Doctor Recommeded Against Lap Band

[WASaBubbleButt 41]

Actually my point was that long term effects are primarily keyed off of the quality of the surgeon and not the type of procedure.

For example, check out this web site. I wouldn't buy a ShamWow from this hard-sell clown college.

- The Mini Gastric Bypass

There are Sleeve Mills and Bypass Mills just like there are Band Mills.

PS to "clos.net": Since you like to take our out-of-context quotes from lapbandtalk and use them without our permission to imply that lap band surgery is deadly and ineffective, I'm giving you permission to use this post on your site as well. :thumbup:

It's both, it's the surgeon and the device. The best surgeon in the whole world can't change the problems of the device. The long term affects of the band have nothing to do with surgeon skill. Esophageal damage, stoma spasms, slips, band intolerance... those are not surgeon issues. Those are a direct result of the band.

MGB is a horror. That's another procedure that the best surgeon in the world isn't going to make the problems of that type of surgery better.

[AirKuhl 1]

The long term affects of the band have nothing to do with surgeon skill. Esophageal damage, stoma spasms, slips, band intolerance... those are not surgeon issues. Those are a direct result of the band.

Those are common quotes against the band.

Here are some common quotes against the sleeve I found in a few minutes with Google:

• The stomach remaining after your sleeve gastrectomy WILL gradually stretch and permit larger meals.
  
• VSG is not reversible, and quite often, additional weight loss surgery is performed some time later after gastric sleeve.
  
• One study comparing gastric sleeve to gastric banding that shows the gastric sleeve to be about as effective as the lap band at 1 and 3 years following surgery.
  
• Less than 1000 patients with VSG have been studied and we really don't know what happens beyond 3 years!
  
• A portion of your stomach is cut out using a stapling device and then the surgeon sews over the staple line to try to prevent leaks. However, this is not fool proof. If your stomach leaks or there is a small perforation, it could cause a condition called peritonitis, which is life threatening. These metal staples stay in your body forever, much like the silicon lap band.
  
• Although thought to be safer than gastric bypass, truth be known, the safety of this procedure has NOT YET been established because it is very new. Of concern is the amount of stomach removed. Most surgeons are now removing and throwing out, 90-95 percent of the stomach and since the stomach is a critical digestive organ, this might cause some Vitamin deficiencies as well as Protein deficiencies.
  
• Vertical sleeve gastrectomy patients are told they have "fully functional stomachs" but since the stomach is now only 1-2 oz, this is highly UNLIKELY. In truth, all that is left from their stomach is 1-2 oz pouch which is the same size as a gastric bypass patient except the gastric bypass patient can have their stomach reconnected if there are problems.
  
• A percentage of patients get severe reflux... not only of acid but of bile as well.
  
• The risk of death with the gastric sleeve is likely considerably less than the bypass but higher than with the adjustable lap band.
  
• In the long term, you may be in higher risk for a herniated stomach or distention of the esophagus. Some patients have complained that the tiny part of the stomach left can "twist"
  
• Because of most of the stomach being cut away, the digestion of Protein and Vitamin B12 may be compromised. This is due to less stomach acid and also possibly a lower amount of "intrinsic factor" being produced. You may have to take vitamin B12 shots. - should check levels often.
  
• Unlike the lap band, the amount of restriction is not adjustable. If you need a revision, it's another risky surgery.
  

Again, all I'm saying is that all surgery has risks, what is the right choice for one person may not be the right choice for another, and that choosing a good doctor is critical.

[elcee 3,341]

Thanks Airkuhl that was really interseting. I am getting banded on 2 June and have noticed that there appears to be a lot of band bashing on the boards. I have also read lots of messages saying how wonderful and safe the sleeve is and how few side effects there are.

We all know that there are risks to every surgery, some because of the procedure, some because of the surgeon and some may be because of the patient (e.g Auto immune disorders can cause problems).

What your post does is help to restore some balance. It will be interesting to see more data on the long term effects/risks of the sleeve further down the line when it becomes available.

