RNY - lapband...which way to go???

[Hollins2003 0]

I have been lurking for awhile, reading posts and doing research. I am about one month out from my surgery date (July 2nd). My surgeon (Dr. Maher in Richmond, VA) originally recommended laparoscopic gastric bypass during my initial consultation. He suggested this for two separate reasons: 1) the amount of weight I need to lose (130 pounds) and 2) the adjustments needed for the lap band. While he is willing to do either surgery he felt that in the long run gastric bypass would be more successful. When I met with him I was dead set on lap band. However, reading about the complications, adjustments, etc. I am beginning to waver. I feel that the surgery for the lap band is safer and less complicated...but I trust my surgeon 100%. He has been performing the gastric bypass and lap band for a long time and has had zero mortalities for either surgery. I am beginning to wonder if he is correct...maybe the gastric bypass would be a better option. I am not looking for a quick fix..rather I am looking for one and ONLY one surgery that will provide a tool to maintain weight loss. My fear is that I will not be successful with the lap band and will opt for a revision to gastric bypass.

Any advice, suggestions, etc. would be greatly appreciated. I just want to make sure I make the best decision for me!

Jennifer:mellow:

[sundance 0]

if I had a choice I would do gastric bypass hands down. No question about it.

[Hollins2003 0]

Could you explain why? At the moment I am leaning towards gastric bypass because:

1) I don't want to be considering a revision surgery in a few years if I am not successful with the band.

2) The amount of maintenance a band requires (I live two and a half hours from my surgeon).

[sundance 0]

I have not been all that successful with the band. I am starving all the time and eat very little but have only lost 40 pounds. I through up almost daily, which makes me afraid my band will slip and there you go ...another surgery...I have a friend that had gastric bypass 3 months ago and he has lost over 100 pounds already. I wish I could have the gastric bypass now and I would not have to worry about fills, slips, throughing up, etc.

[UT LB Loser 0]

Are you both serious? Gastric bypass has so many drawbacks!! I looked into that long and hard. I have friends who have done gastric bypass. While they did lose alot of weight initially, they are both struggling to keep it off. They each have dumping syndrome. That very well could last FOREVER!!!! I know a few people that had gastric bypass many years ago and have now regained much of their weight.

My own experience has been awesome with the LapBand. I have lost over 60 lbs in 6 months and am now training for a triathlon. I never thought I could have results like this. I once said that the LapBand changed my life. I have now amended that to : I have changed my own life, the LapBand has made it simpler.

I know of a few ladies that were banded the same day as I was that aren't having the same type of success as I am. They have lost over 30 lbs. They are comparing themselves to me and others who are doing better. Remember, we each have our own weight gain history, so we'll each have our own weight loss history. Men and women are different as well.

Think long and hard before you cut your stomach away. The LapBand is reversible, if necessary. Gastric bypass really isn't reversible.

Good luck whichever decision you make!!!

Edited May 30, 2008 by UT LB Loser

[Hollins2003 0]

I am actually very serious. I am attempting to make a decision (and whichever way I decide it will be life altering).

While gastric bypass has drawbacks so does lapband. One of the first and foremost being the adjustments needed for the band. While I agree that I have seen many people initally lose a lot of weight and then gain most of it back with bypass, I have also seen people not utilize their band and lose 9 pounds in a year.

Like I said earlier, I am just attempting to make the best decision for myself.

- Jennifer

[UT LB Loser 0]

I have had 9 fills in 6 months. My Dr. is not very agressive in doing fills. The nurses have all had the LapBand surgery and they have told me that while you can find your sweet spot by filling the band and unfilling to the point that you can drink Water, it is safer and more advisable to slowly fill the band. This allows the stomach to gradually adjust to the band and lessen the swelling and possibilty of slips. I have asked how many slips they have encountered in the past year. I was told that they have had only a couple. Some of those were attributed to other factors.

I understand you want to make the right decision for you. For me it was a no brainer. I am not all knowing about the LapBand or Gastric Bypass. I can only speak from my own experience. I am glad I made the decision I did. If for any reason in the future I decide that this is not the thing for me, it is reversible. I can't imagine that ever happening, however.

Again, good luck!!!

[tmusicmaker123 0]

I too am very glad I chose the Lap band. My doctor also tried to encourage me to have the gastric by-pass because of the amount of weight I needed to loose (200lbs). I have lost 78lbs since my surgery in January. I don't think I could have lost it any faster with the by-pass. I have several friends who chose the by-pass and have also gained some or most of their weight back over the years. I do not see that being a problem with the band as long as I do my part to maintain my fills, etc. Good luck in your decision and either way, you will be glad you made the decision to change your life.

