Sleeve vs. Band

[YWeight 0]

Hi everyone, I am in the beginning stages of testing and not ready for surgery for at least three more months. I was originally going to be banded and now I am seriously contemplating the sleeve. Has anyone been in my position and has chosen the sleeve and if so, why? Any feedback will be greatly appreciated.

[Tiffykins 673]

I've had BOTH. Go with the sleeve. There are so many revisions being performed now it's just not worth having to go through 2 surgeries.

I'm 2 years out from my band to VSG revision, and it's the best thing I ever did by getting that band out.

I've also added you as a friend on here so if you'd like some scientific information, research articles and more information that is not just based on personal stories, check out my blog.

Lap Band Failure

Are you looking for information on lap band surgery failure rates and long term success rates?

Lap Band surgery has only been in existence a relatively short time, approximately 10 years. Initial results with lap band were very positive with respect to weight loss and morbidity. Not many long term studies have been done. Here are the results on one eight year study. The study defines failure as losing less than 25% of excess weight. Average age of the patients was 38 years and included 50 men and 270 women.

Complication Percent affected General Complications 33.1%

Erosion 9.5% Slippage 6.3% Port Problems 7.6% Thirty three percent, fully one third of all patients developed complications such as erosion, slippage, catheter or port problems. Twenty two percent of the patients required reoperation to fix failures of the lap band.

Now for the disheartening results, only about 60% of those banded that don't have major complications maintain an acceptable excess weight loss in the long run. That means of those without complications only 4 in 10 are going to be successful. Did your doctor tell you that? Did you ask him?

In five years 40% of lap bands fail and only 43% have lost 50% of excess weight after seven years. The study concludes that LGB (Laporoscopic Gastric Band) should no longer be the surgery of choice until they figure out a way to either screen out those that have complications or eliminate the complications. The study indicates other longer lasting procedures should be used.

If you would like to read more about the study, here it is.

A reader writes regarding this study...

OK, as somebody who has been banded 6+ years, I have to say that at least 60% of the people I know who were Banded around the time I was Banded or soon after no longer have their Bands. I know that if I post something like this in the General forums... I get a lot of hands over eyes and mouth saying "no no no ... that can't be true..." because most newly Banded people do not want to hear this. I can't find any concrete statistics from Inamed/Allergan.. nor do I think they keep them (or want to keep them)... but I did find this study:

[Foxbins 625]

I was originally going with a band. Went to a surgeon's seminar, saw the skinny lady who had lost 120 lbs with her band and she just loved it, signed up for a consultation with the surgeon that same night. The next morning I went to the lap-band manufacturer's site and started reading about complications and a re-operation rate of 25%. On the MANUFACTURER'S site...so I figured the reoperation rate was probably higher than 25%...(and it is). I also started understanding the euphemisms...PB for "productive burping" which was a polite way of saying "vomiting in your mouth." I discarded the idea of a band pretty quick. I heard about the sleeve by reading about failed bands and thought, "What has my stomach ever done for me except demand food all the time? I can live without 85% of it, easily." I liked that it was a permanent, low-complication procedure with weight loss statistics better than band. So I had the surgery in January and couldn't be happier. I am one of those lucky people who lost my hunger right after surgery and I am so grateful for that, I cannot tell you. Not to be hungry, ever! And I don't miss it one bit, it's like a demon off my back.

Good luck with whatever you decide.

[Suzannesh 376]

Hi everyone, I am in the beginning stages of testing and not ready for surgery for at least three more months. I was originally going to be banded and now I am seriously contemplating the sleeve. Has anyone been in my position and has chosen the sleeve and if so, why? Any feedback will be greatly appreciated.

Hi,

I consider the band at first--and that was only for a short time. After a lot of research and talking with people who had the band--I knew I NEVER wanted to have the band. I had sleeve surgery almost 3 years ago.

There are too many problems with the band, and people have ended up having to have it removed and then pay for a revision to a sleeve$$$$.

The cost in more for the band in the long run because you are always needing to have it filled and unfilled at the cost of $200 to $300 each time. You have problems eating with the band too and they are on a liquid diet so much of the time--I don't think that is how you want to spend your life. It can slip and cause you a lot of problems. I just read an article that had followed people who had a lapband for 12 years and over 50% of them had to have it removed.

So I would NEVER consider having a lapband. Go for the sleeve. If you have more question please ask.

Suzanne

[Wheetsin 714]

I have a band. Here's my take, but let me preface by saying that I'm not drawing a tit-for-tat comparison between the two (I don't have VSG, so I couldn't if I wanted to). In other words, if I say "I like that the band can X," that doesn't mean the VSG cannot.