[WASaBubbleButt 41]

Those are common quotes against the band.

Here are some common quotes against the sleeve I found in a few minutes with Google:

• The stomach remaining after your sleeve gastrectomy WILL gradually stretch and permit larger meals.
  
• VSG is not reversible, and quite often, additional weight loss surgery is performed some time later after gastric sleeve.
  
• One study comparing gastric sleeve to gastric banding that shows the gastric sleeve to be about as effective as the lap band at 1 and 3 years following surgery.
  
• Less than 1000 patients with VSG have been studied and we really don't know what happens beyond 3 years!
  
• A portion of your stomach is cut out using a stapling device and then the surgeon sews over the staple line to try to prevent leaks. However, this is not fool proof. If your stomach leaks or there is a small perforation, it could cause a condition called peritonitis, which is life threatening. These metal staples stay in your body forever, much like the silicon lap band.
  
• Although thought to be safer than gastric bypass, truth be known, the safety of this procedure has NOT YET been established because it is very new. Of concern is the amount of stomach removed. Most surgeons are now removing and throwing out, 90-95 percent of the stomach and since the stomach is a critical digestive organ, this might cause some Vitamin deficiencies as well as Protein deficiencies.
  
• Vertical sleeve gastrectomy patients are told they have "fully functional stomachs" but since the stomach is now only 1-2 oz, this is highly UNLIKELY. In truth, all that is left from their stomach is 1-2 oz pouch which is the same size as a gastric bypass patient except the gastric bypass patient can have their stomach reconnected if there are problems.
  
• A percentage of patients get severe reflux... not only of acid but of bile as well.
  
• The risk of death with the gastric sleeve is likely considerably less than the bypass but higher than with the adjustable lap band.
  
• In the long term, you may be in higher risk for a herniated stomach or distention of the esophagus. Some patients have complained that the tiny part of the stomach left can "twist"
  
• Because of most of the stomach being cut away, the digestion of Protein and Vitamin B12 may be compromised. This is due to less stomach acid and also possibly a lower amount of "intrinsic factor" being produced. You may have to take vitamin B12 shots. - should check levels often.
  
• Unlike the lap band, the amount of restriction is not adjustable. If you need a revision, it's another risky surgery.
  

Again, all I'm saying is that all surgery has risks, what is the right choice for one person may not be the right choice for another, and that choosing a good doctor is critical.

Sorry but you have old information. Long term studies were just released a year ago and clearly, your source is unaware of this.

BTW, this same list has been posted before and we corrected it then but I will do so again.

The stomach does not stretch. Oh, it will a little but they know that and figure that in at the time of surgery. It is made amazingly small just for this reason. By 4-6 months it is going to get as big as it gets. I am 1 year post op and I can eat 2oz of solid protein. Period.

Nope, it's not reversible. I don't see that as a bad feature, I see that as good. When was the last time you wanted temporary results from a diet? I'm done for life. I have no aftercare, I'm at goal, I have nothing left to do. Well, other than plastic surgery. The claim of needing an additional surgery after the sleeve has a history. This will show you how outdated your source is. It used to be if someone was say... a 100 BMI and they were too high risk to do bypass or DS due to their weight, comorbids, etc., they would sleeve them and send them home telling them to lose 200-300#. When they did they could come back and safely have the rest of the procedure. (Think 1970s here) They discovered that people were doing exceedingly well with the sleeve alone and people did not need bypass or DS. They still do that, if you have someone that is just plain too big and high risk for DS they do it in two stages, the sleeve first and later if the person needs it, DS.

The study referring to banding and sleeves being the same at 1 and 3 years was blown out of the Water with the long term stats as they discovered people are not keeping their bands. More than 50% are removed by 5 years. Notice how they don't go on and discuss how effective bands are beyond 3 years? Your source is so seriously biased towards the band it's beyond silly. Due to the fact that most do not keep their bands long term, it's good that banding is reversible.

More than 1000 people have been studies and we do know what happens long term. People have been getting partial gastrectomies since the late 1800s for issues such as stomach cancer and ulcers. We know they do quite well.

