How to Choose Between Band and Sleeve

[marysmom1216 12]

Hello...I am brand new here. I am 36 (will be 37 in less then a month). I am 5'7 and 245lb. I have PCOS, Diabetes, and high cholesterol. I just found out my insurance covers bariatric surgery and I am torn on what kind to get. I would like to loose around 70-80 pounds to get down to a healthy weight. How do people decide between the sleeve and LapBand? What are the benefits of one or the other?

THanks for your time!!!!

Alicia

[KateP 359]

Please bear in mind that I am a very happy and very successful bandit now 9 years post-op. I do not regret my band, would do it all over again and if I ever have to have it removed, I would hope to have a replacement.

When I was banded in 2006, it was a miracle surgery. And for some people, who accept that they will still have to work hard, it is just that. It was and still is for me. But over the years it has become clear that serious complications necessitating further surgery are much more common than originally thought, some of these are avoidable by careful eating and by not keeping the band tight; unfortunately others are beyond our control.

We used to be warned about band slips, leaks and about ( very rare) erosion into the stomach tissue but it turns out that a build up of scar tissue round the band (causing it to tighten) is quite common. It can be very difficult to get the right level of restriction and some people are tempted to keep it tight enough to physically limit food, in fact it was once thought this was how it should be. But this causes food to back up into the oesophagus and that risks problems such as oesophageal dysmotility which may be irreversible. It can also damage the vagus nerve.

Quite a number of doctors have stopped implanting bands as they found the removal rate was unacceptably high and it was too easy not to lose enough weight. Revision from band to sleeve is nit uncommon!

We still need lots of will power. The band makes it easier by dimming hunger, but it does nothing for head hunger and, contrary to popular opinion, it does not and should not physically stop us eating. If it does it is too tight!

Having said all that, I love my band, I know many successful long term bandits in real life. My own experience has been good and so has that of almost all those I actually know and have met.

[GreenEyes604 753]

It was a very easy decision for me. I just felt strongly that I did not want a foreign object permanently placed in my body.

[CanyonBaby 1,852]

The sleeve was for me. I just wanted something permanent, something I wouldn't have to "get after", or have anything done to it. I have had 22 surgeries, including this one, and I don't want any more. At some point in time, I feel invasiveness will get the better of me, and I need to stop having things done, or it will. If I continue to follow my plan, and I fully intend to, this "permanent" fix will do what it was intended to do, and I should live "happily ever after"!

[Kimberly Bouche-Perez 48]

Hi, when I went to my first group in Septemebr of 2012, both me and my PCP decided to get the band.

Well after meeting several people in the group (there wa almost 50 people there is was the first groiup seminar) and hearing there horror stories about the band (I did NOT meet not 1 person who was happy witht the band) I very quickly changed my mine.

This is how they explained the diffrence ion that first group.

Gastric Bypass you will loose between 70-80% of weight

Sleeve around 60%

Lap Band was only MOST 30%

Since my insurance has a clause of Once in a LIFETIME weight loss surgery, I decided that I wanted to go big or go home.

I chose the gastric bypas surgery. I knew it was more invasive but I just didn't want the band just to have it removed down the road and then, that was it.

This website is great!!!! I found it just over a week ago and it's great. Just do research with ALL the surgery's.

Choose what i right for YOU!

I wanted thiis weight gone. I did what was right for me.

However, I am grateful that I DID NOT choose the band. All I have heard is problems with GERD and slippage. In fact a lot of doctor's are not even doing it anymore cuase of the complications.

I think and this is MY opinion. If you want to loose more then 50 lbs then the band is not right for you.

The diffrence between the sleeve and the bypass is the bypass your new stomach is the size of an egg verses the size of a bananna.

The sleeve does not change the metobolic (excuse the spelling) rate in which food is digested.

There have been a lot of sucess with BOTH surgery's. Again you have to choose what is right for YOU.

Talk to your doctor and discuss this.

If you need a eight loss buddy let me know and I will give you my email.