What I like(d) about the band: I really like the concept behind a removable tool, versus an irreversible procedure. The band doesn't work, take it out. An irreversible procedure doesn't work, what then? The overriding idea of reversibility was (and still is) very appealing. I also really like that restriction can be adjusted. There were times when I needed to have fill removed (e.g. when I was pregnant and had to chug the glucose drink first thing in the morning -- there's no way I could drink that much that quickly in the morning when I had good restriction) and I liked having that flexibility. I liked that I could eat whatever I wanted, just less of it. I really liked the weightloss I saw with my band. I liked that all of my body was remaining intact.

What I dislike(d) about the band: my restriction was not constant. For example, I have more restriction near my period, when it's humid out, and when I've flown in a plane than other times. Overtime I developed "windows" when I could comfortably eat (generally not before 11 and not after 6), which I could easily adapt to - but the windows also changed about 3 times since I've had surgery (early 2006). I have virtually no confidence in the band as a long-term solution. I know too many people who are at an advanced post-op stage (5+ years out) who have had slips or other complications, including me. I don't like the pain that comes when something is stuck (but I do like that once it's out, you're golden).

What I like (so far, as a researcher) about VSG: I like that, like the band, it's a restrictive option. At this point in my life I would not consider a malabsorptive option. I like that it seems like restriction will be more reliable. Again, I don't have VSG so I don't know how this would work out for me. I like the idea that it's once & done. I never minded after care for fills/unfills, but I did doubt the longevity of the band. Having automatic longevity would be nice (and scary at the same time).

What I don't like (so far) about VSG: I don't like the increased complications that revision patients have (I've been quoted stats in the area of 3x - 4x). I don't like that when something goes wrong, it has a higher chance of being significant -- a higher degree of criticality. E.g. a staple line leak/sepsis versus a flipped port. I know some people develop a mild version of RNY's dumping syndrome. It doesn't seem that common, but I didn't think it happened with VSG & apparently it can - don't like that. I don't like that I'm voluntarily excising, permanently, the majority of my stomach. I am struggling with this a bit. But I'm objective as hell, so of course I see at least two sides to it. Side 1 = What if something goes wrong, then what? Side 2 = If something goes wrong, so what? Is it something the other 90% of your stomach would have been able to fix, anyway?

All that aside, I've submitted for insurance approval on a VSG revision. For me, it boils down to a couple easy facts:

1. Due to the severity of my slip & likely scarring/adhesions/etc. my surgeon is not considering me a candidate for re-banding. Even if he were, my confidence in keeping a 2nd band long term is virtually none. Re-banders just don't stay that way very long.
2. I do not want a malabsorptive procedure. With banding not being an option, and my reservations about some of the other procedures out there, that kinda just leaves two choices: VSG or nothing.
3. I have no confidence in my ability to maintain my weightloss, or lose more, on a long term basis, by myself. I have maintained for going on 3 years, but I still have some help from my (slipped) band. I do not trust myself to truly do it alone.
4. That kinda just leaves VSG.

I wanted the band. I chose the band. It didn't work for me. This is my 2nd choice. It doesn't feel great to me to have to go with choice #2, but it sure beats the heck out of the alternative.

HTH

[Wheetsin 714]

By the way, I don't know if you saw it but there is a forum on the board dedicated to bnad -> sleeve revisions: Band to sleeve revisions

[Oregondaisy 2,021]

Wheetsin I so remember you from LBT! Believe me, you're going to love the sleeve. There is no comparison between the band and sleeve. It's like night and day.

I hope your insurance approves you!

[Raine 170]

I chose the sleeve because I did not like all of the complications that came with the band and read about all of the revisions, and figured, with my medical luck (or lack there of) I would be one of those that would HAVE to have a revision lol so why not go there first.

[Suzannesh 376]

I have a band. Here's my take, but let me preface by saying that I'm not drawing a tit-for-tat comparison between the two (I don't have VSG, so I couldn't if I wanted to). In other words, if I say "I like that the band can X," that doesn't mean the VSG cannot.

What I like(d) about the band: I really like the concept behind a removable tool, versus an irreversible procedure. The band doesn't work, take it out. An irreversible procedure doesn't work, what then? The overriding idea of reversibility was (and still is) very appealing. I also really like that restriction can be adjusted. There were times when I needed to have fill removed (e.g. when I was pregnant and had to chug the glucose drink first thing in the morning -- there's no way I could drink that much that quickly in the morning when I had good restriction) and I liked having that flexibility. I liked that I could eat whatever I wanted, just less of it. I really liked the weightloss I saw with my band. I liked that all of my body was remaining intact.

What I dislike(d) about the band: my restriction was not constant. For example, I have more restriction near my period, when it's humid out, and when I've flown in a plane than other times. Overtime I developed "windows" when I could comfortably eat (generally not before 11 and not after 6), which I could easily adapt to - but the windows also changed about 3 times since I've had surgery (early 2006). I have virtually no confidence in the band as a long-term solution. I know too many people who are at an advanced post-op stage (5+ years out) who have had slips or other complications, including me. I don't like the pain that comes when something is stuck (but I do like that once it's out, you're golden).