Leaks can happen, that's why it's critical to go to someone who has a lot of staple line experience. My doc has done over 500 sleeves and he's never had a sleeve leak. But they happen. Sleeve leaks are less common than band erosion. BTW, leaks are only a concern for the first few weeks. After that it is a non issue.

Again, we most certainly DO know what happens long term with partial gastrectomies and it is NOT new. It's been around longer than the lap band. It "might" cause nutritional deficiencies... old info. It can cause a B12 deficiency in less than 1% of sleeved people. Your stomach produces a chemical needed to absorb B12. With a smaller stomach you produce less IF. I am quite sure there are those that have to take a vitamin daily to make up for this but I haven't met one yet. Most surgeons are NOT removing 90-95% of the stomach, they are removing 60-85%. Who wrote this nonsense anyway? Surely not a doctor? The portion of the stomach removed is called the fundus. The fundus does two things. It over produces a hunger causing hormone called Ghrelin and it is designed to hold a lot of excess food. I miss neither feature of my fundus. I want it to stay in the garbage. I view it as a diseased organ just like a gallbladder gone bad.

We most certainly do have a fully functioning stomach minus the hunger causing hormone, Ghrelin. The pyloric valve, the vagus nerve, everything necessary is there and working quite well thank you. For the author to say that we do not have a fully functioning stomach because it is "Unlikely" due to size is ridiculous. I'd love to see something other than his hunch that this is the case. He is correct in that we cannot go back and have our stomach put back but can you give me a few examples of why we would want to? For the author to say that gastric bypass can be reversed as far as the stomach goes is a stretch. Theoretically it is possible, but it is not likely. In some cases it can be reversed but it's a very tricky procedure and quite dangerous. If the author knew anything about the bypass procedure he would know that.

True, a very small percentage of people get reflux from the surgery. What he doesn't mention is that it usually goes away after a month or two. He forgot that part. I have severe reflux, horrific reflux. I take 8x the usual dose of Omeprazole to try and deal with it. Of course, I got it when I was banded and we hoped it would resolve with the sleeve but no such luck. Now, if someone has severe reflux not due to a mechanical problem (such as the band) or a hiatal hernia then they shouldn't be getting banded or sleeved. They should get bypass.

The risk of death with the sleeve is higher than banding. About 0.4% higher than banding. Insignificant to me. The risk is a leak, again... a leak happens in less than 1% of sleeved people. Of that 1% some do die but it is extremely rare. I know of a hack in Mexico (Huacuz) that just killed another person from a sleeve leak in March. Had the person gone to a better surgeon he would still be here. :thumbup:( Is that the procedure or is that the surgeon?

If the surgeon makes the stomach too small it can twist. That's why it's nonsense that they typically remove 90-95% of the stomach.

B12.. already went over that. For the less than 1% that have a Vit B12 problem they do not need injections. They nee SL tablets, under the tongue. I could live with that. I don't though as I do not have that problem. Protein.. nonsense. We do quite well with protein.

We don't need to change restriction, we have perfect restriction for life coming out of surgery. Consider this, you have a valve at the bottom of your stomach called the pylorus valve. It controls how fast your stomach empties. When you get fills and adjustments to your band what is really happening is that they are trying to adjust the band to do what the pyloric valve does naturally, they just try to do it higher up in your stomach. It is true that a revision from ANY WLS to another is quite risky. The scarring and adhesions the band left my stomach with made infection, leaks, bleeding, and perforation x3 with my sleeve revision where if I would have just had the sleeve to start with, I wouldn't have had the added risk.

Now, with all that written let's take a look at the fact that I never claimed the sleeve does not have risks. No clue where you get that from. What I wrote is that long term the sleeve is safer than the band and the risks and complications are MUCH less than that of banding.

We do agree on finding skilled surgeons. People die when the shop for cheap instead of skill.

