Sleeve vs. Lap-Band - How did you decide?

I went in wanting a band but my doc recommended the sleeve. I did some research and thought that the sleeve would be better for me. Your chances of success are higher with a sleeve.

Amy,

I am a five year bandster *****vised to the sleeve. My advice is if you are a self pay, you are much better off with the sleeve. Both are restrictive, but there is little maintenance involved with the sleeve after the first month. I had 17 fills and unfills over five years and if I did not have insurance I would have been financially suffocated with band maintenance costs since most of my fills were done by flouro. I also had an endoscopy done and those aint cheap. Plus, I had lots of band related complications that ruined the experience for me altogether. I was successful with the weight loss, but miserable with the complications.

Babs

In my journey towards WLS, at first I was sure I wanted the band (because I did not want any rearranging of my intestines). Then I began to read about the potential difficulties with fills and leaks, etc. I decided to give weight loss on my own another go. Two years later, I knew I was ready for surgery. I went in thinking I needed to have RNY because I wanted to be sure I lost enough weight and thought the malabsorption would help me. However, at the meeting I went to, my surgeon mentioned that he no longer does the band surgery (due to problems with the band) and he mentioned the Sleeve (which I did not know anything about). Since then, I have researched the VSG, RNY, and DS. In the end, I chose the VSG because it does not re-route the intestines (and there is some research indicating the intestinal rerouting may not be necessary for good weight loss), it reduces the amount of ghrelin in the body (and therefore hunger), it is a simpler proceedure than the malabsorptive ones (decreasing surgical risk), has a lower rate of complications (comparable to the band), and a weight loss comparable to the RNY (although perhaps not quite as quick). I also like the fact that if I need to, I can be revised to the RNY or DS (if I did not lose enough weight). The VSG seems superior to the band (to me), and my surgeon feels it will replace the band in the future. No fills, no worries about port leaks or flipping, band leakage, erosion, esophogeal damage, unable to eat meats, etc. Plus, the VSG will help control hunger and will not stretch out once healed. So, you can only eat small amounts forever. The downside of VSG is that any surgery has risks, and removing most of a perfectly healthy organ (the stomach) is not a decision to make lightly. You do need to take supplements for the rest of your life -- with less stomach acid, your body will not be able to digest some nutrients as well as before. With the VSG you will probably not need as many supplements as those with a malabsorptive proceedure, but you will want to keep a close eye on your levels. Of particular concern are B12, protein, calcium/Vit. D (which seem to be a problem for obese individuals, surgery notwithstanding), and possibly some others. You do need to be prepared to take the supplements you need for life (on the positive side, I think most Americans would benefit from the same supplementation anyway). Ultimately, the choice is yours. There are individuals who are happy with each of the WLS. Research seems to indicate that the DS has the most weight loss and less potential for regain -- but there are more serious consequences to be considered with that surgery also. It is all about what post-surgery complications you are willing/able to accept. The VSG does not have the long-term studies showing if people struggle with regain the way they do with the band and RNY. That is definitely an unknown -- but, thinking logically, your stomach will only be able to hold 4-8 ounces (average) at a time, and your ghrelin production will never be what it once was. These two things make me hopeful that it will be relatively easy to maintain any weight loss. Time will tell. I should tell you, also, that my BMI is 55-56, and I am still choosing the VSG. I believe I will be able to lose the majority of my excess weight with this surgery! That's the plan, anyway! I am also self-pay, and going to a local surgeon. Sorry this was so long. I think it helped me to revisit my reasons for having this surgery - mine is tomorrow! Eeek! Good luck, and keep researching! Kimberly

Good Luck on your surgery!  Please make sure to let us know when you are home and how you are doing!

Amy

I am also a band revision. My band eroded and was 80% inside my stomach. I had to remove it. Glad it was reversible? No! I gained all the weight back plus some, very quickly. This is a much more consistent option for me than the band was. I am not hungry all the time this time.

With the band I had a tight restriction in the morning preventing me from eating, but at night it would be wide open at night so I could eat too much before bed time. When I had restriction I couldn't eat much, so I would still be hungry after I ate. Also with the band you can eat again once the food passes the band to the lower stomach ( you can feel it pass). Sometimes it's only a few minutes before you can eat again. Not with this surgery. you can only eat only so much, and stay full for a lot longer. The hunger is minimal and gone once you eat a little.

