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

I have been researching WLS for some time.  I was pretty confident that I wanted the Lap-Band [due to cost (my insurance doesn't pay for WLS) plus feeling that I didn't want my insides rearranged].  I took my first step tonight by attending the required seminar.  Now I don't know what to think as I became very interested in the Sleeve.  My BMI is above 50 and the possibility of faster weight loss as well as not having to deal with adjustments, etc. has me has opened up a new line of thought.  I'm in a quandry.  Has anyone else researched the pros and cons of both?  What led to your final decision?  Any help would be greatly appreciated.

Thanks,

Amy

(Cross posted in the Sleeve forum)

Hi, you have to decide what is best for you. The big difference with the band versus the sleeve is the band is always adjustable. Also part of your stomach will be removed. I chose the band because it was the least invasive procedure and didn't cut into my digestive system. Good luck in your decision. Mona

You have a valve at the bottom of your stomach.  It is what controls how fast food travels from your stomach to your intestines.  When you are banded the doctors are trying to do with the pylorus valve does naturally.  Slowly release food to the intestine.  Sleeved folks have a fully functioning pylorus valve, in bapassed folks this valve is stapled off and no longer used.

Yep, MOST of your stomach is removed during surgery.  It's the elastic portion that holds a great deal of food.  When I was a newbie "permanent" sceeered the bejezuz out of me.  Today I want permanent and forever more than I want anything.  Removing the fundus elastic portion of the stomach also removes the majority of Ghrelin, the hunger causing hormone.  That makes dieting much easier.

Least invasive does not mean the same as safest long term.

For me it was simple-I'd never heard of the sleeve!

I don't think you can go wrong either way. The sleeve shows promising results. I chose the band because the sleeve is a newer procedure and has less data than the band. I wanted the least invasive of the surgeries so I was not thrilled about cutting out the majority of my stomach. However, the removal of most of your stomach means you will have less hunger producing hormone called gherlin(sp?) so it definitely has it's pluses. Desicions like this are so individual....you will have to weigh the pros and cons and decide what you can live with. Good Luck! P.S. I love my band!!!

  I choose the band because I was scared of the other procedures.. I had seen to many things happen to RNY patients and didnt know about the sleeve.. Its a personal choice.. My aunt had gastric and had a stricture and that scared me.. so I knew the right choice for me was the band...
Good luck!
 dawn

My insurance made up my mind for me.  They don't cover the sleeve.  I was originally going to have a lap band through OSU Bariatrics but the surgeon wasn't real supportive.  Then I read that Dr. Trace Curry was doing the sleeve and after reading about had decided on that.  Well my insurance doesn't cover the sleeve so I decided to have Dr. Curry do my lap band.

Thanks to everyone who has replied.  I really do appreciate the input.  I certainly have a few things to think about and some more research to do in the next few weeks.

Amy

My biggest deciding factor was that the band is always adjustable, and can be removed if necessary. With the sleeve, they throw out the part that is removed-there is no option to undo. Also, it seems like every few years they are making great strides i WLS, and -God Forbid- I do regain, I like knowing that maybe something will come along later down the road-I'm only 35-that might be even better. Band for me was the best choice at the time and is working great so far. It's really just a matter of personal choice.

Hi, Amy - I'm attending a conference this afternoon on the sleeve and will share what i learn.

I choose the band because I wanted the best chance at permanent loss, I did not want to cut out most of my stomach, and I know that removing much of the hunger hormone, ghrelin, has serious side effects. since low ghrelin levels are closely tied to severe clinical depression, this concerned me.

Obesity itself is already closely linked to depression, and i don't think we need added risk. some people I know with the sleeve are extremely depressed, not getting help from their psych meds, not handling divorces well, unable to work, and engaging in very unbalanced behavior online.

and  I also feel that we don't know nearly enough about the other hormones produced in the stomach to be just chopping them out for the sake of temporary weight loss with the sleeve. I'd like to see several years of much more complete research before people flock to the sleeve. Remember, people all flocked to the bypass at first too, and we now know some of the very poor stats and outcomes.

The sleeve pouch is also likely to stretch out in time, just as the bypass pouch does, unless one can SELF limit to tiny meal - and this is exactly what I could not do by myself before. I need the band's help! Many of the top bariatric surgeons, including Dr fielding, will not do sleeves for this reason.

there are more than a few people who had a band here, got a sleeve later, and are not doing well at all. ALL the WLS procedures require the very same things from us - much better eating, much better activity,  hard work on the food and eating issues, and many mental changes and lifestle changes - and forever. People fail all procedures if they do not take these things to heart. I felt that, since I had to do the same work to succeed longterm, I wanted the safest and least invasive procedure, one that did not remove most of my stomach, and one that i had more control over.

more later after the conference - I'll add it in this post .

sandy r
band educator
at goal 4.75 yrs