Lap band or sleeve? Why did you get revision to sleeve?

[okaykay 7]

Thank you so much for the replies! I think I am going to talk to my Dr. about the sleeve. I'm only scared that if I have a leak (as rare as that may be) or other complications, that I'll have to revise to a DS or RNY ( I read somewhere that this can happen, can't remember which one..) Is that true? I'm not super knowledgable about the complications yet. Please correct me if I've been misinformed! I do NOT want either of those surgeries. Please don't take offense, I am SO happy for those of you who have had good experiences with them, it's just that I have decided those are not the routes for me. Also, I read on some forum that a lady had the sleeve done and her surgeon did not use staples. What would he have used? I tried googling it and I couldn't find anything.

[stacielynntate 88]

Thank you so much for the replies! I think I am going to talk to my Dr. about the sleeve. I'm only scared that if I have a leak (as rare as that may be) or other complications, that I'll have to revise to a DS or RNY ( I read somewhere that this can happen, can't remember which one..) Is that true? I'm not super knowledgable about the complications yet. Please correct me if I've been misinformed! I do NOT want either of those surgeries. Please don't take offense, I am SO happy for those of you who have had good experiences with them, it's just that I have decided those are not the routes for me. Also, I read on some forum that a lady had the sleeve done and her surgeon did not use staples. What would he have used? I tried googling it and I couldn't find anything.

I was banded in 2008 and lost 121 lbs. the. I had my sin in 2011 and let's just say the next 3 years where not fun. Could not keep any food down even Soup and dealt with 24/7 acid reflux. Only time I had no issues is when my band was emptied. My dr had me do several test to see what was going on and found my band was sitting a little higher then normal,after my pregnancy. So I finally said enough and on 6/18 I got revision to the sleeve. Thank god there was not a lot of scar tissue from the band and my dr was able to clean it up. I'm now 2 weeks out and feel good. It is so nice to be able to eat and drink and keep,food down. I'm still worried of a leak but don't stress over it. Yes if there are major issues they I'll revise to DS or RNY but all depends on what is going on.

[CowgirlJane 14,259]

Leaks are higher risk for revision. It's a bad plan to think that "I'll try the band and then revise".

Main reasons people revise from sleeve to bypass is out of control reflux. If you already have reflux think long and hard if the sleeve is right for you.

Leaks can happen with sleeve or bypass but aren't THAT common for first time surgeries. I think about 1-2% for sleeve. ..higher for band to sleeve revision.

Read that link that was posted above. Study it. Great article on some underlying theories about how the surgery works.

I was originally told I would not do well with sleeve since it is just restriction and you have more capacity than band even. This article even helped me understand why the sleeve worked so well for me when band did not. Sleeve seems to be more than restriction it does create some other changes.

[Sharpie 3,306]

The band has less risk and just as much success - lots of articles written about that. % of success is about the same either way. I had my band on 1/12 and have had zero problems, I have lost 65 lbs and I have changed the way I think about food. I live a normal life, eat out , have family dinners and just eat less.. I think everyone has to decide what they can live with. If the band is too much trouble than maybe weight loss surgery will not work for you. If you want 85% of your stomach removed or your insides rerouted than the other two surgeries would be your option. There is no magic bullet , it's work no matter what you choose. This subject always comes up and always the negative comments about the band amaze me. the part about foreign objects are a hoot. so nobody should ever have a knee replacement or pacemaker or anything replaced? I hope my band last for the rest of my life and I don't ever have to have a drastic surgery like the sleeve or bypass.

[johnsydney 65]

I was banded in 2004 at 136kg, got down to 90kg over about 4 years, now back up to 110kg. The only was I lose weight is with super tight restriction then I get the reflux and get miserable. I've decided to have it out and have a sleeve on the 12th of August. Can't wait to have the band removed and am looking forward to getting back on the losing side. I've also been doing my own fills / unfills for the last couple of years too. Over it now.

[chris73 38]

Stay away from the lap band!

