SLEEVE OR RNY AFTER LAP BAND SLIP AND REMOVAL
A week ago, I had to have my lapband of 13 months removed due to a slip. My bariatric surgeon does not recommend another band. He suggested a sleeve or RNY. I am looking for advise on which procedure to choose. I am still apprehensive at the thought of instestinal change with the RNY, but if this is the better procedure then I would consider. Thanks.
MomWinke, Janesville WI
lap band 1/28/11, band removal 3/7/12, vsg 5/30/12
lap band 1/28/11, band removal 3/7/12, vsg 5/30/12
It's really what you are comfortable with, if your insurance covers both surgeries. Myself I would have a sleeve just because I don't want my insides re-routed. However I know folks who have had both and they seem to be pretty equal as far as success. The RNY might be a tad faster but the sleeve is every bit as good a surgery. So research both and make a decision based on that. Good luck to you!
I agree it is which ever surgery you research and feel comfortable with. I too had the band, for 3 yrs and never had any success at all with it, just constant problems. I chose RNY, my insurance covered it and I knew several people who had it before me with success. I had surgery on 11/2/11 and so far have lost 54 pounds to date. Best decision of my life. No diabetes,no meds anymore and I feel better than I have in years. Good luck to you on your journey!!
This is my standard reply when this question pops up every couple of days. I won't try to sway anyone one way or another, but I'll give you my reasons for choosing VSG over RNY for my revision from the band. You can also check out the revision, failure, and food issue forums on here to get an idea of some long term RNY patients. For me, it was never an option. The cons outweighed the pros.
The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.
1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.
2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.
3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.
4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me
5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.
6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,
7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.
8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.
9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.
I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!
Best wishes in your research!
I delivered my daughter 4.5 months ago, so this part is a bit old, but pertinent. I was able to have a spinal block and an uneventful csection delivery with zero clotting issues. And, I was on 60mg of Prednisone for over 30 days, plus received IV boluses of steroids as well, and then 3 days of steroids via iv while in the hospital after delivery with zero gastro issues.
P.S. I wrote this before pregnancy. And, just as an update, I'm 8.5 months pregnant and thriving. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.
As a very recent addition; as of 10 days ago, I was advised I would have to be given a steroid(dexamethasone or prednisone) to help get my platelet count up as they have dropped. If I would have had the RNY, this would NOT be possible, and pretty much general anesthesia would be required for the csection. We're looking at other options for delivery such as a spinal block instead of a full epidural, but the doctors are positive the steroids will get my numbers up. At any rate, if I would have chosen RNY, I would surely not be able to have steroids. Looking back, I can't tell you how grateful I am that I was able to choose VSG.
The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.
1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.
2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.
3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.
4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me
5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.
6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,
7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.
8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.
9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.
I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!
Best wishes in your research!
I delivered my daughter 4.5 months ago, so this part is a bit old, but pertinent. I was able to have a spinal block and an uneventful csection delivery with zero clotting issues. And, I was on 60mg of Prednisone for over 30 days, plus received IV boluses of steroids as well, and then 3 days of steroids via iv while in the hospital after delivery with zero gastro issues.
P.S. I wrote this before pregnancy. And, just as an update, I'm 8.5 months pregnant and thriving. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.
As a very recent addition; as of 10 days ago, I was advised I would have to be given a steroid(dexamethasone or prednisone) to help get my platelet count up as they have dropped. If I would have had the RNY, this would NOT be possible, and pretty much general anesthesia would be required for the csection. We're looking at other options for delivery such as a spinal block instead of a full epidural, but the doctors are positive the steroids will get my numbers up. At any rate, if I would have chosen RNY, I would surely not be able to have steroids. Looking back, I can't tell you how grateful I am that I was able to choose VSG.
Band to VSG revision: June 3, 2009
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
On March 17, 2012 at 5:23 PM Pacific Time, MOMW wrote:
A week ago, I had to have my lapband of 13 months removed due to a slip. My bariatric surgeon does not recommend another band. He suggested a sleeve or RNY. I am looking for advise on which procedure to choose. I am still apprehensive at the thought of instestinal change with the RNY, but if this is the better procedure then I would consider. Thanks.There isn't really much value in the extra risk of RNY vs. a sleeve. You are only going to malabsorb calories for 6-18 months and then you'll have to eat like a sleeved person anyway. For me ... I don't care for RNY. The benefits just don't outweigh the risks. You risk complications for life with RNY. Your risks for the sleeve are for about 3 months except for a possible low B12 which is usually easily fixed.
The weight loss is about the same for both sleeve and RNY. Sleeves are the safest surgery type long term of all four major surgery types.
One big question is how you did when the band was working. Did you lose well with restriction alone? If so check out the sleeve. If you were unable to control food issues DS is a far better bet.
You really need to research and see what you feel comfortable with. Personally I'd rather have NO WLS than RNY. I would never go that way. Based on long-term issues, failure rates and on and on.
I revised from band to sleeve and am thrilled...it took me a lot of research to get comfortable with another WLS but I am glad I put the time in and figured out what I wanted to do.
I revised from band to sleeve and am thrilled...it took me a lot of research to get comfortable with another WLS but I am glad I put the time in and figured out what I wanted to do.
Band (09/07) removed, revised to sleeve 2/9/12.
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