What I like (so far, as a researcher) about VSG: I like that, like the band, it's a restrictive option. At this point in my life I would not consider a malabsorptive option. I like that it seems like restriction will be more reliable. Again, I don't have VSG so I don't know how this would work out for me. I like the idea that it's once & done. I never minded after care for fills/unfills, but I did doubt the longevity of the band. Having automatic longevity would be nice (and scary at the same time).

What I don't like (so far) about VSG: I don't like the increased complications that revision patients have (I've been quoted stats in the area of 3x - 4x). I don't like that when something goes wrong, it has a higher chance of being significant -- a higher degree of criticality. E.g. a staple line leak/sepsis versus a flipped port. I know some people develop a mild version of RNY's dumping syndrome. It doesn't seem that common, but I didn't think it happened with VSG & apparently it can - don't like that. I don't like that I'm voluntarily excising, permanently, the majority of my stomach. I am struggling with this a bit. But I'm objective as hell, so of course I see at least two sides to it. Side 1 = What if something goes wrong, then what? Side 2 = If something goes wrong, so what? Is it something the other 90% of your stomach would have been able to fix, anyway?

All that aside, I've submitted for insurance approval on a VSG revision. For me, it boils down to a couple easy facts:

1. Due to the severity of my slip & likely scarring/adhesions/etc. my surgeon is not considering me a candidate for re-banding. Even if he were, my confidence in keeping a 2nd band long term is virtually none. Re-banders just don't stay that way very long.
2. I do not want a malabsorptive procedure. With banding not being an option, and my reservations about some of the other procedures out there, that kinda just leaves two choices: VSG or nothing.
3. I have no confidence in my ability to maintain my weightloss, or lose more, on a long term basis, by myself. I have maintained for going on 3 years, but I still have some help from my (slipped) band. I do not trust myself to truly do it alone.
4. That kinda just leaves VSG.

I wanted the band. I chose the band. It didn't work for me. This is my 2nd choice. It doesn't feel great to me to have to go with choice #2, but it sure beats the heck out of the alternative.

HTH

Hi,

I think you were fair and honest when you compared the band vs the VSG or better known as the Sleeve. So like so many of us the Sleeve was our choice because of all the things you have stated about the problems with you lapband. I hope you find what will work for you and Congratulations on reaching your goal.

Hugs,

Suzanne

[nikki c 16]

I am having banded plication. It operates like a sleeve for rapid weight loss + the band for continued control down the road. I was in a debate about this as well. You should see if any surgeons in your area are doing this, as it's relatively new (perform in MX for a while, though). Results have been excellent so far.

If you have to choose only between the sleeve and band, i'd say sleeve for sure. No doubt that's what i'd definitely do, and i've researched both of them thoroughly.

http://www.peachtreebariatrics.com/gastric-band-plication.php

http://www.verticalsleevetalk.com/topic/15214-banded-plication/

http://www.ncbi.nlm.nih.gov/pubmed/21546318

http://www.fortworthlapband.com/BandedPlication.aspx

http://www.hollywoodbariatrics.com/bariatric-surgery/banded-gastric-plication

hth!

[YWeight 0]

Hi everyone, I am in the beginning stages of testing and not ready for surgery for at least three more months. I was originally going to be banded and now I am seriously contemplating the sleeve. Has anyone been in my position and has chosen the sleeve and if so, why? Any feedback will be greatly appreciated.

Making a decision for wls is hard enought but chooing the right surgery is even harder. You guys have really helped with your replies. I'll keep you posed as I still have a few months before all my test and approval is complete.

[Wheetsin 714]

Eekgads, I have a hard time following posts here. I'm not sure why. I don't mean to be so one-night-stand with my messages, I just never manage to find my threads again. (Which makes no sense, since this is the same BB software LBT runs on and I do just fine over there.)

They are, I guess, making the case for my approval. I've been scheduled for an EGD, which is required as part of the documentation on my slip.

I know VSG is covered, and I can't imagine I wouldn't qualify. And I don't exepect much argument that removing my band is "medically necessary." We shall see. If I have to do an EGD to be denied, I'm gonna be a frowny face.

I hope I love it. I've been banded so long that I actually manage to forget I'm banded. I'm just a still chubby girl who chews her food way more than anyone else. I hope what I have learned eases the transition, and that it isn't a 100% start over from scratch. But if it is, it is. I suspect my brain will struggle with trying to make direct translations between feelings/sensations/etc with the band, and the sleeve.

Wheetsin I so remember you from LBT! Believe me, you're going to love the sleeve. There is no comparison between the band and sleeve. It's like night and day.

I hope your insurance approves you!

Suzanneh - thanks. I'm a pretty straight-shooter, factual, and objective to a fault. While that's probably a ripe combination for messageboard suicide, it does let me see the band for what it is, and not get involved on a "my band" level.