I'm losing weight much faster with this surgery. I don't have port pain (that site is tender for a long time). I can't reverse back to obesity, no follow up care needed. I wish I'd had known about this surgery when I was researching the band, it might have saved me thousands of dollars in removal costs, and the revision surgery cost! 

I currently have the band and it was great for the fist year, I lost 60 lbs. Then the second year came and I developed acid reflux and esophageal dilation at 13 months out.  I am at the doctors office at least once every 4-6 weeks getting fills and unfills.  That can get very expensive! I have not made any weight loss progress in the last year. I lose weight with each fill and then after 4-6 weeks when I have to have an unfill due to excessive vomiting I gain everything I lost back within days. I am currently in the process to revise to the sleeve.  It can be very difficult to get the band to the right restrictive balance for you, it can change daily due to other factors: stress, temperature, allergies and just regular body fluctuations. There are also other people that the band has worked miracles for.  You said you were self pay, please take into account all the aftercare with the band and it is a lifetime of post op care.

Wow!  Thanks to everyone that's responded thus far.  Your thoughts are much appreciated.  I've been thinking about and researching this virtually all night (insomnia - isn't it fun) and I keep coming down on the side of VSG.  In all honesty, I just hadn't thought of it as an option (I had it confused with the StomaphyX revision procedure) and the surgeon's explanation last night made sense. 

I have to be honest; the price of both the Band and RSG is a prominent factor.  Even if  everything goes right with the Band (and I gather that's a big if), the cost of fills, extra doctor appointments, etc. makes the actual long-term price considerably more.

WLS is my last ditch effort at losing weight.  Like most of you, I've tried almost everything with no long term success for a variety of reasons.  Most significant is perhaps that for ten years, I have been over 300 pounds and slow loss is psychologically difficult (Anyone else sit in Weigh****chers meetings and think your issues were very different than the people there to lose less than 50 pounds? Plus it's hard to be excited about a 10% reduction in weight when in all honesty you can’t tell on me.  Also it's sort of difficult to feel camaraderie towards the "successful leader" who was able to lose and keep off 30 pounds - big whoop! *  End of rant ~smile~).  Most recently I had small success with liquid meal replacement but I can't seem to do that for longer than about 6 weeks before I give up because I get hungry/need to actually eat something.  I think that if I can have the restriction from day one and start succeeding from day one it will do a whole lot towards keeping me motivated.

I realize that whatever my decision, this is going to be a life-altering decision and a life-long process that will require commitment forever. 

I certainly have a lot to think about in the coming weeks...

Amy

 

*  Of course I realize that everyone’s struggle is their own  and I don’t truly believe that  “merely overweight”  people don’t have their own struggles or aren’t entitled to their own victories.  I only mean to say that their issues/struggles/victories are very different than mine as a super morbidly obese person.

I went in thinking I wanted the band. I talked to the lady who does my taxes and she said she hadn't lost anything with her band. She had lost a little at first, but gained it back and was right back where she was. I was worried about the idea of having this foreign object inside of me. They say that you can actually feel the port from the outside of your stomach (not actually touch the port, but you can feel the hardness from it). With the sleeve, they take out the hunger hormone. You don't have to worry about upkeep and you feel totally normal (once you are all healed up).  With the band, from what I hear, you are pretty much always aware of the band being there. The only difference for me is I get full faster. Also, I hear way too many people "tricking" their band. They aren't able to eat lots of different types of foods, so instead they will eat the soft high calorie foods.
I went in to talk to my surgeon about the band and he talked me into the sleeve. If someone is self pay, he will always recommend the sleeve. In fact, a couple in my support group asked him which surgery he would do on a loved one. He said he had done the sleeve on 2 family members and his office manager.
Anyway, good luck with your research. I think you'll see that people are much more happier with their sleeve and do better with weight loss. I have lost over 100% of my excess weight.
Teresa

I can't really add much, but like many I initially wanted the band and praise God everyday that He lead me to the Sleeve.  I have lost 75lbs to date and it's just surreal.  I like the fact that my restriction was instant and I don't have to go back and forth with fills, unfills etc.  I started at 300lbs.

Keep researching =)

Ms Shell