Lap band or Gastric Sleeve???

[Mommato4 0]

I had been to a couple surgeons who only did lap band and this last seminar talked about the gastric sleeve as well. I'm now trying to decide between the two. I know the complications of both....with the sleeve I like that there aren't any adjustments or pb'ing or getting "stuck", but I don't like the idea of how permanent it is. I would love to hear some opinions from others on the topic.

Thanks!!

Kylie

[SParkle 4]

I know theres loads of people on here who have reverted from the band to the sleeve. I looked at the bend but am so glad I didn't go that route as I think I'd have ended up spending even more money in the long term with a reversion.

Don't get this wrong tho - the sleeve is permenant - they remove 80% of your stomach, totally.. gone forever.

In the end it comes down to personal choice, and I'm sure you'll get lots of response to help you decide - but the sleeve rocks!!

[Papillon 7]

The decision for me is the sleeve because of the long term weight loss success. I know several people personally that have had the band and it worked for awhile but then they were back into bad habbits and are now in the same boat they were in before the band. It is a personal choice... I would also talk to your surgeon. I was surprised at the response my surgeon gave me. He said he would never talk someone out of getting the lapband but he was glad I had changed my mind to the sleeve. If you search online there are complications from both procedures. I decided on the sleeve because I did not want anything in my body. - but like I said before it is a very personal choice. :smile1: I wish you all the best in your journey.

[lmmore 0]

Do yourself a favor. DON"T GET BANDED. The sleeve is great. It's still your real stomach, only smaller, and you lose the hunger, which you don't get from the other procedures. Read this site.......you won't be sorry.

[MINI-Me 196]

The decision for me is the sleeve because of the long term weight loss success. I know several people personally that have had the band and it worked for awhile but then they were back into bad habbits and are now in the same boat they were in before the band.

I could have written this myself.

Someone I knew with a band actually had the fill taken out so she could "gorge" on a cruise. I wanted something permanent that would not allow me to fall back into old habits and continue the yo-yo of weight loss/weight gain.

None of my Band friends have made goal. AND - none have maintained to the level where they stopped losing. All have gained back. And, they have all had complications such as pb'ing, swollen esphogus, stretching of the upper pouch, etc.

While I am only 5 months into this, I can definitely say it's been a life changer for me. I love the restriction and the ability to eat anything I want - just much smaller proportions.

Good luck with your research. We are here to help if you have specific questions.

[Jachut 487]

Hmmm, I've made goal and then some and I've maintained it for well over 2 years with a band.

I dont think you'll find many who would say get a band here, and to be honest, it requires good aftercare and a lot of maintenance and the way things seem to work in the states, with your health insurance system and so many people going to Mexico etc, I just dont think its maybe the best choice unless you happen to be able to find a surgeon a suburb or two away and can be SURE you can afford all the aftercare etc.

When the band goes wrong, it goes very wrong, as many people here can attest, they are thrilled to have the bands out of them and a new chapter of life beginning.

For a bandster with a perfect working band that has been successful, long term, the adjustability of the band is GREAT, I wouldnt want to give that up for anything. I have been able to eat a good 2000 calorie a day diet to maintain, its NORMAL eating, just without overeating! When I hit plateaus etc I was able to go tighter, the adjustability thing is a very big advantage.

As to day to day issues, from reading here, I'd say with a well functioning band, the eating issues are similar between the two surgeries, I've read of many people here having far more issues than I ever had with a band - reflux, am I full yet, did I just eat too much, why cant I eat this food or that food, etc etc. But that's weight loss surgery, you take that on when you decide to do it, and if anything were to happen to my band, even though I've had such a great experience, I think I'd choose a sleeve next time simply for the permanence, the lesser aftercare and not having this feeling that one day, something's going to go wrong and I'll lose my band. I fully expect that this band wont be in me forever, and even my surgeon said it will probably wear out one day.

I truly dont think anyone should let the permanence of a sleeve put them off - ANY weight loss surgery has to be considered permanent if you want to stay thin and healthy - just because the band can come out, doesnt mean it should or will one day.

[cwalker 12]

I didn't choose a band for health reasons, I have rheumatoid and my body could reject the band plus a 2 hr drive for fills and unfills well it would be insane. I have friends who have the band and have done well and one who nearly died with a band, it's a personal decision for each one of us. I can say I thought the band surgery would be easier but the sleeve surgery was smooth, no problems,no fills,port problems.Why would you want a big ole stomach anyway? lol. It is a amazing tool.Good Luck with whatever you choose.

