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

True, but that does not affect band intolerance or a host of other issues.

I went to a doctor that has done over 2000 bands, your doctor has done 75 according to his OH profile.  My doc has done over 850 staple lines.  No clue how many your doc has done.  If your doc's OH profile is updated and if it is accurate that he has done less than 250 bands he isn't even through his learning curve yet.

I went to the best of the best doctors, I did everything I was told to do and I lost my band.  It happens a LOT.  Look at the revision board.

I'm not here to tell you that banding is wrong or evil but the stats as you claim are simply not true.  In writing Inamed states slips are 3.1%.  Yet in public speaking they admit slips are over 7%.  The band can potentially be very hard on your esophagus.  Latest studies also indicate that banding can cause reflux in up to 1/3 of the folks with a band.

You may have your whole stomach with a band, but with a sleeve I have FAR fewer long term potential risks and complications than you.  You risk slips, erosion, refllux, pouch dialation, esophageal dilation, port issues such as infections, flips, leaks, mechanical breakdown of the band and plastic parts, intolerance, esophageal damage, etc.  I don't have anywhere near that many potential problems long term.

it's a trade off, you trade a higher risk of complications for a slightly lower surgical risk.  I trade a slightly higher surgical risk for much fewer potential long term complications and better weight loss.  It isn't a matter of  the right or wrong surgery, there is no one surgery that is best for everyone.  You have to get what works for you.  Just go into it knowing the true stats because what you are listing are not accurate stats anymore.

The chance for re-op is most certainly NOT 3%, it is as MacMadame explained, 10-40%.  There are hopsitals that won't even DO banding anymore because of such high failure rates and re-ops.

I didn't lose an organ either, I did have part of my stomach removed but it was as faulty as an infected appendix.  It needed to come out.  It held too much food and proceduced too much ghrelin.  It was slowly killing me.  My stomach performs quite well.  I have no food intolerances, I eat normal quantities of food, with a band it was verrrry hard to eat veggies or solid proteins.  Many have these problems.  Today (usually, not lately) my diet is mostly veggie, much healthier than I was eating with a band.

Some do very well with a band, some do not.  It is not always the surgeon's fault when something goes wrong and it isn't always the patient's fault.  Sometimes it's nobody's fault such as my case.  But let me tell you, there are a whole lot of people like me out there.  I had my revision 6/3/08.  I have not had ONE day go by that someone doesn't PM or email me since my own revision asking questions about revision, sleeves, etc.  There are a bunch of us out there and a whole lot more than 3%.

While I respect your personal decision, do not speak of what you do not know.

it would make you DIZZY to hear of all the stuff that can happen with the Band!

having 2 failed Bands and personally knowing lots of people who have also, i hope for you that you NEVER have to have first hand knowledge of Band failure. its NOT pretty and VERY common...

i had THREE bands surgeries. original, port replacement (very common) and replacement. i got off easy. try port infection, which can and has KILLED, erosion (also can kill), slippage, aspiration (also a killer, causing pneumonia)

WHY DO YOU THINK THERE ARE SO MANY REVISIONS???

i still have my stomach, so it is not waking around "w/o God given organs.."
you certainly werent born with a Band, so you've done alterations, which arent meant to be temporary as well...

the ignorance here is astounding.

Wow you sleeve people seem pretty angry at bandsters....ok...I am totally out of this conversation....
I did my research and according to my data...I did the safest thing available...for MY BODY.....glad you felt you did the same thing for YOUR OWN body.....
But dont dare call me ignorant....I am extremely well educated and informed.....
have a nice day and to the OP...I am so sorry this turned so nasty....I have seen some of this by the sleeve people over on the LapBand board....but I usually ignore it....I thougt it would be a nice conversation but once again the sleeve people turned it nasty....

Since YOU are "educated" on the VSG, where is the recent VSG study from LAPSF?  You only posted ONE study....Hmmmm

Interesting findings.  Just one clarification-- this is from a web conference that ONE surgeon in Austrailia presented (as you said, this info was based on his presentation from March 2008).  This was not the "official" International Consensus Summit for Sleeve Gastrectomy results (your PP slides might be a little misleading if folks don't read the details).