[HF2008 0]

Jennifer,

You are a young thirty, I am thirty one and I have a friend who had gastric bypass. She went with me to my intial consultation and she asked my surgeon to explain his choice. And he said, I was young, lap band is reversible, less evasive, blah blah! The main thing that stuck with me is.... I am young and I can do this! Bypass is easier because you don't have to work that hard at losing weight. But as someone else mentioned, why cut your stomach off?

Also, when something comes so easy.....maybe that's why the weight comes back with bypass. Because you didn't work at it!

I have not been banded but I believe the lap band is a better choice and you have to work with the band and be dedicated to a change in your life. If you work with the band and have a regular excercise routine. It will work in your benefit and perform just as good as the bypass.

Things that come fast are not always the best....

NO matter what anyone says...You have to look at what's best for you. Explore your history and really dig and find out how you gained the weight(i.e. overeating, choices in food, or whatever your reason), and think about how you lose weight, and how you have to work at losing weight. And I think you will find your answer there....

Just my 2 cents

[moosey52 0]

Well I was banded 4/9/08 and as of to date I have lost 26lbs. I choosed the band because I wanted a more slow way to lose, and I feel the band I have more control what I want and when I want it. I always felt at the begining that what if I really got sick and I needed all the nutrition I could get in to me without them putting a feeding tube in my nose. Well with the band I can get the Dr. to take all the band fluids out and eat whatever I needed. With the band I know I have control of my body and I would never go for anyone taking parts of me apart or disconnect here or there. Oh I know we all heard the saying well I wouldnt want a object laying around inside of me. Well believe me there are more people with something in them

eventually. Knee or hip replacements, breast implants, a screw here or there. The Band has come a long way now. My Dr. used the new 10cc band on me called the realizeband. Go to www.realizeband.com there you find the new band they are using, and they even have a number you can call to ask any questions and its a real person you talk to.

My neice had the gastric and now she is so sorry for it, she cant keep Protein in her long enough to do anything for her so now she has to go get a IV of protein once a week, and her hair keeps falling out. Oh she has lost alot of weight but she is paying for it now.

So whatever you deciede good luck and besure to check the website I think you will learn alot more there.

[eazes 0]

Personally I chose the Lap Band because I wanted to be more active in my weight loss journey. When we all make the decision to persue WLS we all do it for different reasons. I really could not stomach, for lack of a better word, the idea of having my stomach cut and floating around in my belly and then also have my intestines rerouted. To others this way may be the best for them and they have no problems with the procedure. To each his own. The lapband will allow me to relearn how to eat and take care of my body. That is what I am trying to do now. I'm trying to stick to a good exercise regime and trying make good food choices.

You can talk to as many people as you want and you will get half saying lapbands the best and the other saying bypass is better. When it comes down to it listen to your heart and decide what you can live with. Only you can make this decision and only you have to live with the results. I wish you luck on your decision and I hope that you make the right choice for you.

[snowbird 2]

I don't consider the fills/adjustments a drawback; I consider them one of the positives of lapband. If I start to eat too much, there is a quick and easy fix. Two and a half hours?? That's nothing. DH and I drive 5 hours for our fills. It isn't that often, and we make a day of it. I've had two fills and I will not need another to reach goal.

As others have said, I have friends who had gb, lost over 100 lb, then gained it all back. Plus, one friend who did that STILL throws up every time she eats a meal. The fact that the band can be adjusted when weight gain slows down or stops is one of the things that sold me on it.

Your doctor may have reasons for recommending GB over lapband for reasons that have nothing to do with your health or chances of success.

[MacMadame 81]

I am always shocked when a surgeon recommends GB over lap band for any reason other than a patient needing a more immediate weight loss due to health reasons (i.e., you'll be dead in a few years if you don't drop 100 lb. NOW) or a patient just being psychologically unfit for the lap band.

Outside the US lap band surgeries are the #1 WLS precisely because they are less invasive, more customizable, cheaper to perform and have less complications. It's only in the US that gastric bypass is the #1 WLS. Personally, I find that mystifying and I wouldn't find a US surgeon recommending bypass to me over lap band to be particularly compelling just because I think their thinking on the subject is so warped.

I mean "you're young enough to have a riskier surgery" isn't my idea of an impressive argument unless that surgery had a much better chance of success. Yet long term studies show that bypass patients keep off no more weight than lap band patients so it has no better chance of success. The only thing it has to recommend it is faster weight loss with less lifestyle changes -- though the lifestyle changes are still necessary if you want to keep the weight off in the long run.

So basically it's a bit easier and a bit faster at first, but no easier and no more successful in the long run. Hey, cut me open and slice up my internal organs, I'm sold! Not.

