Lap band vs sleeve...help

[Blyss 12]

Hello all. I am just starting in my wls journey. I have made the decision to have surgery, just not which one. I initially planned to have the lap band but the more I read, it seems my bmi may be on the high side for a band. And the upkeep seems daunting. This started me reading about the sleeve and now I'm just not sure which is the best. I will be travelling about three hours to have the procedure, whichever it is. I have an appointment with the surgeon in about two weeks and would like to go in prepared to ask the right questions. Any guidance would be appreciated. My bmi is 45.7.

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[Arabesque 7,197]

From all I’ve read & heard, lap band is not very popular today & the number of lap band surgeries have decreased quite dramatically. Gastric sleeve is much more popular & common with fewer side effects & complications. But you have a few surgical options.

Your health & medical conditions will influence which surgery is most suitable for you & your lifestyle. For example if you already suffer from reflux, you would not be a suitable candidate for a sleeve.

Before I made my choice, I did a lot of reading & sat with my surgeon who went through the pros & cons of each surgery. He then made his recommendation based upon my medical history which matched my leanings towards the sleeve. I’m very happy with our decision.

Good luck with your journey & whichever surgery you choose.

[catwoman7 11,210]

hardly any surgeons do the lapband anymore - too many complications. It's largely been replaced by the sleeve (VSG). RNY is still very popular, too.

[Blyss 12]

I am relatively healthy. No hypertension. Not diabetic. No sleep apnea. Only on meds for depression. Occasionally I take something for heartburn but it's not an every day issue for me. I'm doubtful that I would want a bypass because I'm afraid of the malabsorptive procedures in general. The surgeon I'm going to still does lapbanding. I plan to ask about both and see where he leads me.

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[Hop_Scotch 1,630]

When I first considered weight loss surgery, I actually didn't want a surgically option and in the past had considered a band or balloon. I let it go for a few years but as weight continued to escalate I started looking again. I found what I thought was a great solution to not wanting surgery...endoscopic sleeve glastroplasty, I wish I hadn't found it. I wasted about 18 months and a lot of money.

Your BMI is high, if I were you I would pass up on the band but look to the sleeve or other weight loss surgical options, ask the surgeon what he would consider to be the best option for you given your weight, your health history, your past weight history etc. You may even what to consider seeing another surgeon too.

[New&Improved 1,780]

9 hours ago, Blyss said:

Hello all. I am just starting in my wls journey. I have made the decision to have surgery, just not which one. I initially planned to have the lap band but the more I read, it seems my bmi may be on the high side for a band. And the upkeep seems daunting. This started me reading about the sleeve and now I'm just not sure which is the best. I will be travelling about three hours to have the procedure, whichever it is. I have an appointment with the surgeon in about two weeks and would like to go in prepared to ask the right questions. Any guidance would be appreciated. My bmi is 45.7.

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Well there's more than just sleeve these days; but you have to ask yourself a few questions.

How much weight do you need to lose?

Do you suffer from reflux or gerd?

Do you have diabetes?

45.7 is quite high I would look at the bypass or even DS

[Blyss 12]

Well there's more than just sleeve these days; but you have to ask yourself a few questions.
How much weight do you need to lose?
Do you suffer from reflux or gerd?
Do you have diabetes?
45.7 is quite high I would look at the bypass or even DS

I need to lose about 120-130 lbs. I do have reflux at times but do not regularly take anything for it as it is not always a problem. No diabetes. No other health conditions at all except depression. I really don't want to go with a malabsorptive procedure. Has anyone with a bmi as high as mine been successful with the sleeve? Or lapband?

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[catwoman7 11,210]

1 minute ago, Blyss said:

Has anyone with a bmi as high as mine been successful with the sleeve? Or lapband?

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sleeve - yes - lots of people have been successful with that - even with fairly high BMI's.

lapband - again, almost no one gets those anymore. I'm very surprised your surgeon still does them.

[New&Improved 1,780]

I would talk to surgeon about your reflux just to be Safe as sleeve can make it worse..

[catwoman7 11,210]

I really think with your reflux issues, even though they're occasional, you should be considering the bypass. But if you are dead set against malabsortive procedures and will only consider lapband or sleeve, then I would go with the sleeve. The lapband is an old surgery that is rarely done anymore because of all the problems with it. Many people who had it back in its heyday having since converted to sleeve or bypass.

[Blyss 12]

I really think with your reflux issues, even though they're occasional, you should be considering the bypass. But if you are dead set against malabsortive procedures and will only consider lapband or sleeve, then I would go with the sleeve. The lapband is an old surgery that is rarely done anymore because of all the problems with it. Many people who had it back in its heyday having since converted to sleeve or bypass.