What I find interesting about this is that the overall OFFICIAL findings from that first Summit were very encouraging.  It will be interesting to see what happens at the official summit in May!

http://www.ncbi.nlm.nih.gov/pubmed/18357494

The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25-27, 2007.

Deitel M, Crosby RD, Gagner M.

Obesity Surgery, 39 Bassano Rd., Toronto, ON M2N 2J9, Canada. [email protected]

Sleeve gastrectomy is a rapid and less traumatic operation, which thus far is showing good resolution of comorbidities and good weight loss if a narrower channel is constructed than for the duodenal switch. There are potential intraoperative complications, which must be recognized and treated promptly. Like other bariatric operations, there are variations in the technique used. The laparoscopic sleeve gastrectomy (LSG) is being performed for super-obese and high-risk patients, but its indications have been increasing. A second-stage bariatric operation may be performed if necessary, with increased safety. Long-term results of LSG and further networking are anxiously awaited.

Peace,
Rana

Wow the firestorm like no other!

I did not consider the sleeve because the surgeons I chose were not yet experts in its long-term effects and that made me nervous, bottom line.  There are only two patients with the sleeve (based on support groups) that I know of, so I didn't go there for that reason.

Honestly, I think the sleeve is a great surgical option.  I love my band and I am tolerating it really well, so I don't anticipate the need for a revision, but IF I DID I would TOTALLY consider VSG.

Whew!!!!!!!!!!!!!!!!!

It took me a very long time to decide what I believed what would be best for me and on 10/1 I had my sleeve done.  You have the greatest resource at your disposal.  Dr. Srikanth was my surgeon and really helped guide me through this whole process.  My needs were pretty different.  I had a large surgical hernia from prior colon surgery and didn't want the possibility of adjustments or future surgeries.  I wanted a forever lifestyle.   I was approved for a Band but decided to bite the bullet and went self-pay for the sleeve.  He was and is wonderful so please utilize his expertise.  It's one week today and I'm down 25lbs since my pre-surgical diet, 85 more to go.  I have an associate I work with who 6 months out is down 40lbs with the band.  Doesn't mean his choice was wrong but it does show how fast weight loss can be.  Got to drink my protein for the first time in a week and it was better than any exotic dark chocolate mousse I ever had.  Please don't hesitate to ask me any questions.  Whatever you chose, Be proud!  What a wonderful choice you have made to change your life.  Isn't that really the hardest thing to do.  Please don't hesitate to send or ask me anything. 

Again, thank you to everyone who has responded to my inquiry.  There's no such thing as too much information!  I really do appreciate the responses albeit not the acrimonious nature of some of the debate.  I will continue to research and soul search so that in the end I make the decision that is best for me.

Amy

I applaud your answer. Good luck in your quest. I sincerely hope you find both what you need and will work best for you.

If you are interested in some studies, here is a presentation of data based on 750 sleeve patients since 2002.

http://www.ssat.com/video/2008/SSAT%2049th%20Annual%20Meeting(3)-Cirangle.htm

This summary of the presentation was reported in Digestive Disease Week Daily New:

Paul Cirangle, MD, FACS, Laparoscopic Associates of San Francisco, California Pacific Medical Center, San Francisco, reported results from 1,000 vertical sleeve gastrectomies performed since 2002. Overall, the vertical sleeve offers shorter operative time, shorter length of stay and comparable weight loss to the Roux-en-Y gastric bypass with lower long term morbidity.

The vertical sleeve procedure limits the gastric pouch to the lesser curvature of the stomach.

One key advantage of the vertical sleeve is that it maintains more normal anatomic relationships than the gastric bypass, including access to the bile duct. Dr. Cirangle also noted that the vertical sleeve offers weight loss and complication rates similar to the adjustable gastric band without the need to leave the band in place.

http://ddw.dailyenews.org/tuesday.html