New to Site, trying to decide between sleeve and band?

[ljdewitt123 1]

I have been struggling with my weight for about 10 years now. My heaviest was 303lb and I have been up and down for many years. I already have a surgery date scheduled but have not decided 100% on what surgery I should do. I have been torn between having the sleeve or the lap band. My surgeons are afraid that I won't lose what I want to if I have the band. When I found out that my doctor offered the sleeve that was the surgery that I was initially drawn to. I'm very nervous about doing surgery at all! Surgery is scheduled for march 30th and my preop is on March 17, the doc said I had to have my mind made up on the 17th. Advice would be much appreciated!

[shaundra 5]

i want you to make your own decision, but i had the band for 4 years and i have hade the sleeve for 17 days. i wish i would have started with the sleeve and never had the band. its totally different...like night and day. the band is a lot of maintenance and for me i never found that sweet spot. i was either way too tight and throwing up everything i ate or it was too lose and i would gain back what i lost from vomiting. i hope you make this decision on your own and make peace with it before surgery, but my opinion is get the sleeve. ive done both and i can tell you i hated that damn band and im so happy its gone! have you been to the thread on here "band to sleeve revisions"? there are quite a few of us on here and im sure you can read other stories about the differences between band and sleeve on there. dont be nervous... i know its scary ,i had 2 band surgeries and 1 sleeve surgery. i was scared too, but you will be so happy when you start losing weight.

good luck!

shaundra

I have been struggling with my weight for about 10 years now. My heaviest was 303lb and I have been up and down for many years. I already have a surgery date scheduled but have not decided 100% on what surgery I should do. I have been torn between having the sleeve or the lap band. My surgeons are afraid that I won't lose what I want to if I have the band. When I found out that my doctor offered the sleeve that was the surgery that I was initially drawn to. I'm very nervous about doing surgery at all! Surgery is scheduled for march 30th and my preop is on March 17, the doc said I had to have my mind made up on the 17th. Advice would be much appreciated!

[MRSKOUBiK 27]

I originally was going for the band until the NUT told me it wasn't likely I'd lose the weight I wanted to with it alone.

I came here and read as many things as I possibly could and decided I wanted the sleeve instead.

Mainly because I knew I wasn't going to be happy with just a 50 pound loss with the band(on average).

If I was going to have WLS I wanted something that would make me successful.

Today I'm 69 days out, and 71 pounds lighter.

I have lost 5 pounds more than my mom in 2 months than she lost in an ENTIRE year with her band.

Plus the band just has too much maintenance for me. I'm glad I didn't go that route. Especially when I see my mom constantly struggling with hers.

But, at the end of the day it's YOUR CHOICE! I'm simply giving you the reasons why I chose the sleeve over the band. GOOD LUCK!

[klus263 9]

When I started my journey, I was going to have the band. But with my first visit with the surgeon, he suggested the sleeve and my insurance had just recently approved coverage for it. I came home and did my research. After weighing the risk and complications of both surgery and discussing with my husband-I chose the sleeve. I am so grateful for making that decision. I have no limitations on food except for what I chose. I am following my diet closely and have lost 56 pounds so far and I have only been sleeved for 3 months. I have never vomited, regurtitated, slimed my food. I don't have to make appointments for fills/worry about slippage/rejection/breakage. Some people are very succesful with the band-but I have only seen one-everyone else I know has had complications and had revisions to the sleeve. I know you will need to make your own decision and good luck but I do not regret having the sleeve instead of the band.

[myrori 55]

Reasons I choose the sleeve over the band:

Read the horror stories of people having erosion and slippage

People not losing or regaining their weight

Productive burping was not the least bit attractive to me

I did not like the idea of a foreign object in my body

Did not like the ideas of going for fills and knowing each fill would be followed by some pain and nausea.

[Tiffykins 673]

I won't bore you with my band horror story. I highly recommend you checking out the research links at the bottom of this very long post for VSG information. This huge entry is directly from the band makers. It's a study they did, it's not just personal stories, this is scientific evidence.

Easy break down, 1 in 4 band patients will have another surgery to either remove, reposition (after a slip then you're risks for another slip quadruple), revise to another surgery, or repair the band will happen in the first 3 years of having the band.

Think twice, cut once. I had the band for 8 short months, if you'd like to add me as a friend so you can read my torrid tale of my band life and the VSG revision feel free to do so. I've included some of the information for you to read now. I have tons of information in my blog.

I could NEVER in good spirit recommend the band knowing what I know now. I have recommended the sleeve to 7 friends, 5 have followed through with the surgery and we're all living fabulous, full active lives.

http://www.lapband.c...ty_information/

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 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