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Info From My Surgeon



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My sleeve surgeon just did a gallbladder removal for me a couple weeks ago. I saw him today for follow-up and he chatted a bit about a bariatric surgeon conference he just attended in Sydney, AU. Just as background, my surgeon does mostly sleeves and the occasional bypass. He used to do a ton of bands but now only does the band if the patient insists. He still maintains a lot of bands.

He said that the band is way down in Australia and whole areas of the country have no band surgeons anymore. He also said that the re-operation rate (for all types of re-operation) is as high as 40% with the band. He said that the band has a lot of potential points of failure, including that the port can flip, the needle can puncture the band during a fill and cause a leak, or lots of other ways that are not really direct failures of the band. He seems pretty down on the band now but wants to give his existing band patients the highest standard of care.

He also confirmed that Allergan has sold the lap band to another company, Apollo Endosurgery. I googled that and found a story in the Wall Street Journal. http://m.asia.wsj.com/articles/SB10001424052702303471004579165961441181356?mobile=y

He said that the sleeve is gaining massive popularity because of the low complication rate, high success rate, and that they are starting to feel really confident about the long term prospects of the sleeve, starting to see some patients with more than 10 years sleeved. He said that the sleeve may stretch 3-5% over time but then it stops. He said it is like taking a t-shirt and cutting off a sleeve. You can stretch the sleeve but it will never be nearly as big as the shirt.

The bypass is going to be around a long time and is still very well regarded. It is the #1 choice for people with reflux or bowel diseases and it is the best salvage surgery for people who have reflux problems after the sleeve.

The DS is very uncommon these days because the sleeve works so well on its own.

This is my surgeon's summary to me about the state of bariatric surgery in Australia today from the point of view of the surgeons.

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Interesting information, Mistysj. Thanks for sharing!

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"He said that the sleeve may stretch 3-5% over time but then it stops. He said it is like taking a t-shirt and cutting off a sleeve. You can stretch the sleeve but it will never be nearly as big as the shirt."

This is really interesting information. In particular I like the sleeve/t-shirt analogy for the stretching concept that we hear a lot of misinformation about. Thanks!

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"He said that the sleeve may stretch 3-5% over time but then it stops. He said it is like taking a t-shirt and cutting off a sleeve. You can stretch the sleeve but it will never be nearly as big as the shirt."

This is really interesting information. In particular I like the sleeve/t-shirt analogy for the stretching concept that we hear a lot of misinformation about. Thanks!

You're right, there is a lot of bad information floating around regarding this. Recently I saw a picture of a stomach that was sleeved 5 years out and it was just stretched a little bit and that's to be expected. I always just assumed the reason we still have to watch what we eat is because after a certain amount of time our metabolism changes and adapts to how little we can now eat. Even 1, 2, 3 - 5 years out.

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Thanks all for taking this in the spirit it was given, as information from a particular surgeon (who has done over 100 sleeves a year for the past 3 years and fewer before that) but not as a researcher. It is anecdotal but still interesting. He was quite candid with me about the balancing act between the concerns he has about the band and the desire to give his current band patients excellent care, in particular. I can really respect that.

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Thanks for the info...greatly appreciated!

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Excellent post! I know Australia has been generally doing sleeves longer than the U.S. I met a few ladies on a forum who were sleeved in Australia in 2003. A few successful--a few not so successful and revised to either DS or bypass. Thank you for the info. I never considered the band because of its complications but I think it's great he takes care of the already banded patients who need his help. As far as stretching--I think his analogy was great. For me personally, mine hasn't stretched at all since about 7 months post op and I'm almost 2 years out. So it's been the same for well over a year.

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My WLS journey has been at a Bariatric Center of Excellence in a major Medical Center. The Weight Loss Center here has done thousands of surgeries in the last ten years. The program is discouraging patients from pursuing the lap band procedure because of the risk of complications. In my classes, I met two lap band revision patients that have had multiple issues. After talking with them, I am very comfortable with my decision to do the sleeve.

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This was not meant as a lap band bashing post it a pro sleeve post per se. We all have the reasons for the choices we have made. I just want to make that clear.

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