Bypass Bias

WASaBubbleButt · May 1, 2009

What I was told by someone "in the business" is that the 1% band complication rate is during or immediately after surgery while in recovery. That sounds accurate to me. However, just reading this board, its quite evident that there are far more than 1% complications with bands overall.

If that is what Cathy was writing it would be closer to truth, but that isn't what she repeatedly writes:

Originally Posted by ParrotheadCathy
And the simple statistical FACT remains that 10% more patients have complications by Bypass compared to the 1% with the Lap Band. Bypass complications include malnutrition (results from the bypass part of the deal) and death. I was assured that the risk of death was so minimal with Lap Band but they flat cannot say that with Bypass. And I consider it an extremely radical approach to rearrange someone's insides. So there was no question for me that bypass WASN'T for me. If you feel overly pressured by this doctor, GET ANOTHER DOCTOR. My surgeon does lap band and gastric bypass. And he told me in my consultation that if he trulyl thought bypass was better for a specific patient, he would tell them

circa · May 1, 2009

If that is what Cathy was writing it would be closer to truth, but that isn't what she repeatedly writes:
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I think that there has been so little information gathering on the band in the US thus far compared with GB as well. I know they've been doing the band in other countries for years - anyone know what their statistics are? I find it hard to believe that there's a 1% overall complication rate with _anything_ that is this involved.

Jaffa · May 1, 2009

Circa, I think you are seeing exactly the problem with the whole statistics sales point thing. And yes, it is being used as a sales point, don't kid yourself.

I have seen it by doctors and several people, that will take the 1% sugery complications rate of the band and compare it to the 5 year complications rate of GB. You just can't use statistics that way and be valid, because they are comparing surgical risks versus overall risks. I have even seen a doctor do this, which makes me think it isn't always by accident when they do this.

Most important, just to be clear they aren't saying anything about the sleeve when they talk about the gastric bypass statistics. Heck, I'm not so sure that several people don't even understand the significant difference between gastric bypass and gastric sleeve. Especially, when you suggest gastic sleeve as an option and someone responds that they don't want their intestines and such rearranged. What? They make your stomach small. They don't change the plumbing.

I used the 25% number in 5 years for the band, because it was actually one of the lowest long term complication rates numbers I had found, most were actually higher.

But, I get accused of being a band basher.

I really love my band, but I'm not going to just sit here and give you a testimonial, when your specifically trying to understand the differences and the options out there and why the doctors may or may not be arguing with your reasoning.

Now here is my testimonial, that I know you were not really looking for in the original question.

I love the band, it has been great for me. I would never get Gastric Bypass, because I don't want to deal with all of the stuff they go through, and honestly my brother died from complications from it, so it scares me. But, I would have loved to had Gastric Sleeve, I just couldn't because of my job.

You are so right, research, research, research. You will pick the right thing for you.

Edited May 1, 2009 by Jaffa

ParrotheadCathy · May 1, 2009

Those were the statistics quoted in a book I was given by my surgeon on my first visit. I believe it was referring to serious complications. ... like GB causing quite a lot of malnutrition, many more deaths, etc. versus erosion by the band (and other stuff like slippage that cannot be reversed by a liquid diet).

The risks regarding ANESTHESIA are not what I have referred to. To me that is separate and probably fairly equal.

Sorry if you feel I'm waaayy off base in feeling that band surgery isn't extremely complicated. I figure it takes 30 minutes or so, involves putting a belt of silicone in the right place around my stomach and anchoring down the port (though it appears that some docs aren't so good an anchoring down ports!) doesn't qualify as extreme. And I missed 3 days of work and could have cut it to 2 if I'd been so inclined. I believe the complication of the procedure lies in the follow-up and that is the doctor many times more than the device.

And that's my opinion.

WASaBubbleButt · May 1, 2009

Those were the statistics quoted in a book I was given by my surgeon on my first visit. I believe it was referring to serious complications. ... like GB causing quite a lot of malnutrition, many more deaths, etc. versus erosion by the band (and other stuff like slippage that cannot be reversed by a liquid diet).
The risks regarding ANESTHESIA are not what I have referred to. To me that is separate and probably fairly equal.

Sorry if you feel I'm waaayy off base in feeling that band surgery isn't extremely complicated. I figure it takes 30 minutes or so, involves putting a belt of silicone in the right place around my stomach and anchoring down the port (though it appears that some docs aren't so good an anchoring down ports!) doesn't qualify as extreme. And I missed 3 days of work and could have cut it to 2 if I'd been so inclined. I believe the complication of the procedure lies in the follow-up and that is the doctor many times more than the device.

And that's my opinion.

I believe you may be misunderstanding the complications because there is no way banding is 1%. Perhaps actual surgical complications but you did go on to compare the 1% surgical complications with long term GB complications and that's just not accurate.

Just because something is less invasive does not mean it is safer long term.

Jaffa · May 1, 2009

They are using statistics to convince you and sway you by giving you that book.