Not only am I not sold, but I find the "you're young and healthy" argument to be a better argument for lap band... if you are young, you can take an extra year to get the weight off. If you're old like me, an extra year is a long time. :w00t:

Sure you are going to read a lot about complications of the lap band on this site -- it's a support site for lap band. Go to a support site for GB and you will see all the complications they suffer. You think PBing sounds gross? Try dumping syndrome. You are scared of slippage or erosion? How about getting a leak in your staple line!

Both surgeries have complications, but many of the lap band complications can be dealt with while many of the bypass complications are more dangerous or just have to be lived with.

If you are still feeling hungry after getting a lap band, you can get another fill until you don't. If your portion size is too small and you can't eat a lot of foods, you can get an unfill. It's in your control. If you get GB and you can still eat too much or you can hardly keep down anything and are having trouble getting enough nutrients, what are you going to do? You are SOL if you can't get in enough food. If you can eat too much, then I guess you could get a revision to another type of WLS. But there goes the money you saved by just getting the bypass right away instead of getting a lap band and then revising to bypass. :tt2:

Then, if your body reacts badly to a bypass, what are you going to do about it? Technically it can be undone but that is a pretty rare surgery so most bypass patients just live with whatever problems bypass gives them even pretty severe ones. With a lap band, you can have it removed if your body just won't tolerate it. Over time, everything should heal back up to normal and it's as if you didn't do it. Even if you don't get back 100%, you are still better off than a bypass patient who has complication after complication and no recourse.

There are some people for whom GB is the right surgery. Such as those who need to lose weight now because their health is rapidly deteriorating. There are also those who will not be compliant and they know it and/or it's clear from their psych eval that they won't be compliant. If you aren't going to follow the rules, the band won't do much for you.

But I do have this thought for those who don't want to make lifestyle changes... if you aren't willing to change what you eat and be more active, how successful do you think a bypass will really be? I wouldn't want to have my insides rearranged and then gain all my weight back because I wasn't willing to change my eating habits.

Finally, think about 10 years from now. In my case, I'll be over 60 and so a lot of treatments won't be recommended for me. But for those in their 20s and 30s, there are a lots of new and better treatments for obesity on the horizon. If you get a lap band, you are in a position to take advantage of those treatments. If they come up with a ghrelin-blocking pill? You can have your lap band removed and start taking it and get the hunger control of a lap band without the sliming and PBing. If a better lap band or a better surgery is introduced, you can have it. If that new VBLOC device works out, you can get it. If you get bypass though, you may not be able to take advantage of new obesity treatments. Something to think about.

[CapitolChick 1]

I have began to see that many doctors tend to prefer the RNY (I assume because of the volume of loss people can have quickly, the unlikely hood you would regain with such a drastic surgery as well as the fact that the RNY was the gold standard for so many years.)

But, after doing research that surgery is very scary surgery.

1) You are permanenly rerouting your organs

2) hair loss and other problems are very common

3) it is not reversible without major out of pocket money

4) Many people who eat more tan 10grams of sugar per serving - DUMP. Dumping is way worse than any lap band issues. - Sugar is in EVERYTHING (ok, not everything...but it is in a lot of things.) and going out to eat is a real pain.

Read these things - I did and it changed my mind for good. I am soo happy now, I know I am making the right decision (I have 140 pounds to loose)

[ame=http://www.amazon.com/Want-Live-Gastric-Bypass-Reversal/dp/0972655409/]Amazon.com: I Want To Live: Gastric Bypass Reversal: Dani Hart: Books[/ame]

Also, I just got back form a seminar and the RNY vs. LB are not about weight loss because studies show we get to the finish line too! Just not in the first 9-12 months like RNY (at my weight anyway).

I have read so many books and was going to do the RNY but just couldn't go through with it.

You will see in the next 5 years LB will surpass RNY as being the Gold standard procedure.:w00t:

Edited May 30, 2008 by CapitolChick

[MerryHearted 20]

It's a very personal decision. You're on a band board, so of course we're primarily pro-band here. :w00t:

Ultimately, you need to choose the one you think will work best for you. The band does take adjusting in order to work well. Probably several times during your first year. If you don't think that you'll be compliant with going the 2.5 hrs to get filled & unfilled as you need it, then banding probably isn't your best choice.

Yes, there is dumping with RNY, but it doesn't happen for all patients. Some people find it extremely useful as behavior modification -- they are the ones who can't use liquid calories like milkshakes to eat around their bypass. When I went to an RNY seminar several years ago, the patients who were there to talk about their experiences had positive things to say about dumping and how it helped them make better food choices.

Good luck making your surgery choice -- it's a big decision and either way your life is going to change in wonderful ways! :tt2: