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Undecided.

strikie
on 4/9/12 5:14 pm
 Hello everyone, I've enjoyed reading all of the forums. They have been some great stories. I need help on deciding on which surgery I should try to have done. The sleeve or the lap band. Can anyone help?  Thanks
Ms. Poker Face
on 4/9/12 5:23 pm
Keep reading and researching.  It's a very individual decision based on your medical history and medical conditions.

That being said, if you are deciding between sleeve and lap band, then get the sleeve.  The lap band has a lot of complications, poor results and they are NOT meant to last a lifetime.  

Good luck!

 

5'5"    Goal Reached!  
Start Weight 246    Maintenance Range <155    Current Weight 158
Starting size: 22, 2x
Current size: 6/8, S/M

 

Jamie_45
on 4/9/12 5:24 pm - CA
VSG on 01/09/12
Which type of wls people have is so personal and depends on so many things.  I knew several people who had lap band and were successful, but my Doc and Hospital will not even offer the lap band any longer due to the high rate of side effects.  For me there was never any question.  As soon as I was given the option of VSG my mind was made up... it's the smartest decision I've ever made!
    
    
USAF Wife
on 4/9/12 5:46 pm
I've had both. Personally, I wouldn't suggest a band to anyone. NOT only because of my deplorable exerpeice,but because of true medical stats and horrible long term complications, this long and wordy, but if you want the real information on the band, here it is:

Before the band stats: go here to read about vsg - http://vsgfaq.wordpress.com/

You don't have to just read posts here, there's lots of medical information about the complication rates of the band, and the truly scary things that can happen with it.

The first part of this is from this topic on the main board:

http://www.obesityhelp.com/forums/amos/4519684/Approved-for-Lap-Band/#37425732

I didn't want bypass either and flat out refused for my revision. I told my surgeon "once you get in there, if you can't give me a sleeve, take out the band and I'll stay fat". That is how serious I was about not having bypass, so I get all of what you are saying. I'm not using scare tactics, or trying to tell you what to do.

Like I said, we all go in hoping to beat the odds, well unfortunately, more and more of us are barely making it out alive. And, some of us are not so lucky. I personally have permanent nerve damage, have chronic pain in my port incision area.

Just make sure the insurance covers complications, and do not excluse surgery in the future if it's needed. That is a very common problem that is plaguing so many band patients these days.

They NEED to have the band out, yet their insurance doesn't cover it, or have the exclusion.

This is long, but if you want some real factual information, here's some medical statistics for your review:

And here's one personal story of a very successful bandster who is now having to revise after just 4.5 years with her band. She wrote a book about being a successful band patient, talk about following every rule and it still screwing a patient. This is real life, hardcore truth. We share these things because we don't want anyone to suffer through what we have experienced.

http://www.obesityhelp.com/forums/vsg/4504450/Band-to-sleeve-revision-due-to-esophageal-dilation-amp/

This is directly from the band manufacturer:

http://www.lapband.com/en/learn_about_lapband/safety_information/
Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. In the United States clinical study, with 3-year follow-up reported, 88% of the 299 patients had one or more adverse events, ranging from mild, moderate, to severe. Nausea and vomiting (51%), gastroesophageal reflux (regurgitation) (34%), band slippage/pouch dilatation (24%) and stoma obstruction (stomach-band outlet blockage) (14%) were the most common post-operative complications. In the study, 25% of the patients had their band systems removed, two-thirds of which were following adverse events. Esophageal dilatation or dysmotility (poor esophageal function****urred in 11% of patients, the long-term effects of which are currently unknown. Constipation, diarrhea and dysphagia (difficulty swallowing****urred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. The access port design has been improved. Four out of 299 patients (1.3%) had their bands erode into their stomachs. These bands needed to be removed in a second operation. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications.
Adverse events that were considered to be non-serious, and which occurred in less than 1% of the patients, included: esophagitis (inflammation of the esophagus), gastritis (inflammation of the stomach), hiatal hernia (some stomach above the diaphragm), pancreatitis (inflammation of the pancreas), abdominal pain, hernia, incisional hernia, infection, redundant skin, dehydration, diarrhea (frequent semi-solid bowel movements), abnormal stools, constipation, flatulence (gas), dyspepsia (upset stomach), eructation (belching), cardiospasm (an obstruction of passage of food through the bottom of the esophagus), hematemsis (vomiting of blood), asthenia (fatigue), fever, chest pain, incision pain, contact dermatitis (rash), abnormal healing, edema (swelling), paresthesia (abnormal sensation of burning, *****ly, or tingling), dysmenorrhea (difficult periods), hypochromic anemia (low oxygen carrying part of blood), band system leak, cholecystitis (gall stones), esophageal ulcer (sore), port displacement, port site pain, spleen injury, and wound infection. Be sure to ask your surgeon about these possible complications and any of these medical terms that you dont understand.
Back to Top What are the specific risks and possible complications?