I guess, in the end they should just quote all of the statistics, and not change the parameters to their own benefit. That is a classic, but common misuse of statistics. Heck it is so common, we almost accept it as being honest, when it really isn't. They aren't being dishonest, they just aren't completely reporting the facts, which intentionally leads people to the wrong conclusions.

It is like Clinton saying "I did not have sexual relations with that girl". Well he is being honest, because he defines sexual relations as vaginal intercourse. But he isn't completely reporting the facts, because he lets the person listening assume what he means by "sexual relations". What makes it especially bad and dishonest, is simply that in his case it is intentional. He knows that what he is saying is leading you to a conclusion that isn't accurate. That she is a liar and he is telling you nothing happened.

That book they gave you, is doing the same exact thing.

circa · May 1, 2009

Circa, I think you are seeing exactly the problem with the whole statistics sales point thing. And yes, it is being used as a sales point, don't kid yourself.
I have seen it by doctors and several people, that will take the 1% sugery complications rate of the band and compare it to the 5 year complications rate of GB. You just can't use statistics that way and be valid, because they are comparing surgical risks versus overall risks. I have even seen a doctor do this, which makes me think it isn't always by accident when they do this.

Most important, just to be clear they aren't saying anything about the sleeve when they talk about the gastric bypass statistics. Heck, I'm not so sure that several people don't even understand the significant difference between gastric bypass and gastric sleeve. Especially, when you suggest gastic sleeve as an option and someone responds that they don't want their intestines and such rearranged. What? They make your stomach small. They don't change the plumbing.

I used the 25% number in 5 years for the band, because it was actually one of the lowest long term complication rates numbers I had found, most were actually higher.

But, I get accused of being a band basher.

I really love my band, but I'm not going to just sit here and give you a testimonial, when your specifically trying to understand the differences and the options out there and why the doctors may or may not be arguing with your reasoning.

Now here is my testimonial, that I know you were not really looking for in the original question.

I love the band, it has been great for me. I would never get Gastric Bypass, because I don't want to deal with all of the stuff they go through, and honestly my brother died from complications from it, so it scares me. But, I would have loved to had Gastric Sleeve, I just couldn't because of my job.

You are so right, research, research, research. You will pick the right thing for you.

Haha - that's all any statistic is - a sales or talking point to further an agenda - there's nothing real about most statistics. They're compiled using studies and surveys. They're never accurate.

I'm glad you love your band and I hope you have no complications from it - I'm opting for the sleeve because it makes more sense for me. I'm very sorry that you lost your brother too. That's a horrible tragedy. :thumbup:

I think we all have our preferences. We all have our reasons why. Many are ingrained into us by others - family and known and trusted professionals - others are gained by experience. its a personal choice to make but I think we all agree that GB isn't the way for any of us :ohmy:

Cleo's Mom · May 1, 2009

TSB - How many bandings has your surgeon done? Perhaps he is not as experienced at doing them as he is with GB. He could also be a surgeon who relies on the number on the scale to somehow prove his worth or success and is used to the fast and big losses with GB. He equates weight loss with his success. I recently changed doctors because (1) My surgeon lied about what band I had (2) he is a general surgeon who does bariatric surgery, too. (3) He had only done 22 bands before me and (4) His inexperience became apparent when I developed problems. I then sought a second opinion with an experienced doctor and have now switched. Please make sure you are comfortable with this doctor BEFORE you have the surgery. You don't want to end up in arguments at every post-op with him telling you you should have had the GB if you develop problems. Good luck.

TSB · May 4, 2009

TSB - How many bandings has your surgeon done? Perhaps he is not as experienced at doing them as he is with GB. He could also be a surgeon who relies on the number on the scale to somehow prove his worth or success and is used to the fast and big losses with GB. He equates weight loss with his success. I recently changed doctors because (1) My surgeon lied about what band I had (2) he is a general surgeon who does bariatric surgery, too. (3) He had only done 22 bands before me and (4) His inexperience became apparent when I developed problems. I then sought a second opinion with an experienced doctor and have now switched. Please make sure you are comfortable with this doctor BEFORE you have the surgery. You don't want to end up in arguments at every post-op with him telling you you should have had the GB if you develop problems. Good luck.

Hi Cleo. My sense is is that he the numbers on the scale are the focus of this surgeon. He does only bariatric surgery. I am impressed w/ the support in place at his practice. There are support groups, an exercise class, 2 nutritionists on staff who give very specific and individualized nutrition plans to patients. I am not "uncomfortable" with him. I have not asked for a specific # of LB he has performed, I did ask what ratio of lb to gp patients he sees at orientation and I believe that he said something along the lines of 1 in 4 being lb. So, one of the things that has become clear to me, particularly w/ this thread, is that I have a some more specific questions to ask at my next visit. As far as the statistics debate, being a sociology major, I am skeptical about any and all statistics :unsure: As far as I am concerned there is ALWAYS a bias, both from the presenters end and the audiences end. I really appreciate the great dialogue that has gone on here!