Confused: Lapband or Sleeve

[ngory07 22]

Ok so I was 100% sure I wanted the LAP-BAND?. I've been doing research for about 6 months and it made the most sense for me. I am a single mom of a 2 1/2 year old boy (and I mean SINGLE ! No man at all and no family except my sister who will only babysit once in a blue moon) So if anything happens to me I have little support. But I went to my seminar yesterday and learned about the sleeve. It is less drastic than the bypass but still body altering. And the woman made it sound like there was very little chance to loose 100+ pounds with the band. I am 310 and my goal weight is 150-160 depending on where I feel confortable. Now I know that wls is just a tool and I have to change my lifestyle and I am ready to do that. But I hesitate to spend so much money on the band and not lose my excess weight. But I am not sure how I will manage with the time off work with the sleeve. And the thought of something so permanant scares the shit out of me. I would love to hear from people who changed from LAP-BAND? to sleeve or just people who have had the sleeve especially single mothers. I am just so confused and want to do the right thing. Thanks!

[Tiffykins 673]

I've had both. And, I can tell you that the band sucks, and by the stats that are out, you will only lose 50% of your excess weight in 3 years.

It has the lowest and slowest weight loss.

1 in 4 patients (25%) will have another surgery due to complications with the band. If you're paying, think twice, cut once.

I was a single mom for 10 years before I married my husband. So, I understand where your concerns are in that department. But, with the band, I had more issues than I've had with the sleeve. I couldn't eat decent foods, foods got stuck, and I puked weekly. It was tough on us as a family because eating out was a chore, and an embarrassing episode. You'll also need to know that you will not have restriction with the band until you get enough fills to hit the "sweet spot". If you don't have a solid sitter, can you really take your child to appointments to get poke with an 18gauge needle every 4-6 weeks until you finally get restrictions. If you get too much of a fill, you'll have to have an unfill. My mom had 22+ fills and unfills in 2 years, and still has never found her sweet spot with her band. She pukes 2-4 times a week, and is approaching 3 years with her band. She weighed 245 pre-op, and she is still hovering in the 170s. She still has 40lbs to lose, and it's not going to happen with her band. But, she's considered a success because of the weight she has managed to lose. Sadly, she can't eat most meat, most lettuces, no bread, and an entire list of other foods that I have zero issues eating.

I won't try to convince you because it's a personal decision, but if you want the truth, then the sleeve is by far the superior option here. The band destroyed my stomach tissue severely, and caused complications with my revision. Losing a large portion of your stomach can be scary, but having a silicone band erode into and destroy your stomach permanently is scarier. It happened to me. Read the complications I've highlighted in the box below.

I share this information with everyone that asks about the band vs. the sleeve.

This is directly from the manufacturers of the band. At the bottom, you'll find some research links for VSG. This gives you reliable, research articles and studies and not just personal experience.

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

[educationrulz 18]

Hey ngory,

I haven't been through what Tiff has been through with the band, but reading what I've read about it is enough for me. I too was going to get the band but fell in love with the idea of the sleeve after researching it. A year or so ago when I started thinking about the band, my sister (who is a nurse) tried to discourage me due to the foreign body aspect. I didn't totally get her point at the time and felt like she was being a party pooper. Then, a year later, I did more research and started to get the point. Clearly there are people out there who have been successful with the band, but I do think you need to consider how long it would take you to loose the weight IF everything went 100% ok with the band.

I too am a single mother with little support to care for my child. Believe me, I spent many nights crying in my pillow thinking about something happening to me as a result of this surgery and leaving my child motherless. That's a BAD feeling! But I kept coming back to my real reasons for doing this. I wanted a better quality of life for me and my baby (who happens to be 4). I wanted to stop taking so many medications, be motivated to get out and explore the world with her, be happier and healthier and feel good about myself. All of those things are going to benefit her. Yes, there are risks and there is the possibility that something could happen to you. This is where you do your research about the doctor you choose and don't pick a doctor that you have any doubts about. If you are confident about your doc and his/her stats, you will go into surgery much less anxious.