It is failing at an alarming rate. In my case as with many others I have dilated my esophagus and have been in horrible pain.

Vomiting in my sleep. I have been completely unfilled and have severe cramps and sickness.

I lost about 50 lbs at my best and gained 20 back in the last few months, going right in line with the failure of the band. Ask your dr directly, "is the band meant to be permanent?"

The answer is no!

I was not told this up front and would have chosen differently.

I am being revised to the sleeve, I feel this is probably the safest choice, after all we are modifying something from its original.

The foreign body thing, fillings are hardly a comparison.

[ambieambs 54]

The surgical weight loss center that I am going through does not even do the lapband anymore.

[chris73 38]

My band has failed and caused issues to my esophagus.

Rather than just remove, they will do a sleeve. Which by my research is probably the safest, and effective.

Bypass is very hard on the body, malabsorption does crazy things.

[2muchfun 8,927]

Chris, I asked my doctor about the band and he said he's still performing surgeries at about the same clip and maybe more since the lapband helps diabetics lose enough weight to lower their medications. It's offered here by maybe a dozen different doctors.

I'm sure most docs have seen a decline in band placements due to the popularity of the sleeve. But it's not failing at an alarming rate. It's still failing around 10-15% depending on your definition of failing.

The downside to the band is if you don't follow the rules, dilation, erosion, slippage can cause some very bad problems such as yours. But don't judge the surgery just by your own experience. It's not atypical of most patients journey.

[chris73 38]

No need to take my word for it look around the boards.

10-15% is a huge number! The band doesn't help diabetics losing weight does, and that makes the other surgeries more effective.

I have been extremely compliant, I eat very clean and still had problems.

The band is a short term solution, and is not meant to be left

In permanently, you will eventually need surgery to either replace it, repair it, revise the surgery all together. Had I been told that up front I would have opted for the sleeve.

Additionally the "older" the band is meaning, getting past 3-5 years the incident a of failure and removal moves up sharply.

It is NOT a safe device, and has not been marketed with full disclosure

[2muchfun 8,927]

I'd like to see your documentation Chris? Short term? 3-5 years failure moves up sharply?

Yes, I've looked around the boards and since the band has been around longer than the sleeve, there will be many who have revised. But that's the point. They were able to revise. There are still patients out there who have had their band 20 years.

Many people would not have WLS if not for the band. Many of us would not have our stomachs removed. That's why we were banded. And you know what? About 60% of us lost enough weight to make it worthwhile and still have our bands. The band has a place in bariatrics that is obvious.

Sorry your band failed you as you say, but you're just throwing out wild assertions with no proof. Vent away my friend. Vent away.

[JustWatchMe 7,117]

My surgeon told me flat out that this band was permanent. He did initially ask why I ruled out the sleeve. I told him my reasons and he accepted that. He still does many bands and his is a Bariatric Center of Excellence. By reading these boards I've learned that too tight leads to many problems. And PBs, stuck episodes, reflux, etc. are signs of being too tight. So I'm very aware of this and cautious. I want my band to last and I am scared of erosion and slippage. I also know that with proper monitoring I can make sure I'm not developing problems. Right now that's easy to see with good satiety and steady weight loss. When I get to goal and maintaining, it will be more of a challenge but still my responsibility to listen to my body and have the doc check my band annually. I'm still in the honeymoon phase but I know this is a lifelong commitment.

[CowgirlJane 14,259]

I wish everyone utmost success regardless of the surgery they choose. I was banded in 2001 and had it for 10 years. My unscientific observation of my peers from that time is about 1/3 seem to do really well. Another 1/3 have fair to middling results but I believe never getting to goal is one of the reasons I regained. Another 1/3 just never find that sweet spot between pain and proper restriction. Over the 10 year haul, many did have it removed. In the early days it was always tagged as the patients fault, I think now a little more balanced view of the situation exist....As many of the failures just happen. .no shame no blame.