Good luck

Kim

[1Day1Life 26]

Everyone needs to choose which surgery is best for them. We all have different needs, fears and life styles. My doctor was not to keen on the lap band though she had done a large number of them. She told us of some difficulties some of her patients had recently had so I then had to select the gastric bypass or the sleeve. I was looking for a life style change but didn't want to deal with the dumping syndrome you get from cheating with the bypass. So for me, the only choice was to go with the Gastric Sleeve. I have loved it, I've lost weight, and I have never had the first problem. I love my sleeve and I will forever eat less than the average person. I'm good with that and I enjoy being able to share clothes with my 26 year old daughter. Life is good. Good luck to you which ever surgery you decide to get. Maybe your doctor can give you some guidance.

[gowalking 10,790]

Do your research and pick what you are most comfortable with. Most people who get banded do so because it's not permanent.

All I can tell you is that you shouldn't rely on opinions on this or any other forum. You have to decide and the best way to do that is to know as much as possible about whichever weight loss surgery you are considering.

Good luck with whatever you decide.

[snickysnack78 131]

Hello,

Definitely make sure to do your research. Talk with your dr. They will help you with any questions that you may have and depending on how much you want to lose, you will come together and make a choice. My insurance doesn't do the lap band anymore because there isn't a high success rate, too much maintenance, and the ability to have a 2nd stomach and not lose the weight is great.

This forum is amazing and you will find a lot of information on here. Good luck on your journey

[losing_the_band 133]

I'll warn you in advance, this post is very passionate. I'm going to tell you about my personal experiences, and what made me come to my conclusions about the band.

I'm currently on my second band and trying to get a revision surgery to RNY bypass approved by my insurance. Obviously, my advice would be "anything but the band!" When I first got the band, doctors were encouraging us to have it filled to the point where it severely physically limited the amount you can eat. Unfortunately, that leads to a huge likelihood of complications (slippage/prolapse, erosion, esophageal problems, GERD, and others). I stupidly listened to my doctor when she just prescribed proton-pump inhibitors for the GERD that I developed, instead of telling me to come in to have liquid removed. I now know that I was way, way, way too tight. Eventually, I had to have a major unfill because the acid reflux was to the point where I was waking up choking on stomach acid, even though I was sleeping almost upright.

When I moved across the country and switched surgeons, my new surgeon had a fluoroscope in his office and could do imaging right there. We found out that I'd had a major slip, to the point where the space where food passes from the upper pouch to the lower pouch was only about the size of a pencil eraser (and this was after the unfill by my first surgeon several months beforehand). Obviously, that band had to come out. My second band has been nothing but a pain in the hiney. I can't get to the "sweet spot" with it at all, and at this point, I've regained almost everything I lost with my first band (and I was initially very successful with the first one, lost 90 pounds and was well within a normal BMI range). I've developed acid reflux again, and that's cause me a lot of issues. I actually have to go this week to get two tooth fillings replaced because the acid is causing them to break down. I'm getting acid erosion on my teeth, too, so I now have to use a prescription toothpaste. I have zero fill whatsoever at this point, because when I tried to eat a raw carrot, the band decided that even though it had let me eat them every day for a month, it didn't like it that day, and it got stuck and caused a major "PB" session in the bathroom. That caused my acid reflux to come back with a vengeance, to the point where I thought I'd had another slip.

People say, "Oh, it's less invasive." Bull-you know what. The only time the band is "less invasive" is during the initial procedure. Don't forget that you've got to have regular fill/unfill appointments, which if they're done right, are done with fluoroscopy, so that the doctor knows the condition of the pouch and band as he fills the band. If you have any complications with the band, you're going to be having surgery again, because all the complications of the band are generally going to require either removal or repositioning. You have to constantly worry about getting sick or something getting "stuck" in the band, because vomiting can cause a slip/prolapse. I am always worrying about getting the flu or having motion sickness and causing myself even more problems than I already have.