Things were rough for me after surgery and I still feel bad because I've been kind of pitifull around my daughter the last few weeks - between the postop healing and now a sinus infection. But, I'm able to get around and take care of us. Although I don't usually have help with anything, I was able to convince my sister to come stay with us for the week of my surgery. She lives out of state so she had to take a week off, but it worked out as a good vacation for her also. I didn't really need her to do much for me, just take care of my daughter. She brought her kids with her and they had a ball. That was huge life saver. But, I would have made do if she couldn't have come.

I'm on summer vacation right now, so I can't speak to aspects of you having to go back to work. It would have been a problem for me but others go back in a week or two and are fine. That's something you may have to play by ear.

In the end, you will have to do some soul searching to come to a comfortable decision. I personally feel that if you can afford it or if insurance will pay, the sleeve or possibly even the new plication (sp?) surgery makes more sense to me than the band. Although I was dead set against the bypass a couple of years ago, I would have gotten that before the band now that I've done more research. I was lucky that my insurance covered the sleeve so I didn't have to make that choice. Keep researching until you find the option that seems right for you. A year ago the best option for me was to put it off and think about it some more. Then I was ready to decide. Others just know right away.

Feel free to contact me if you have any more specific questions and keep us up to date on what you decide.

[ngory07 22]

Thank you both for the the great advice. I am pretty much settled on the sleeve. My insurance (bcbs IL) just started covering it. I am still scared about anything happening to me and leaving my son w/o a mother. But I feel like if I keep going down this path he will lose me anyway. I have no energy to play with him and that breaks my heart. I want to help him learn and explore the world but I barely feel like leaving the house most days. I want to set a good example and be there for him for a long time to come. He is my entire reason for living. The time off is not something I like but my boss is pretty understanding ( I am a nurse but it's more paperwork than anything) so I think I can manage. I am really excited and can't wait. I have never been thin so I can't even imagine how I will look or feel when I lose the weight but it has to be better than this.

Has anyone known or have you lost over 150 lbs with the sleeve? How long did it take?

[educationrulz 18]

Thank you both for the the great advice. I am pretty much settled on the sleeve. My insurance (bcbs IL) just started covering it. I am still scared about anything happening to me and leaving my son w/o a mother. But I feel like if I keep going down this path he will lose me anyway. I have no energy to play with him and that breaks my heart. I want to help him learn and explore the world but I barely feel like leaving the house most days. I want to set a good example and be there for him for a long time to come. He is my entire reason for living. The time off is not something I like but my boss is pretty understanding ( I am a nurse but it's more paperwork than anything) so I think I can manage. I am really excited and can't wait. I have never been thin so I can't even imagine how I will look or feel when I lose the weight but it has to be better than this.

Has anyone known or have you lost over 150 lbs with the sleeve? How long did it take?

I think you'll be happy with your decision. I haven't been thin since 3rd grade so I have no idea what it's going to be like to be a thin adult. It should be interesting to say the least. :001_tongue:

[Tiffykins 673]

Thank you both for the the great advice. I am pretty much settled on the sleeve. My insurance (bcbs IL) just started covering it. I am still scared about anything happening to me and leaving my son w/o a mother. But I feel like if I keep going down this path he will lose me anyway. I have no energy to play with him and that breaks my heart. I want to help him learn and explore the world but I barely feel like leaving the house most days. I want to set a good example and be there for him for a long time to come. He is my entire reason for living. The time off is not something I like but my boss is pretty understanding ( I am a nurse but it's more paperwork than anything) so I think I can manage. I am really excited and can't wait. I have never been thin so I can't even imagine how I will look or feel when I lose the weight but it has to be better than this.

Has anyone known or have you lost over 150 lbs with the sleeve? How long did it take?