[Tiffykins 673]

Here's my typical reply when people ask me about band vs. vsg Also, just because the band can be removed, you have no idea what or how severely it may damage your stomach or esophagus before you are able to get it removed. I've been there, and done that. My band only lasted 8 months, and I lost additional stomach tissue during my revision because of the scar tissue from the band.

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. 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.

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.

Quote:

Weight Loss Surgery Risk Information | LAP-BAND?

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

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

__________________

[Mommato4 0]

Thank you for your responses I posted the same entry on lapbandtalk and got one response telling me to come here lol.

I think my biggest concern is that if something can go wrong it will (with me that is)...I'm a walking murphy's law. My mother was a nurse and talked about "GBGB" patients quite a bit (that's Gastric Bypass Gone Bad).

I know this isn't a bypass operation but those stories still haunt me. I figured with the lapband if something were to go wrong I could just have it taken out....but when I looked at all the complications that could happen with it is when I thought about the VGS. My other concern is that I have bad GERD already and the surgeon said he doesn't recommend it for GERD. I used to not have but after four babies, a hiatal hernia, and being heavy it just happens. I'm hoping getting the hernia fixed will help as well as a diet change.

[Jachut 487]

Truth is, I think GERD is a problem for any WLS - the band is *supposed* to fix it, but I dont think many people would say that was the case.

Good luck with your decision, it is a very personal one in the end and only you know what you're comfortable with doing.

[Bornagainbabe 4]

I didn't want the permanence 3 years ago when I had my band as I believed that once I lost weight there was no way I would ever put all that back on and then the band could be removed. I also deluded myself that I was that big and really didn't need that extreme a surgery. Wrong! Neither of my surgeries has fixed the issues I have with food. Physical restriction is the only thing that prevents me from stuffing myself and then I do still do that occasionally with my sleeve until I am sick. I have a few friends who have bands and they have all suffered severe slippage, erosion, pouch dilation etc. My sleeve has been great and I have no regrets - I should have gone for that in the first place.

You need to have a good think about why you are considering surgery and be truly honest with yourself and if you are like most of us and can admit that you have always had and will always have issues with food then go for the permanent option. Don't have a band.

[val628 1]

i had the band inserted 2 years ago and i loved my band. there is alot more follow up and can be expensive. well i had a slip and had surgery monday but he was unable tp reposition the band so i now have the sleeve. i just had it done, so i cant really say i like it better. the surgery was more painful, not a ton more but a little bit. my doctor told me there is less follow up. it was hard going to the doctors every 6-8 weeks but he told me it would be every 3 months now

[deletedsally 8]

Lots of the above posts did a good job explaining the advantages/disadvantages of each surgery...and yes, as you said, the sleeve is permanent. I had some anxiety about that too--but I want my weight loss to be permanent, so I decided to choose what I hope to be a permanent solution.

At 3 months, I have no regrets about the surgery. I am able to eat any food and feel satisfied with much smaller portions. My biggest fear at this point, is not that I can't have my stomach back--I don't want it back. My fear is that maybe the surgeon didn't make it small enough and that as I get further out, I will be able to eat too much.

[Jaffa 5]

Get the sleeve. There is NO justifiable reason to get the band. Just marketing and people thinking it is less invasive....it really isn't.

Mine worked fine, and then suddenly it was really hard to stay in the sweet spot.....I was just defilled to prepare for sleeve revision, and it turns out my band was leaking.

[TexasT 99]

I was having vague pains and went to see my band surgeon to just check to make sure it was still OK. Turns out I had a hiatal hernia and gall stones. But during the office visit, the doc told me that most patients have complications with their bands 3-5 yrs out (I had mine 3.5 yrs) and needed some type of surgery to replace it or fix something. He then told me about the sleeve, which wasn't available 4 yrs ago when I first started all of this.

Since I HATED living with the band at that point (food getting stuck, not being able to eat so many foods that are actually good for you, etc.), I was anxious to learn more about the sleeve. My doc had sewn my band and port in me to stay, so taking them out was probably not a pretty sight. In fact, I ended up getting a hematoma in the area where my port was. The incision above it opened up, blood gushed everywhere, the wound had to heal from the inside out for weeks - and all because I had this huge bunch of plastic in my body for years. Yes, I lost some weight with the band, but that was only in the first few months after getting it. It was NOT worth the problems I experienced afterwards.

Life with the sleeve is MUCH better in my experience.