Question:
Confused if I want to try the Lap or RNY, Help any suggestions? Thanks Kelli

— kdsmiles (posted on January 10, 2006)

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January 10, 2006
Hmmm, are you referring to the laparoscopic adjustable band versus the Roux-en-Y which can also be done laparoscopically? "Lap" refers to the way a procedure is done, not a specific surgery (appendectomies, cholecystecomies (gall bladder), even some heart surgeries can be done laparoscopically). Laparoscopic surgery involves having several small punctures and maybe a small incision or two, whereas an "open" procedure involves having one larger incision. Both the lap band and the lap RNY are considered permanent. Both require significant changes to your lifestyle and a lifetime committment to making either procedure "work" in the long run. The main differences are that the Roux-en-Y (typically called the gastric bypass) does involve bypassing a part of the intestine and is a more complicated procedure than the lap band. That means there is more likely to be some more weight lost than with the band, but the payback is that there is a need to take extra vitamins and supplements the rest of one's life. Also, the band also involves having a port under the skin that has to be accessed for filling the band. Both surgeries restrict the amount of food someone is able to eat. But, with either procedure, if you eat the "wrong" foods in small amounts and frequently, you can gain the weight back.
— koogy

January 10, 2006
Kelli, It sounds like you are trying to weigh the differences of the different TYPES of weight loss surgeries done. Method of surgery (lap versus open) is an important consideration, as well. The wave of the future seems to be the minimally invasive type surgeries (done via the lap method) - with several tiny incisions, much less injury to the abdominal wall, and much less incidence of incisional hernia. I've taken care of patients who have had open surgeries and I've taken care of patients who have had lap surgeries. Hands down, the lap post-ops recover SIGNIFICANTLY faster. Keep in mind that there are MANY forms of WLS being done today. Be sure to invest time into researching each form, and considering the life-long lifestyle requirements for each of them - and ask yourself if you are willing (happy even?) to adopt those in your own life. Kind of the BIG camps out there are forms of WLS that include malabsorption and those that do not. Another subcategory are those that involve the use of a foreign body implant and those that do not. And another significant subcategory are those that retain pyloric function and those that do not. For me, with over 200 pounds to lose, I WANTED a malabsorptive procedure. I didn't want to lose pyloric function, however. And I decidedly did not want a foreign body implant. After meeting post-ops of LOTS of different types of WLS, I was most impressed with the quality of life that post-op DS'ers in my area were enjoying. After doing lots of research (and realizing that different surgeons surgical protocols had a big impact on surgical outcomes and long-term weight loss) I decided to have an open BPD/DS surgery with Dr. Aniceto Baltasar in Alcoy, Spain. That was 3.5 years ago - and I'm still thrilled with the result! If I had to go through the decision making process again RIGHT NOW to pursue surgery, the two surgeries that would be front runners for me would be Lap BPD/DS and Lap Sleeve Gastrectomy. The results that I'm seeing with folks in my local support group and with post-ops of my surgeon have been nothing short of phenomenal. It's very impressive. Best of luck to you as you research and make decisions! Blessings, dina
— Dina McBride

January 10, 2006
I would suggest you go to http://www.inamed.com (who makes the FDA-approved LapBand) and look for a seminar. AND then go to http://www.asbs.org/html/about/membersearch2.html (to find a nearby board certified surgeon) and put in your Zip Code &, in the other box, LB (for LapBand). This will bring up an extensive list of surgeons, listed in order of how many miles they are from you. ..... This will include their websites & other contact info. Call them about seminars and support groups you can attend before surgery. ..... You can also join the best LapBand support group on the web to find out what the experience is like, what the lifestyle entails, including hurdles and problems. http://health.groups.yahoo.com/group/SmartBandsters/ Good luck in your journey to a slender life. - Theresa
— SouthTX LapBand

January 10, 2006
Susan, great post. It's a tiny little pet peeve of mine, (people saying Lap vs RNY; it's confusing) but I've never felt up to addressing it. Good job. Kelli .. the key to deciding between LapBand and RNY (if that is what you are trying to do) is to know the differences between the surgeries, and then to apply those differences to yourself and your eating habits, lifestyle, and the changes you are willing and able to make. The changes necessary for success with any surgery (and this includes DS, gastric sleeve, etc) are very similar, but each surgery makes different demand on the patient. Do your research, then do some soul searching. Talk to doctors, patients, and nutritionists, but remember .. ultimately, the decision is yours. Best of luck!
— Jeanie

January 10, 2006
Kelli email me at [email protected]
— DanaDee1969

January 10, 2006
Let me clarify, I was rushing and did not pay attention to what I was writing. I do know the difference in both surgeries. I meant to say I was confused about the Lap Band or the bypass. I have been to seminars on both, but both were almost a year ago. My insurance was terrible at that time and I didn't even try. Now I have new insurance and am starting to research again. I am going back to a lap band seminar on 1/26/06. I have just not been able to decide between the two. I have said in the past I don't like the fact of messing with nature, as far as, the bypass goes. I am also not sure if I want a port in me to be concerned with for the rest of my life either. Confused???? I also, wanted to know if anyone has had experience with UHC ppo. Now, I already know I do not have WLS coverage (because I called UHC), but I was told by many people to proceed and let which ever surgeon's office I decide on, to do the writing of the letters etc....Have any of you known anyone who did not have WLS coverage, but did get approved anyway? I do not have comorbidity factors, in which I take medication for, but I do have issues and a BMI of 44. Thanks to all of you for your information, it is all appreciated~Kelli
— kdsmiles

January 10, 2006

— SteveColarossi

January 10, 2006
while your pondering surgical types, dont forget to consider the DS, the third often held back alternative proceedure. its quite different from the rny, in its results, lifestyle postop and the surgical requirement, I cannot have the rny or band, they are not compatible with my comorbids.
— walter A.

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