I lost 142lbs with the sleeve in less than 11 months. It's very doable, and I honestly believe everyone can make their goal. I was extremely strict with the post op diet guidelines. I hit goal with 115lbs lost in 6.5 months, and continued to fall below goal weight by 25+pounds. I'm still in a healthy weight range for my height, and my labs look amazing. I'm happy, healthy, and living a very normal life at 13 months post-op.

If you have any specific questions, please feel free to contact me.

[Mary Gordon 3]

you have made a very good decision, the sleeve is the best!!! goodluck and please keep us posted.

[dbrar88 5]

I have to go with the others and vote for the sleeve over the band!!

I have had my band now for 3 years and have only lost 100 pounds which was in the first year and a half. Weight loss has been no more than 10-15 pounds since!! It has helped me keep what weight I have lost off, but I need to lose another 125 pounds!! So, I have just decided to meet with a physician about the revision and can't wait! The band was good for me, but you do have the constant issue of whether or not something will or will not go down each day. And Believe me, each day it TOTALLY different!! There are days when I can drink skim milk in the morning and then on others, there is no way in haitus that one sip is going down!! I will be glad to get the sleeve and have some consistency!!!

Go with the sleeve!!

[kalew 0]

So glad I got the sleeve. I too was thinking of getting the band when I went to Dr. Nick's seminar and heard about the sleeve. It has been amazing. I do not have any issues with any food, just the amount of it. I eat about a 1/3 of what I used to eat, if that. I feel so much better than I did before surgery and it hasn't even been 2 mo yet. It is scary but go to someone with a good track record. Do what your doctor says, eat only what he says post op and you will do fine.

Edited July 14, 2010 by kalew

[Ellisa 6]

Ok so I was 100% sure I wanted the LAP-BAND?. I've been doing research for about 6 months and it made the most sense for me. I am a single mom of a 2 1/2 year old boy (and I mean SINGLE ! No man at all and no family except my sister who will only babysit once in a blue moon) So if anything happens to me I have little support. But I went to my seminar yesterday and learned about the sleeve. It is less drastic than the bypass but still body altering. And the woman made it sound like there was very little chance to loose 100+ pounds with the band. I am 310 and my goal weight is 150-160 depending on where I feel confortable. Now I know that wls is just a tool and I have to change my lifestyle and I am ready to do that. But I hesitate to spend so much money on the band and not lose my excess weight. But I am not sure how I will manage with the time off work with the sleeve. And the thought of something so permanant scares the shit out of me. I would love to hear from people who changed from LAP-BAND? to sleeve or just people who have had the sleeve especially single mothers. I am just so confused and want to do the right thing. Thanks!

I don’t mean to argue with anyone here, but before you decide what is best for YOU, I would not recommend getting your advice from this board alone. Those of us who are sleeved after being banded obviously had issues that lead us here. However, I have 3 close relatives who are banded, my husband… 5 years post op, he’s lost 170 lbs. and is keeping it off. At 55 years old, he doesn’t make any conscious effort to exercise and doesn’t follow a strict diet. He does however “obey the band.” Meaning, eats slowly, and quits when he’s full, yadda yadda. My 77 year old mother was banded over a year ago, same story, 50 lbs lighter. My sister nearly 3 years ago, same story, 80 lbs lighter (nearly at goal), she does exercise some. I had lost 90 lbs with mine before having it unfilled, I also am ashamed to say do not make a conscious consistent effort to exercise. My issue that lead to being sleeved wasn’t because my band slipped or did anything wrong. It couldn’t be properly adjusted with the large hiatal hernia I had. I’m happy to be sleeved, but know there are many people who are happy to be banded.

Take your time, work with your surgeon and make the decision that’s best for you and your situation.

