I recently got approved for surgery and there is  question about whether I should have the lap band or the sleeve. I truly believe that the sleeve is the best surgery for me. So my question is how do I make the surgeron see this

How to make a sureon see this is easy.

Tell him what you want, and if he won't do it, find another surgeon.

This is your decision and your life, you make the decision that you feel is right for you.

My wife and I researched all the different surgeries before deciding on the sleeve for her.

Good luck
Charles

I completely agree with the other poster.  YOU make the decision, not the surgeon.  You have to feel completely comfortable with your surgeon.

Why are they pushing the band?  Do they not have any sleeve experience or very little?

If you want the sleeve fight for it, or find another surgeon that will do it. 

You choose which surgery. You do not allow another human, especially one who will be making money hand over fist off of band maintenance, decide what they do your anatomy. There is NO convincing a surgeon which surgery is best for you, your lifestyle and your long term goals.

Here's some documented information, research links, and statistics that might help you make the best decision if you are on the fence about which surgery you really want and need.

Personal stories are great, but here's some documented facts. I've had the band, don't waste your time, energy, or money. I'm over 2 years out with my VSG revision, and couldn't be more ecstatic with my life post-op.

Research all the surgeries and decide what is best for you, for the REST OF YOUR LIFE.

Personal stories and research information

http://vsgfaq.wordpress.com/


http://all-about-lapband.com/problems/failure.html

Lap Band Failure

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:


From the makers of the band:
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.

LapSf Study that I swiped from MacMadame's profile
LapSF Educational presentation to FACS - includes some 2 year results
LapSF Two Year Study
LapSF Five Year Study - abstract only
LapSF Five Year Study - presentation (requires Windows to play)
Literature review on the sleeve - requires $ to get the full text unfortunately
Sleeve best for over 50 crowd
Video of a sleeve with lots of education discussion
Video of a sleeve that is more about the operation
Ghrelin levels after RnY and sleeve
Ghrelin levels after band and sleeve
Diabetes resolution in RnY vs. Sleeve
Comparison of band to sleeve - literature review