Talk to your doctor about all of the following risks and complications:

  • Ulceration
  • Gastritis (irritated stomach tissue)
  • Gastroesophageal reflux (regurgitation)
  • Heartburn
  • Gas bloat
  • Dysphagia (difficulty swallowing)
  • Dehydration
  • Constipation
  • Weight regain
  • Death
Laparoscopic surgery has its own set of possible problems. They include:

  • Spleen or liver damage (sometimes requiring spleen removal)
  • Damage to major blood vessels
  • Lung problems
  • Thrombosis (blood clots)
  • Rupture of the wound
  • Perforation of the stomach or esophagus during surgery
Laparoscopic surgery is not always possible. The surgeon may need to switch to an "open" method due to some of the reasons mentioned here. This happened in about 5% of the cases in the U.S. Clinical Study.
There are also problems that can occur that are directly related to the LAP-BAND� System:

  • The band can spontaneously deflate because of leakage. That leakage can come from the band, the reservoir, or the tubing that connects them.
  • The band can slip
  • There can be stomach slippage
  • The stomach pouch can enlarge
  • The stoma (stomach outlet) can be blocked
  • The band can erode into the stomach
Obstruction of the stomach can be caused by:

  • Food
  • Swelling
  • Improper placement of the band
  • The band being over-inflated
  • Band or stomach slippage
  • Stomach pouch twisting
  • Stomach pouch enlargement
There have been some reports that the esophagus has stretched or dilated in some patients. This could be caused by:

  • Improper placement of the band
  • The band being tightened too much
  • Stoma obstruction
  • Binge eating
  • Excessive vomiting
Patients with a weaker esophagus may be more likely to have this problem. A weaker esophagus is one that is not good at pushing food through to your stomach. Tell your surgeon if you have difficulty swallowing. Then your surgeon can evaluate this.
Weight loss with the LAP-BAND� System is typically slower and more gradual than with some other weight loss surgeries. Tightening the band too fast or too much to try to speed up weight loss should be avoided. The stomach pouch and/or esophagus can become enlarged as a result. You need to learn how to use your band as a tool that can help you reduce the amount you eat.
Infection is possible. Also, the band can erode into the stomach. This can happen right after surgery or years later, although this rarely happens.
Complications can cause reduced weight loss. They can also cause weight gain. Other complications can result that require more surgery to remove, reposition, or replace the band.
Some patients have more nausea and vomiting than others. You should see your physician at once if vomiting persists.
Rapid weight loss may lead to symptoms of:

  • Malnutrition
  • Anemia
  • Related complications
It is possible you may not lose much weight or any weight at all. You could also have complications related to obesity.
If any complications occur, you may need to stay in the hospital longer. You may also need to return to the hospital later. A number of less serious complications can also occur. These may have little effect on how long it takes you to recover from surgery.
If you have existing problems, such as diabetes, a large hiatal hernia (part of the stomach in the chest cavity), Barretts esophagus (severe, chronic inflammation of the lower esophagus), or emotional or psychological problems, you may have more complications. Your surgeon will consider how bad your symptoms are, and if you are a good candidate for the LAP-BAND� System surgery. You also have more risk of complications if you've had a surgery before in the same area. If the procedure is not done laparoscopically by an experienced surgeon, you may have more risk of complications.
Anti-inflammatory drugs that may irritate the stomach, such as aspirin and NSAIDs, should be used with caution.
Some people need folate and vitamin B12 supplements to maintain normal homocycteine levels. Elevated homocycteine levels can increase risks to your heart and the risk of spinal birth defects.
You can develop gallstones after a rapid weight loss. This can make it necessary to remove your gallbladder.
There have been no reports of autoimmune disease with the use of the LAP-BAND� System. Autoimmune diseases and connective tissue disorders, though, have been reported after long-term implantation of other silicone devices. These problems can include systemic lupus erythematosus and scleroderma. At this time, there is no conclusive clinical evidence that supports a relationship between connective-tissue disorders and silicone implants. Long-term studies to further evaluate this possibility are still being done. You should know, though, that if autoimmune symptoms develop after the band is in place, you may need treatment. The band may also need to be removed. Talk with your surgeon about this possibility. Also, if you have symptoms of autoimmune disease now, the LAP-BAND� System may not be right for you.
Back to Top Removing the LAP-BAND� System