The whole point of the band is that it artificially creates a smaller "stomach" pouch that limits the amount you eat by making you feel full faster. I feel like if you can't have the band filled to where it's doing what it's supposed to do (limiting the amount you eat), because it puts you at high risk of major complications, then what's the point of having it? If we had great will power and were able to limit the types and amount of food that we eat on our own, none of us would be at the point of needing WLS in the first place.

I honestly think that a lot of us are still stuck in that mind-space where we think that weight loss should be hard, and we try to make it harder than it has to be. Like a lot of normal-weight people think, we subconsciously think that we're taking the easy way out, so we try to make it more difficult, that the process being harder "builds character." People always say, "I didn't put the weight on in a day, I shouldn't take it off in a day." Why are we making this harder than it has to be? "Harder" doesn't build character, it's just harder. Why is it bad to do something "the easy way?" (Yes, we all know it isn't, but I'm talking about our subconscious thoughts.) We use dishwashers instead of washing all our dishes by hand using Water boiled on the stove, we don't usually wash all of our clothes by hand, we don't walk to work, and we aren't cooking over open fires anymore. Like the saying goes, "Work smarter, not harder."

Edited April 19, 2015 by losing_the_band

[CowgirlJane 14,259]

@@KateP your post resonates with me very loudly!

I had the lapband for 10 years and was an EPIC FAIL. I want to be completely honest - I contributed to that fail. Well, my lack of understanding of my disease process (obesity) combined with very limited support from my surgeon (told me I would just eat petite portions and be satisfied) was all part of me failing.one.more.time. I vomited alot. I was socially embarrassed by that more then I can describe. It was awful.

My experience with the band was that I was constantly hungry and vomited at the least "transgression". Even after 10 years and a completely stretched pouch, a single bite of rice and I would vomit! You would think that at some point that would stop, but it didn't for me even as huge as I became.

I am 5'5" female

Band: Started at 272, got down to 204; regained to mid 300s....highest recorded was 332 post band

Sleeve: Started at 308; got down to 140; regained to about mid 150s...and hanging out there. I think I am hawt

At three years post revision to sleeve I have a "new" wisdom. They (WLS choices) are all hard. You need a huge education on how to behave differently.

I personally think the band has way more day to day "difficulties" and I was much relieve to be rid of it. I say this because of the fills and that damn port. Hated it. Really, it ruined my life for awhile.

I also see failed sleeve patients.

I can never recommend the band, but I deeply respect the many success stories including @@Alex Brecher founder of this site.

Whatever you decide - it take a pretty serious commitment to stay in the realm of normal. I am 3 years 4 months post sleeve and maintaining. I am positivily thrilled, but will never claim that the gastric sleeve is some kind of magical solution either!

I was never transformed by the lapband, but, post sleeve - I live a whole different life. Sleeve has issues too, but I thank God, my lucky stars and whoeve else is listening, every single day... to just be normal.

[Bandista 7,466]

You will get a lot of responses here about one surgery being better than another, especially from people who have had negative experiences and need to vent. Be careful not to take advice from strangers on the Internet as information can be biased even if it well-meant. The important thing is that you are choosing yourself and your healthy future. Only you and your doctor can decide on the best path for you as an individual patient. I chose the band because it is reversible. If there is ever an issue I can have it removed and go another route. I was not prepared to do something more drastic -- I totally respect those who are. For me it was the band or nothing and I'm very glad I got weight loss surgery. It changed my life. When I was starting my research I decided to get some therapy. It helped to have a third party to discuss things with and go through the process with me. We worked on breaking down my triggers and assessing eating patterns, etc. and all that "stuff" around emotional eating, etc. best wishes to you!

[Crosby 303]

I just will share my decision making journey. At first I wanted the band. It was the only non permanent option. I had lost 130 pounds on my own and regained 80 something after a significant hip injury resulted in 3 years of inability to exercise and two surgeries. I thought since I had done that the band would be the extra lift I needed. I then began researching the band and learned it required continue " maintenance " / medical intervention. That just did appeal to me. Then I began seeing how many surgeons were no longer even doing it because of complications. The particular practice I choose was one where they had just ceased doing them. That sealed it for me. Next consideration was the sleeve.

