video of a sleeve that is more about the operation

Ghrelin levels after RnY and sleeve

Ghrelin levels after band and sleeve

Diabetes resolution in RnY vs. Sleeve

Comparison of band to sleeve - literature review

[Mi-Mi 0]

i researched bariatric surgery a few years ago and at the time the RNY and the band were the most popular procedures available. i wasn't comfortable with either of them. the thought of permanently rerouting my insides was something i just couldn't stomach (sorry that's a bad pun.) and the band... well.... i just couldn't imagine having a foreign object like that in my body for THE REST OF MY LIFE! at that the people who told me "you can do it yourself if you REALLY want to" were probably right. so i dropped the notion of surgery.... and here i am about 4 years and 60 pounds later. now i'm with a different husband and we've been trying to have a baby. i did 3 months of clomid just to see what would happen, and nothing. so i talked to hubs about weight loss surgery, as skeptical as i was the first time about the procedures that i knew of. he was super supportive so i started researching once again. i discovered the sleeve via the internet and it seemed so much less complicated and more natural (i know, i know natural isn't the best adjective here but just stay with me) than RNY and the sleeve. by the time i attended the initial educational seminar i knew that the sleeve was the option for me and i wasn't considering any other option at that time.

having said that, i have been getting a few skeptical/negative comments about the sleeve procedure from people in my very large social circle. a few days ago i was so nervous about it that i actually started to 2nd guess my decision and wondered if the band might be a better way to go. but now i'm realizing that it's only because the sleeve isn't covered by as many insurance companies as the other procedures are. therefore, it's less common and we all know people are afraid of things they don't know much about. it was the same with the band way back when i first started to consider WLS. eventually the sleeve will be covered by more insurance companies and will become more common and just as widely accepted as the others.

i know some will read my post and take it personally. anything i've said here wasn't meant to criticize anyone for their choice in procedure. it's only meant to explain my own decision process. after all... this IS the vertical sleeve talk website! :~) whatever anyone chooses, i do hope the best for them!

[Mi-Mi 0]

clarification.... what i meant to say in that 1st paragraph was "i decided that the people who said i could do it on my own if i really wanted to were right."