DS vs Lapband

Hi CT,  been considering the band but I see many positive posts about DS that it's better.  Any thought on this from anyone would be appreciated.  Also, from what I see there is only one docter in CT (Dr. Bell) that performs this surgery.  Anyone know why?

Thanks,  Maria in CT

The two procedures aren't really directly comparable.  If you're interested in a band, the most similar procedure would be a VSG (which is basically the restrictive part of the DS).

The full BPD/DS is a more significant procedure, and, while gaining popularity in some circles, is still not widely practiced.  Historically BPD has been considered somewhat more extreme, and riskier in terms of nutritional difficulties.

Whether or not these beliefs are true (and the DS fans will certainly provide evidence that it's the best thing since sliced bread), the main issue to consider (in my opinion) is that the life-long followup required is not going to be as widely available with a "niche" surgery as if you stick to a more mainstream surgery.  I wouldn't want to have to travel to see a surgeon who understood my plumbing, if i were having trouble.   With any of these surgeries, the key to success, health, and long life is followup.  Lots of followup.  Especially with malabsorbtive procedures like RNY and DS, you can't expect to get a surgery, lose the weight, and be done, unless you want to be caught by surprise by a life-threatening health condition later.

In my own research, I decided the lap band didn't really have particularly good outcomes, with a lot of potential complications.. the potential of having to have a revision at a later date really didn't appeal to me, nor did the relatively slow weight loss compared with other procedures.

So I ended up going with the RNY.. it's the most well understood, most studied, and has good outcomes over the long term.    The other procedure I considered (before deciding that I wanted malabsorbtion as well as restriction) was the VSG.  It's similar to the lap band in basic function, but it has several advantages, and avoids the lap band's most common complications.  It has risks as well, of course, so all that has to be balanced out.

Me personally.. I would consider the DS in a few more years, but right now, in this area at least.. it's not covered by many insurers (including mine), the doctors don't perform it much.. it's a much riskier path to take, and the benefits it offers of the RNY just aren't worth those risks, to me. 

This is of course an individual decision.. read up on all your options, but do make sure you consider the future.. many nutritional issues don't appear for years with any of these procedures.. and all have risks and benefits to consider.

Talk to a surgeon or two and get their opionions and ask for documentation of their outcomes.  (Some, including the one I use, publish outcome data on their website)

Thank you so much for your advice.  There are so many factors to consider.  I want to make the right decision. 

Maria

If those were my only two choices I would go with the DS. There are many things about the band I don't like, but that is my personal opinion. Good luck with whatever you decide to do. It will be the right choice for you.

Thank you for your opinion.  I thought the band was the way to go but now I'm hearing it's not.  Out of all of them, would you still prefer the gastric?  Just curious.

Thanks,  Maria

I was thinking about the DS but what stopped me was the fact Dr. Aranow didn't do them, I wasn't going to change doctors when the RNY would be fine too. I am still happy with my decision. I have had some problems (strictures, gall bladder, low blood pressure) but I would do it again in a heart beat.

Hi-I had the vsg-vertical sleeve gastrectomy-done in April-it is not only a restrictive surgery, but removes the part of the stomach containing the gherlin-this is the hunger hormone.  It is not really similiar to the band,as it does far more than the band.  The part of the stomach left has little chance of stretching.  This surgery has actually been around for 30 years or so-it was originally done for people that needed surgery for ulcers.  You do not have the malnourishment part that you get with the RNY.  The downfall is that there is very little dumping with the sleeve, so you have to be careful around sweets, although most people with the sleeve, myself included, have had a change in tastes and desires.  I had Dr. Bell do my surgery, and he is one of the most experienced in the state-he has been doing the vsg for weight loss when it was being tested as a wt loss surgery-he was part of the testing.  He is a wonderful surgeon, and doesn't make you jump through hoops pre-op with a lot of wasteful testing-he individualizes what you need and takes it from there.  As others have said-you need to research eveerything and decide what is best for you-I just wanted to clarify what the vsg is.
Jeanne

Thank you all for the helpful information.  Maybe one day I'll be lucky enough to have the right surgery!

Thanks again, everyone has been so helpful.

Maria

The band sucks, speaking from experience. It's great for someone that only needs to lose 50-75 pounds and is generally a lot safer than other procedures. BUT, if you need to lose more than 75 pounds (like I do), I'd suggest an alternative. Also, the band requires a LOT of work on your part, more than I ever realized or was ready for. The maintenance is a lot and you need some degree of self control and motivation to succeed. In retrospect, if I had motivation and self-control I would never have gotten fat to begin with !! I don't regret my decision, because it has helped me lose  30 pounds pre-op and 45 pounds  post-op...and keep it  al off thusfar. But for someone like me that needs to lose 150 pounds total, I am a bit disappointed because I'm only about 1/2 way to where I need to be and I am almost 9 months out. It's slow....and honestly I haven't been doing "my part". But if you are someone that can do your part, then it may work well for you. I'm seeing a new surgeon Thursday and seeking suggestions and guidance to get back on track. My current Doc doesn't take my insurance anymore and even though they offered me a deep discount, I can't pay cash at this point. I have too much else on my plate, so to speak   Ok bad joke, sorry.

Hey diddle diddle, I've a bulge in my middle
and I hope to whittle it soon
But eatin's such fun, that I'll never get done
Til my fork runs away with my spoon :)

I have about 70-75 pounds to loose.  I just don't like the complications I hear from the lap.  Haven't heard one "major" complaint about the DS.  Unfortunately there are no surgeons in CT that perform that surgery.

Thanks for your input.  Love the poem!

Maria