[WASaBubbleButt 41]

Thanks Airkuhl that was really interseting. I am getting banded on 2 June and have noticed that there appears to be a lot of band bashing on the boards. I have also read lots of messages saying how wonderful and safe the sleeve is and how few side effects there are.

We all know that there are risks to every surgery, some because of the procedure, some because of the surgeon and some may be because of the patient (e.g Auto immune disorders can cause problems).

What your post does is help to restore some balance. It will be interesting to see more data on the long term effects/risks of the sleeve further down the line when it becomes available.

What band bashing? Posting stats is bashing the band? How so? Are you under the impression that people are only permitted to post the positives of the band?

I had a band, I have a sleeve. I can see both sides. There is no balance that needs to be restored, where are you getting this? Are you under the assumption that the info posted about sleeves was accurate? ;o)

[RestlessMonkey 7]

All else aside, for me the bottom line was this: the band is usually reversible. The sleeve, bypass, duodenal switch, vertically banded gastroplasty...not. I didn't want them to cut out my stomach, my duodenum...

if I have problems with the band in a year or two or ten we'll see what wonderful new thing they have then. For now, I don't care if the sleeve would do back flips and call me "honey"...if it isn't reversible, I don't want it.

[elcee 3,341]

What band bashing? Posting stats is bashing the band? How so? Are you under the impression that people are only permitted to post the positives of the band?

I had a band, I have a sleeve. I can see both sides. There is no balance that needs to be restored, where are you getting this? Are you under the assumption that the info posted about sleeves was accurate? ;o)

Amazing how quickly a difference of opinion can deteriorate.

In my opinion there appears to be a lot of band bashing. However that is my opinion and it is quite possible that other people can read the same posts and interpret them differently.

I have no problem with stats however all stats should be read with caution particularly when the source of the information is not known. It is also well known that stats can be made to suit the purpose. Ask any marketing expert or politician.

I am sure that people are and should be allowed to post the negatives of the band. Ditto the sleeve.

I am glad that you can see both sides, that is wonderful.It is something I try to do myself as far as possible which is why I like balance.If you don't think there is a balance that needs to be restored that is fine. I am entitled to my own opinion .:thumbup:

[WASaBubbleButt 41]

Amazing how quickly a difference of opinion can deteriorate.

In my opinion there appears to be a lot of band bashing. However that is my opinion and it is quite possible that other people can read the same posts and interpret them differently.

I have no problem with stats however all stats should be read with caution particularly when the source of the information is not known. It is also well known that stats can be made to suit the purpose. Ask any marketing expert or politician.

I am sure that people are and should be allowed to post the negatives of the band. Ditto the sleeve.

I am glad that you can see both sides, that is wonderful.It is something I try to do myself as far as possible which is why I like balance.If you don't think there is a balance that needs to be restored that is fine. I am entitled to my own opinion .:thumbup:

Did someone suggest you are not entitled to your opinion? If so, let us know. I think most everyone here would explain otherwise.

I'm just not seeing the lack of balance you write of. Your post is the 67th post of this thread and nobody I recall has been angry, fighting, bickering, none of that. I'm not saying you don't have a right to claim a lack of balance, I'm just not seeing it. Posting stats and facts isn't lacking balance. (shrug)

[elcee 3,341]

I was referring to the boards in general!!!

So far the only fighting,bickering etc that I can see on this particular thread are the ones directed at me for daring to have an opinion that differs from the opinion of "other" people.

Maybe I misinterpreted the tone of certain posts. If so then that is my mistake.

[WASaBubbleButt 41]

I was referring to the boards in general!!!

So far the only fighting,bickering etc that I can see on this particular thread are the ones directed at me for daring to have an opinion that differs from the opinion of "other" people.

Maybe I misinterpreted the tone of certain posts. If so then that is my mistake.

I think you are reading quite a bit into something that does not exist. Just because people have a difference of opinion does not mean it is bickering. Honestly, I really have no idea where you are getting all this drama from. I'm not seeing it.

