From my doctor

My surgeon is a gastro-intestinal consultant, working both for the non-profit making nationall health service and also for a private hospital group. He also teaches in local university medical school/teaching hospital.  He does RNY, band and VSG. This is a copy of an e mail I have just received from him. As he did not write it for publication,  I have removed his name. I also apologise if his paragaphing vanishes! It did when I pasted it on another board. Note the last sentence.

 

 

Dear Kate   Thank you very much for your email and the concerns you express regarding the problems that can develop with gastric bands over the medium to long term.  You have very clearly highlighted the problems that can be associated with the gastric band.  Some of the well recognised problems are, I think, bad luck but many of them can relate to the band not being used and adjusted correctly.  If the band is adjusted correctly, then the band is I think a very helpful tool in terms of helping patients to change their eating behaviour.  The band, if not used and adjusted correctly, will simply cause obstruction in the upper gut and the natural consequence of this is acid reflux, oesophageal dilation and, because people cannot eat an appropriate diet, maladaptive eating with consequent poor weight loss or even weight regain.  Band erosion through the wall of the stomach should now be less common because of the approach to dissecting the space around the stomach to place the band.   

I think that the key with the gastric band is to keep it appropriately adjusted and to maintain a sensible and appropriate level of eating and physical behaviour.   Unfortunately no operation , including the gastric band, sleeve gastrectomy and gastric bypass, is perfect and they all have their own particular problems or complications.  In terms of frequency of problems or complications, my experience is that approximately 10% of patients will have some sort of significant band related problem or another within the first five years that may require a further intervention to treat.  

I am aware that the gastric band has had something of a bad press recently.  If, however, you look critically at the available published evidence, then none of the operations are perfect and we are in fact just about to start a randomised study comparing the gastric band and the gastric bypass in NHS patients in the UK - the BYBAND study.  We would clearly not be embarking on such a study unless we felt there was uncertainty regarding outcome comparing the two operations.  I am also well aware of the popularity of the sleeve gastrectomy but there are a number of potential problems and complications with the sleeve, some of which are very difficult to manage.  

I think your outcome with the gastric band is a reflection of your preparedness to work with the gastric band and to demonstrate what can be achieved.  I am pleased to say that I do not think your experience with the gastric band is particularly unusual.  

Kate, your surgeon IS ABSOLUTELY CORRECT. There is NO perfect weight loss surgery, not sure why there is so much band bashing. Your surgeon mentioned:

If, however, you look critically at the available published evidence, then none of the operations are perfect and we are in fact just about to start a randomized study comparing the gastric band and the gastric bypass in NHS patients in the UK - the BYBAND study.  

We will see in the next 2-3 years the END result of the Sleeve, and from reading the revision board these days there seems to be a alarming trend, with an influx of people looking for "help" due to no restriction and their Sleeve's stretched, I am not sure if the Sleeve will ever out due the Bypass as the "Gold Standard".

 

 

 

 

Naomi,

You really don't know why there is so much " Band Bashing ? "  One only has to read in the,

Failed Bands Group http://www.obesityhelp.com/group/failed_lap_bands/

All the FaceBook Failed Bands Groups

Lap Band Talk- Band Complications Forum

Google LAGB Lawsuits..

to understand why there are so many bandsters and ex bandsters " bashing " the band. I hate the band, and I'll do everything in my power to help get it recalled. I will also support current bandsters who want my tips on how to lose weight with their bands.

What I will not do is advocate for more LAGB implants. There are safer alternatives out there.

 

Totally agree with you.   

Thanks, very well stated.

I applaud your continued support of the already banded.

I cannot understand your desire ( for lack of a better word here ) to promote more LAGB.

perhaps because as the letter points out, that all surgeries come with their own complications if there is bad after care and if people don't do what they're supposed to.

No no that's not it.

Kate, I am not here to flame or Band bash, but unfortunately, almost daily, I am hearing about severe complications caused by the LapBand. My surgeon had an extremely low complication rate and yet, in the last year, numerous patients have had emergency removals. I seriously no longer recommend the Band to anyone. I also have great respect for those who have suffered life changing injuries caused by the Lapband.

And I wanted to say to the other poster, The DS has been done since 1990. The Sleeve is the first stage of the DS, so the info is out there that the Sleeve works as a weighr loss tool. the Sleeve has no pouch like the RNY and Band, so you cannot stretch it. Reflux is a complication of the Sleeve, but taking a PPI helps that.

Thank you for this post!  I had much much more reflux with the band than I do with the sleeve.  I truly think the band is a bad device.