I like the sleeve because it did not have the malabsorption issues of the RNY and it seemed less invasive. ( although now I realize it involves cutting and removing portion of the stomach while the RNY leaves the stomach there). Also the sleeve would allow me to take NSAIDS for my arthritis. But then I read about the increase risk of really bad acid reflux with the sleeve. I already had acid reflux that required twice daily medication and had caused Pre Barrett's syndrome. A risk of more acid reflux could present major problems for me. Later the surgeon I picked said he would not even do it on me.

So that left me with RNY. ( I did not research the duodenal switch ) I was hesitant of course due mainly to the permanence of it. It was scary. During my pre op requirements ( which was 9 months) I did extensive research and became more comfortable with the decision. It had the longest studies and largest success rate. I had to have hip replacement 6 months into the pre op process and I really needed the procedure that would give me the greatest chance of taking the weight off the fastest to help in my hip recovery. Once again that was the RNY.

I had surgery 2/27 and have been quite pleased. The day of surgery I was 269 and today I am 233. I have had a fairly easy adjustment and recovery. The worst for me has been the exhaustion. I am also still limited physically due to my hip. The inability to take NSAIDS is distressing I will admit. I have arthritis all over and some days are tough. I don't take any pain meds. I do hope that as I lose more weight the knees and hips will do much better.

[CanyonBaby 1,852]

@@losing_the_band

You are AMAZING! But I think, after all you have been through, you need a "mental hug", SO here it comes.......hug.....

[losing_the_band 133]

@@losing_the_band

You are AMAZING! But I think, after all you have been through, you need a "mental hug", SO here it comes.......hug.....

Thank you, and I gladly accept!

I think what really gets to me is that I didn't realize how the band affected my quality of life until relatively recently. At some point, you just get used to it, and I think that's the saddest part of it. It becomes second-nature to scope out the restrooms in a restaurant so that you know where they are if you have to go PB in a hurry, you get used to the chest pain and slobbering when something gets stuck, you get used to making excuses to the people you're eating with when you have to keep getting up to go to the restroom because something wants to come up but can't. The worst thing is that when the weight is coming off, you put up with stuff like that because when you've been overweight/obese your entire life, the prospect of finally being a normal weight lets you overlook what you're going through to get there. It's really easy to overlook signs of trouble when your goal is finally in sight.

And a lot of the surgeons/surgery centers/manufacturers seem to encourage it! They gloss over the issues that many banded people have, the rates of complications, etc. They make it seem like a slim chance that you'll have issues, that you just have surgery to pop the band in and then it's smooth sailing from there. I live in Miami, and I hear commercials on the radio for the band every single day, multiple times a day, mostly from surgery mills that are advertising it like it's a minor cosmetic procedure. "You'll be in and out in a day and the weight will just melt off!"

[CanyonBaby 1,852]

@@losing_the_band

And I can totally relate to what you're saying, because after all the crap I have had to endure because of my weight, and the different major surgeries involved because of said weight, I had given up the thought of EVER being "normal" and living without this CONSTANT "weight" around my neck!!! Until, yes it is true, 2 months before I had the sleeve done, I had NO IDEA such a surgery existed, let alone think WLS could be for me. I weighed 232lbs when I started my "journey", maybe not so much in some people's eyes, but what it DID to me over the years was downright DISASTEROUS.

And I couldn't fight it. Genetics, health issues, every diet conceivable....nothing worked, and everything was saying "die, fool!". I had given up. My family history tells me I will die by the time I am 65, if not sooner (sis just passed at 56, mom at 64). SOMETHING had to be done. So I did it. It was surgery number 22. Husband said this time he thought I wouldn't make it - wow, for him to say that. I am 53, and am now in remission from my diabetes. My blood pressure is down. My cholesterol is down. I am down 55lbs since I had the surgery in December. Doing ok, I think. THINK....heck, yeah!

I don't know how long I have, no one does. But I feel I at least, FINALLY, I have a fighting chance. Today is my 18th wedding anniversary. I'm looking for a whole lot more. To us, my dear, to us!