[ccinlv 2]

It is a personal decision on what is best for you. I asked my surgeon when I was deciding on which surgery "if I were your wife which one would you perform on me?" And his reply was the lap band. I also have total trust in my surgeon.

That being said I got the lap band on 8/19/2008 and have only lost 31 lbs. Have gone up and down with the same 7-8 lbs for 7 months, it is a lifestyle change that is hard. The good thing is I am not gaining and for the first time in my life, if the scale starts moving up and can get it in control quickly and it comes back off which is worth alot. I know I will reach my goal eventually and for me when I do I feel it will be easier to keep it off (hopefully) with the help of the band with the lessons I am learning along the way.

And I too have friend who have had the by-pass now going in to get the lap band because now 6 years out they have gained alot of their loss back. She said that for her losing weight with the by-pass was too easy and she didn't really learrn to change her eating habits now its like she never had surgery. Friend number 2 who has had the band, wishes he would have had the by-pass, because he has had nothing but problems with chewing, fills, sliming, dehydration, slow weight loss and getting discouraged.

[Headhunter 6]

In some cases, the Band DESERVES to be "bashed". It has some inherent flaws. Those flaws do not surface on every patient. Rarely, in fact, but when they DO, there can be life threatening consequences.

The Band has been life-changing for many, many people. It's killed a few as well. It's done damage to many others. But, that can be said for ALL of the various types of WL surgeries.

Much of the problem lies at the feet of idiot Surgeons who have gotten into this field to make some easy money.

But a LOT of the problem in WLS is also, I believe, that people are getting bad advice on what surgery would be the RIGHT one for them. The Sleeve is NOT right for EVERYONE. The Band is NOT right EVERYONE. Bypass is NOT right for EVERYONE. It takes a skilled surgeon, with experience in ALL of them to correctly diagnose what it is that a patient really needs. For some, it's restriction. For others, it's malabsorbtion. And, there are plenty of people somewhere in between for whom there IS no definitive surgical answer. And, and there is a certain portion of the obese population for whom neither diet nor surgery will do the trick......for whatever reason, they simply cannot keep food out of their mouths, or they have some rare metabolic disorder that keeps them plump.

I'm coming to believe that YOU don't choose the surgery, IT chooses YOU. I think that extensive psychotherapy needs to be a mandatory part of this process.....and I really mean EXTENSIVE, not just a 30 minute evaluation, with a psychotherapist that has DEMONSTRATED expertise in Bariatric problems. With the correct form of therapy, you MIGHT find the power within you to do it WITHOUT surgery. If not, then you may come away with better understanding of exactly WHAT kind of surgery YOU need.

More than once, on this board I have seen someone complain that their Doctor has tried to steer them toward a WLS OTHER than the Band. I have seen situations where a Person has seen MULTIPLE Doctors, all of whom have tried to direct them to some other type of WLS than the band. But, they get it in their heads that they WANT THE BAND.

They don’t seem to want to consider that these Doctors are telling them that the Band might NOT BE RIGHT for THEM. But, they keep seeing Doctors until they find one who will give them what they want. TV commercials and Billboards make the band seem simple and easy. And that’s what people want…..the simple and easy way out. But, I can assure you that MOST people who have the band, successful or otherwise, will tell you that the Band is neither simple NOR easy.

If you are considering the Band, you NEED to consider the Sleeve as well. Sure, it’s more “invasive”, and it’s permanent. It’s not reversible. But it simply gives you a smaller stomach. And it calms your appetite. It’s restrictive, which is the concept behind the Band. And it doesn’t plant a piece of plastic in your gut, bouncing around, rubbing against your innards, with the potential of doing various types of damage…..like it did to ME, and many others.

And that’s not “Band-Bashing”…..that’s a FACT.

Do yourself a favor, if you’re considering ANY form of WLS……before deciding on any particular procedure, do your Homework. See various Bariatric specialists who have expertise in ALL the procedures, and find out which one is right for YOU.

You didn’t become fat overnight. You need to take the TIME to find out which procedure is the right one for YOUR Body. So, TAKE the time….I think your life is worth it.