Interesting, as more people get sleeve, more failures are seen

 http://arturorodriguezmd.com/the-answers-to-gastric-sleeve-failures

http://bariatrictimes.com/2010/07/22/sleeve-gastrectomy-failure-just-when-we-thought-we-had-the-perfect-operation/

http://gastricbypass.netfirms.com/gastric-sleeve.htm

"In summary, SG as a stand-alone operation is gaining popularity among both bariatric surgeons and patients. This enthusiasm, however, has to be balanced against a paucity of data in regards to potential long-term failure rates. Similar to other bariatric surgery procedures, SG failure is likely to be multifactorial and related to a combination of technical, physiological, and psychological parameters. When discussing SG, bariatric surgeons must review these unknowns with their patients to ensure they will make informed, long-term, surgical decisions based on all available information."

Good advice, no matter what surgery one chooses. Wonder if I should go post this on the sleeve board? Nah, I have better things to do with my time 
Which is also why it is pretty unlikely that I will reply to any baiting posts in response to this one. 

Hurray for you for not getting mired down in the arguments.  Just information to do with as one chooses.

 Go ahead and go post it on the sleeve forum.  You may want to post it on the DS forum since they technically  have a VSG as well and it does have to do with post surgical sleeve dilation.  If you are confident enough in what you posted and you did it with an honestly helpful intent then share it.



However, on your link here:    http://bariatrictimes.com/2010/07/22/sleeve-gastrectomy-failure-just-when-we-thought-we-had-the-perfect-operation/


The Editor (Rosenthal) did come back in an article and state:

Next, I would like to highlight Dr. Mehran’s article on laparoscopic sleeve gastrectomy (LSG) with interest and enthusiasm. I cannot agree more with him when it comes to informed consent. Patients need to know that LSG is not necessarily better, but different to the other well-established procedures. Patients also should be aware that, since LSG is still a new procedure, long-term outcomes and complication rates are still being studied. However, if I am to describe any clear advantage of LSG over biliopancreatic diversion-duodenal switch (BPD-DS), Roux-en-Y gastric bypass (RYGB), and laparoscopic adjustable gastric banding (LAGB), it is the significant lower incidence of short- and long-term morbidity and follow up. Having said that, if we assume that 30 percent of patients who undergo LSG will experience weight regain and require a second step approach, I still believe that we prevented that 70 percent of our patients from having a RYGB or DS, which I consider highly efficacious but at the same time a procedure that has a high incidence of morbidity. In these cases, I do not see the LSG as a failure but more as a “first step" to a second long-term final approach.


Also, this is not an article based on a study it is a literary review.  In the Himpens 5 year review done on 2007 data from 2002 surgeries, which Dr. Mehran cites, the use of a 60Fr bougie size was still very common compared to the smaller sizes today (Usually 32-38).  This means that even though the 5 year reviews are in on the Himpens surgeries they do not accurately portray the outcomes from the newer surgeries using the smaller bougie sizes since there is less remaining fundus. 

So I have to agree that my 5 year outcome is just as up in the air as a Lap-Band 5 year outcome when it comes to weight loss because both are restrictive procedures ONLY, but that I wouldn't agree on the 5 year outcome of complications from the surgeries being the same.

What I will tell you is that I can now eat a wider range of healthier foods now that I have the VSG and I no longer have the fear of prolapse and erosion that I did with the band.  I would make the choice to go from Lap-Band to VSG in a heartbeat even after reading this article. 

Well said and rational. I just get annoyed that there is a certain population (of all surgery types) that have a "my surgery of choice is perfect and is the best for everyone" stance that is very counterproductive. All WLS have risks (health risks, failure risks, etc), each person just has to review the available information and make the best choice they can make for themselves.

The problem with the sleeve is well known. The sleeve stretches and without the malabsorbtion component of the DS weight gain is typical. However, the sleeve is a safe procedure, and it can work well long term for those *****ally dedicate to making good food choices. And VSGers typically don't suffer from vomiting, nausea, reflux, band erosion, and the other horrible complications seen with bandsters...I must not that very tight sleeves do put a patient at risk for nausea and vomiting.

With that said, I am not entirely sure of your objective with this thread, but I find it bizarre that a bandster would be trying to dig up dirt on another surgery when the bands have already been proven to be the least effective procedure.

Well, since long term studies on VSG are still rare, we don't truly know how the efficacy compares. That said, VSG I believe does carry a high risk of acid reflux becoming a problem. In the end, we have to make our own choices, and a lot of people forget that we may each define "success" in a different way and we may each have a different willingness to live with the risk of some things over the risk of other things. Someone may be willing to tolerate the risk of band complication to avoid the risks associated with having part of their anatomy removed. Somene else may choose to accept the risks that go with RNY because they aren't convinced that they can have a band or VSG and not simply "eat around" it. No one can claim that their surgery is the best option for everyone.

 I posted a study a few months ago, and I posted it again this morning.....aren't you glad you got the band.......I knew I made the right decision, I have friends that got the bypass over 5 years ago and they are seeking a band (BOB) it no longer works for them at all. on top of that....they've had several complications, bowel obstructions, hernias, blockages but they say they would do it again...I think the band is bashed so much because of jealously

 I actually didnt even know the sleeve existed and can honestly say I probably would have chosen it , had I know. This does NOT Mean I dont like my band, I do. I am grateful for the help and change it has allowed me.

EVERY surgery will have draw backs failures strong points etc. Its like comparing apples and oranges for Gods sake. There is no perfection or magic bullet.

I have good friends and we have all had different wls. No one is "better" or "more right" or "healthier" than the next. They are all invasive and used as a big gun for a dangerous situation.

It's more like comparing apples and apples, with the question being do you want a granny smith, a red delicious, a braeburn, a pink lady......
Personally, I prefer pink lady and abhor red delicious, but not everyone agrees. We all have our our own preferences, goals, and tolerable risks in mind.

 I agree, your analogy is much closer and accurate, good looking out.

I think that as we continue to watch wls grow and evolve, we are going to see more failures and one reason is simply more patients...I would be interested in seeing the ratios.

These tools that fity one will not fit another, as you said...I take alot of medfs, so RNY wasnt a good choise for me. However my sister, eight years out, had RNY and its been the exact fit for her. I also know people with failed RNY's etc.