[shellbell27 0]

Hello... I had the sleeve done 3 weeks ago and before that I was in the same place you are. I had my mind set on getting the band but I went to a class with a couple doctors and they changed my mind. They basically told me that the band is only really ment to stay in for 2 years and they showed pics of people who had it and their body rejected the band. It was so nasty and that's what changed my mind. But any surgery you choose to get ,you have to remember , the surgery is just a tool .. It will only work if you make it work. Good luck !!!

Edited July 19, 2010 by shellbell27

[Oregondaisy 2,021]

just go to lap band talk and read the complications section of that board.

I don't know anyone who has been able to keep a band long term.

[Ellisa 6]

We don't know how many of us sleevers will have regrets or need some revision in the long term. I mentioned my 3 close relatives with lapbands all of whom are doing great. We also know several people who have done just fine. In fact, we counted 9 people off the tops of our heads and I'm the only one with complications. And my complication (hiatal hernia) can come back with the sleeve. I just figured if I was going to have a hiatal hernia anyway, I might as well have it with a WLS that will (hopefully) allow me to lose weight rather than a band that can't be adjusted and weight gain.

I guess what I'm saying is I don't have strong feelings about one over the other BUT I would not base my opinion of the Cathlic religion on a forum for "ex" Cathlics if I wanted to learn about it. I would probably give the "exes" a viewing but wouldn't consider that the experience of the majority. Though thousands of lives are saved by seatbelts every year, you will have people who are against wearing them because they think there are a few cases where someone was "killed because of the seatbelt."

The sleeve may be the very best surgery for you and by all means ask people with bad experiences and good with various WLS. But in the end, it's your body and your life and you have to make a decision that you can live with. I feel like I'm a bit of a pioneer with this surgery. I don't know what the future holds 5 years out. I certainly hope it's all good.

[Tiffykins 673]

just go to lap band talk and read the complications section of that board.

I don't know anyone who has been able to keep a band long term.

I agree. I'd love to find just one band patient that has had their band for 10 years without complications, another surgery, a 2nd band, or the ever popular "band issues". I was able to find 1 band patient on OH that had her band for almost 9 years, she is on her 2nd band, and now is going in for a revision to the sleeve. She just "lived" with the band issues because she thought it was a fair trade off to lose the majority of her weight.

For me, it's not about doing well, or losing _____% of my excess weight.

It boils down to quality of life. Not being able to eat a good, healthy balanced diet because certain foods would not go down, or the ever lovely puking on the same food I ate the day before without issue. For me, that is not a high and pleasurable quality of life.

Not to mention all of the maintenance, in and out for fills and unfills trying to find the sweet spot.

The stats on revisions for sleeve patients that have been documented at 5-7 years out is between 3-5% vs. 25% with the band. For me, that speaks volumes.

We all know someone or several that have done well with each WLS option. Unfortunately, I know way more people that have complications or "band issues" than I know true success stories.

It is a personal choice. You have to weigh all the pros and cons. Look at the big picture, and then proceed. My mom has a band, and is almost 3 years out. She pukes 2-4 times weekly. Lives on mushy, soft solids, can't eat lettuce or bread, and forget chicken. She's had over 20 fills/unfills trying to find the sweet spot, and still at almost 3 years out she has 40 pounds to goal. BUT, per the stats, she's considered a success. I just hope she doesn't screw up her stomach tissue along the way by just "dealing/living" with band issues. On the other hand, my younger brother has a band also and is about 15 months out, he's lost over 100lbs and doesn't have any of the band issues with the exception of eating certain foods. Unfortunately, he hates getting the fills at this point so he's on a forced diet because they can't get the fill right on him either. If I wanted to diet, I wouldn't have gone through WLS to begin with.

Think twice, cut once.

[kalew 0]

I agree with Tiff, having something foreign in your body, especially one that is putting pressure on tissues, just seemed to me like eventually there would be problems. I was also already thinking of way you could cheat the band, which wouldn't give me the long term weight loss I wanted. I have had zero issues with food so far. I can eat salads, chicken, steak, anything. I don't even want sweets anymore, not sure why really.