I still feel it is not as good of a tool as the sleeve particularly for high BMI people like I was. The sleeve allows you to eat more quantity but is less persnickety and more consistent. I was one of those who could not deal with the ups and downs of band restriction, I felt pain and reflux if I had fill and tended to eat sliders. I hated doing fills and unfills and the ongoing maintenance was a constant reminder of my failure. The band gave me eating anxiety and the last thing I need is more emotions around food!

For me, I also felt weird about the port and a device inside me. I didn't expect that to bug me but it did. I hated that port. I expected to be freaked out at the idea of missing part of my stomach so the sleeve was a desperate last attempt. ..but now that I have it, I feel like I have a normal stomach instead of the always hungry huge capacity one I had pre sleeve.

We are all individuals and there is no way of knowing that my "headspace" reflects someone else. I think each person needs to listen with an open mind about all procedures and make the best decision for themselves.

I admire the many successful bandsters as I was surely not one of them. It can be done - just be sure you know what you are getting into with any of the procedures. One thing I wished I had done pre band implant was actually meet a banded person who was maintaining a large loss - understand how they eat, feel the port etc.

I did that with the sleeve and it helped me "get it" a little.

[Bandarella 223]

@@JustWatchMe congratulations on your success thus far...

The problem with those who experience failure or complications isn't the failure to comply or keep the band a bit on the loose side. The very concept of the band is flawed.

The band "works" by triggering the vagus nerve to signal early satiety. However, it also puts a lot of upward pressure on the lower esophageal sphincter (LES). The esophagus creates strong downward pressure on the LES. The pouch created by the band only holds 1-2 oz of food, but we're told to eat 1/2-1 cup of food over 20-30 min. The opposing pressures, over time can cause damage to the LES which causes it to fail to open (achalasia). Problem is you'll just think you ate too fast, too much or that yoùr band is "finicky". That's how it feels. Your meal is now sitting in your esophagus, drinking Water sometimes helps, but not always. We don't realize what's happening until food is regurgitated from the esophagus in the same condition it went down (no acid, no bile,no foul taste, just chewed food).

I know hundreds of people who've developed this particular complication and the results have been devastating. Some are on feeding tubes, picc lines. Others like me, have a very damaged esophagus and cannot revise. My band was misplaced by my surgeon (who is very respected in bariatrics. The risk of misplacement is 3% according to the manufacturer. That's 1/33 people. Pretty bad odds.

I wish you continued success, but telling a noob that compliance and monitoring = success at 5 months out doesn't make sense.

[JustWatchMe 7,117]

@@JustWatchMe congratulations on your success thus far...

The problem with those who experience failure or complications isn't the failure to comply or keep the band a bit on the loose side. The very concept of the band is flawed.

The band "works" by triggering the vagus nerve to signal early satiety. However, it also puts a lot of upward pressure on the lower esophageal sphincter (LES). The esophagus creates strong downward pressure on the LES. The pouch created by the band only holds 1-2 oz of food, but we're told to eat 1/2-1 cup of food over 20-30 min. The opposing pressures, over time can cause damage to the LES which causes it to fail to open (achalasia). Problem is you'll just think you ate too fast, too much or that yoùr band is "finicky". That's how it feels. Your meal is now sitting in your esophagus, drinking Water sometimes helps, but not always. We don't realize what's happening until food is regurgitated from the esophagus in the same condition it went down (no acid, no bile,no foul taste, just chewed food).

I know hundreds of people who've developed this particular complication and the results have been devastating. Some are on feeding tubes, picc lines. Others like me, have a very damaged esophagus and cannot revise. My band was misplaced by my surgeon (who is very respected in bariatrics. The risk of misplacement is 3% according to the manufacturer. That's 1/33 people. Pretty bad odds.

I wish you continued success, but telling a noob that compliance and monitoring = success at 5 months out doesn't make sense.

Fair enough. I am a noob myself. The more I learn, the more I learn I need to learn. Bottom line is I won't ignore these symptoms, since complications scare me more than regaining does.