If the LAP-BAND� System has been placed laparoscopically, it may be possible to remove it the same way. This is an advantage of the LAP-BAND� System. However, an "open" procedure may be necessary to remove a band. In the U.S. Clinical Study, 60% of the bands that were removed were done laparoscopically. Surgeons report that after the band is removed, the stomach returns to essentially a normal state.
At this time, there are no known reasons to suggest that the band should be replaced or removed at some point unless a complication occurs or you do not lose weight. It is difficult, though, to say whether the band will stay in place for the rest of your life. It may need to be removed or replaced at some point. Removing the device requires a surgical procedure. That procedure will have all the related risks and possible complications that come with surgery. The risk of some complications, such as erosions and infection, increase with any added procedure.

Lap Band Failure

lap band device

Are you looking for information on lap band surgery failure rates and long term success rates?

Lap Band surgery has only been in existence a relatively short time, approximately 10 years.  Initial results with lap band were very positive with respect to weight loss and morbidity.  Not many long term studies have been done.  Here are the results on one eight year study.  The study defines failure as losing less than 25% of excess weight.  Average age of the patients was 38 years and included 50 men and 270 women.

Complication Percent affected
General Complications

33.1%

Erosion 9.5%
Slippage 6.3%
Port Problems 7.6%

Thirty three percent, fully one third of all patients developed complications such as erosion, slippage, catheter or port problems.  Twenty two percent of the patients required reoperation to fix failures of the lap band.

Now for the disheartening results, only about 60% of those banded that don't have major complications maintain an acceptable excess weight loss in the long run.  That means of those without complications only 4 in 10 are going to be successful.  Did your doctor tell you that?  Did you ask him?

In five years 40% of lap bands fail and only 43% have lost 50% of excess weight after seven years.  The study concludes that LGB (Laporoscopic Gastric Band) should no longer be the surgery of choice until they figure out a way to either screen out those that have complications or eliminate the complications.  The study indicates other longer lasting procedures should be used.

If you would like to read more about the study, here it is.

A reader writes regarding this study...

OK, as somebody who has been banded 6+ years, I have to say that at least 60% of the people I know who were Banded around the time I was Banded or soon after no longer have their Bands. I know that if I post something like this in the General forums... I get a lot of hands over eyes and mouth saying "no no no ... that can't be true..." because most newly Banded people do not want to hear this. I can't find any concrete statistics from Inamed/Allergan.. nor do I think they keep them (or want to keep them)... but I did find this study:

You can read all of it, or just the conclusion I've highlighted from this article
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16839478&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
 

Abstract

BACKGROUND:

Since its introduction about 10 years ago, and because of its encouraging early results regarding weight loss and morbidity, laparoscopic gastric banding (LGB) has been considered by many as the treatment of choice for morbid obesity. Few long-term studies have been published. We present our results after up to 8 years (mean 74 months) of follow-up.

METHODS:

Prospective data of patients who had LGB have been collected since 1995, with exclusion of the first 30 patients (learning curve). Major late complications are defined as those requiring band removal (major reoperation), with or without conversion to another procedure. Failure is defined as an excess weight loss (EWL) of 50%), LGB should no longer be considered as the procedure of choice for obesity. Until reliable selection criteria for patients at low risk for long-term complications are developed, other longer lasting procedures should be used.


Band to VSG revision: June 3, 2009
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs


thisbe777
on 4/9/12 6:25 pm
 pretty sad when the manufacturer posts such negative stats...   but facts are facts...

i didn't want bypass either....  and while i initially wanted the band, the more i saw, the less i liked...   i had fought insane appetite issues all my life, and i wanted a permanent solution...  with the sleeve, i got it....

keep doing your research, and don't settle for less than  what you want...



jeris


To live would be an awfully big adventure -- Peter Pan

strikie
on 4/9/12 6:30 pm
 Thanks for the feedback. It's been very helpful. I think I've made up my mind. It looks like to me that the sleeve is the way to go. I was thinking more of the sleeve but what I've seen so far. The sleeve is the way to go. Thanks again.