I work in healthcare and I've seen some horror stories up close regarding the malabsorption and complications after a bypass. I'd rather avoid the risk. I know those cases were likely the exception but still. They were pretty bad. I don't want to risk that type of situation. I know all of the procedures have risks associated, I'm just trying to mitigate those risks where I can. I know I really need to just talk with the surgeon but that appt is two weeks out and I'm really having a hard time not delving into this as much as I can before then. Impatient would be an understatement.


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[catwoman7 11,210]

1 hour ago, Blyss said:

I work in healthcare and I've seen some horror stories up close regarding the malabsorption and complications after a bypass. I'd rather avoid the risk. I know those cases were likely the exception but still. They were pretty bad. I don't want to risk that type of situation. I know all of the procedures have risks associated, I'm just trying to mitigate those risks where I can. I know I really need to just talk with the surgeon but that appt is two weeks out and I'm really having a hard time not delving into this as much as I can before then. Impatient would be an understatement.


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Yes... those cases are almost certainly the exception. I've been active on various bariatric boards for the last six or seven years, and we just don't see many posts about major complications. Maybe a handful a year. Most people seem to sail through with no or very minor issues

[GreenTealael 25,277]

21 hours ago, Blyss said:

I work in healthcare and I've seen some horror stories up close regarding the malabsorption and complications after a bypass. I'd rather avoid the risk. I know those cases were likely the exception but still. They were pretty bad. I don't want to risk that type of situation. I know all of the procedures have risks associated, I'm just trying to mitigate those risks where I can. I know I really need to just talk with the surgeon but that appt is two weeks out and I'm really having a hard time not delving into this as much as I can before then. Impatient would be an understatement.


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From personal experience, I heard the same shocking stories so I opted for VSG which appeared less ... (invasive? harsh? serious? IDK)

Well, I needed to be converted about 1.75 yrs in because of GERD (and other stuff) to which I had no prior indications, and this is not a rarity.

I don't share this often because I don't want to color anyone's view, because VSG is a fabulous tool for those whom it it appropriate. But if I had known that GERD would be a very real possibility for me I would have gone straight to RNY because that's where I ended up anyway (and would have prevented the need for a second surgery).

The majority of the horror stories I heard were exaggerated for effect and from antiquity 😆. These days, as technology and techniques have dramatically improved so have the complications rates. I personally observe very minimal differences between VSG and RNY.

Absolutely there will be some people who experience complications from RNY (also MGB/SIPS/DS)

But there will also be those who experience complications with VSG especially if you have reflux/heartburn/indigestion/GERD

Please carefully consult with your surgeon about the very best surgery for you and please mention the heartburn or any other important information.

Good Luck with whichever path you choose ♥️

[ms.sss 15,495]

On 8/8/2020 at 11:42 AM, Blyss said:

Has anyone with a bmi as high as mine been successful with the sleeve?

I had the sleeve done and went from a BMI 43 to BMI 21 in about 7 months.

But honestly, for the most part, the success (or non-success) of weight loss has a lot more to with the person vs. the type of surgery chosen. Stick to your plan (and barring any complications), we all end up in the same place.

Lapband has been falling out of favour, but yes, there are still surgeons who perform them, and alot of their patients have found success with them (and others who have not). The one thing about lapband though is that the device itself can truly fail (in the sense that it slips), while with the others (vsg, rny, ds, etc.) rarely fail, it is likely more the individual that that failed the tool.

As far as sleeve goes, I also +1 all the other posters who say that if you even have a hint of GERD, or reflux, pre-surgery, it’s probably in your best interest to forego this type of surgery and go another route. I had ZERO reflux issues, and since surgery I’ve been on PPI’s. I’ve been trying (again and again) to wean myself off if them, but no luck so far. i take 30mg every other day. I’m lucky that it is controlled by medication, but I’ve read many of others who are not. With that said, however, I’m still extremely satisfied with my sleeve results (reflux or not).

In the end, go with your gut. You may very well not exacerbate your occasional reflux. And even if you do, there is always a revision.

But do discuss with your surgeon.

Good Luck!

Edited August 9, 2020 by ms.sss

[Zoomzoom 45]

I had a BMI over 50 and had the sleeve. 8 mos out, down 130 lbs since pre-op diet. I had reflux before but I had a hiatal hernia that was repaired at the same time as I had the sleeve. No more reflux so far.

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