Question as to which Surgery: Open or Lap RNY OR Lap Band?

I have just completed the required 6 month diet that my Humana Insurance wanted. All along I've been planning on the Open RNY as Humana didn't cover the Lap Banding. But with the new Medicare requirements, now Humana as I'm told by Dr.Rehnke's staff. Humana is covering the Lap Band which Dr.Rehnke highly suggests but the final decission is my own. I'm just having a hard time deciding which procedure to do. All of my evaluation were with planning for the Open RNY, which I passed with great praise for my progress toward recieving it. I've asked for medical tests leading to a date, but am being told I don't need them. The Lap Band is very less evasive compared to either of the RNYs. Less malabsorbtion plus less time in the surgery and hospital stay. I could compare the money but that's not the problem right now. So I'm in limbo till next week when I see my PCP for Clearence. Any thoughts would be helpful. I'm at 565 lbs. down 35 lbs. since Christmas. Following the Super Atkins Diet. Thank you, Mike

Mike, Congratulations on making such a big decision...your life will be changed forever. I am not an expert on the Band, but do have some personal thoughts on it. Now before anyone thinks I'm bashing, I AM NOT. I'm just telling MY perspective. When I began the process, I too was considering the Band. For me, it was mainly because I was in denial and thought I only needed "a little" surgery for my "small" problem. Well, I soon realized that there is nothing little or small about weighing 500+ pounds like I once did. My doctor wouldn't even talk about RNY with me because of the severity of my obesity. Instead, he explained the benefits of RNY. The biggest one is that since you have so much more weight to lose, you will lose much faster with RNY. Now if you weighed 305 lbs...I'd say BAND all the way. But you have much more to lose than some. Also, I did not trust myself. I would be one of those people *****duced their fill during holidays, cruises and other special occassions. That's not saying every Bandster does that; I'm just being honest with how I would have abused it. If you'd like to discuss more, e-mail me and we can discuss. In the meanwhile, check out my page and see how far I've come since surgery. Jerrell 9/28/06 501/318/250

I have to agree with Jerrell on this one. Not to knock any Bandster out there but with the amount of weight you want to lose the RNY is the best way to go. As most people have said - it's the GOLD standard in RNY surgeries. The OPEN or Lap part of the that is just how they do the procedure - I'd inquire also to be done medial RNY as that is the best chance of losing a more significant amount of weight vs promixal. Good luck to you and see ya on the losing side!!!!!

If you decided on the RNY simply because of economics then it is a tough choice. If you decided on the RNY after considering all of the WLS options (RNY, Lap Band, & DS) then this should not throw you off course. I would do some research on the lap band and look at the average EWL and the percentage of lap band failures and numbers requiring revisions if you can find those stats. The last thing you want, is to have to have two surgeries. I would not at this point be concerned about the shorter surgical time. Evidently the surgical time for the RNY was not an issue for you before so I would not now make a decision on a surgery using that as a criteria. Unless your physician is now telling you that surgical time is an issue, Did your surgeon tell you why he is highly suggesting the "lap band". Is your surgeon considering something like a two part RNY? Is he using the band to get your initial weight down so that you can better tolerate surgery and then go in and do the full RNY? I have heard of that being done. When I was trying to decide which surgery I wanted I looked at all of them and then made my choice based on what I thought was best for me, not what my insurance would cover. I knew that if I had to change then I would have to change but I wanted to know what was best for me. I decided on the DS. I think it is very important to look at all of the research and all of the data and decide. That is what I think you should do. You should be getting the research papers and going to the different websites and doing all of those things so at the end of the day, you can say I made an informed choice. Red

Hi Mike, I would sure want to know why the surgeon is recommending the Band. It will take twice as long to lose your excess weight and that is if you stick to the prescribed diet and exercise program. I agree with one of the other folks who posted if he is recommending this as part one of a two part procedure that may be understandable. But make sure you understand that there is NO malabsorption with the Band only restriction. Gather as many facts as you can and then make the decision that you are comfortable with. I weighed 310 lbs at the time of my RNY and 18 months later only need to lose 10 more lbs, if I had done the LAP Band I would probably only have lost about half that much at this point. Good luck!! Julie

Mike, I have just started my 6 month diet and I know that my insurance will cover either surgery. I think for me (and I weigh 234lbs @ 5 ft 3in) I am going with gastric bypass. This is my thinking:::::If the band slips...and that can happen right after surgery...it can also happen years down the road...I will have to be re-operated on....I personally rather just be operated on one time and get it over with. I also think that the statistics look better for gastric bypass when it comes to long term weight loss. I don't think it is a really big difference, but still there is a difference. The seminar I went to last week (Dr. Lord in Pensacola), I think it was said that after 3 years with Lap Band the average weight loss is only 60% of excess weight, when gastric bypass is like 75-80%...if I remember correctly. I would certainly ask your surgeon why he recommends the LapBand in your situation. I would just do your research between the two and decide what you really want out of the surgery...what results do you want....

(hijack) Hi, I was at Dr. Lord's last seminar too!! Got my call from April and from Shelly. I had considered Dr. Nye too, but decided to wait on Dr. Lord when I heard so many good things about him. Just wanted to give you a shout and wish you luck! Betty

I have to agree with the rest of the group on this one, I feel the RNY is the better choice. I had RNY 2 years ago have lost 145 lbs and am at goal (and feel great!). My brother in law was closer to your size and had the lap band a few years ago. He never got to goal and re-gained most of what he lost. The band works too slowly and is too easy to "cheat" the band.