Struggle between Lap and Rny

I know this question is posted often; but I think individual people need individual answers (if that makes sense).   I'm struggling so hard deciding between lap band and RNY.

For me, the pros of lap band seem to be:  Less invasive, quicker recovery, reversable if medically necessary and if you find yourself over eating; you get a fill.   The cons seem to be;  food getting stuck, possible erosion or slippage, i hear a lot of complaints about GERD, and slower weight loss.

The pros of RNY seem to be:  Faster weight loss, dumping syndrome as negative reinforcement, RNY being the gold standard of bariatric surgeries.

The cons -  possible leakage, stricture, hormonal changes due to fast weight loss, slower recovery and more invasive surgery; including change in anatomy. 

My BMI is right at 40 and I have no co-morbities that are medically necessary to treat.  It seems like the answer should be cut and dry but it's not coming to me.  Advice? Help?  I know many will say "only you can make this decision" but I'm still very torn.  Thanks.

 

 

 

 

 

My BMI was right at the 40 mark when I had my surgery, too.  It took me a while to decide on a procedure, too.  But, I personally know a couple of people who have had the lap-band and they were not successful with it - they did not lose all their weight or they regained, they had problems with food getting stuck very frequently, and there was the hassle of having to go to the surgeon's office to get the band adjusted or filled. 

I was looking for a solution that would get me through the rest of my life in a much more healthy and fit way, leading to my desired weight loss and allowing me to acheive my goal weight.  I finally considered RNY and VSG, but I decided on RNY.

Why?  You are right - it is considered the gold standard of WLS.  It has a long history of studies attached to it since it is not a "new" procedure.  The success rate is good.  I know I will eventually reach a point where I can eat most anything, just reduced portions. 

I am very happy with my decision. 

I hope you reach your decision and feel confident with it, too.  Good luck!

You have a lot of research and reading to do!  Just curious-why are you limiting yourself to just those two surgeries?  Is it because of insurance coverage?

Let me throw my 2 cents in so you can consider this along with many other factors:

I had RNY and a revision.  I don't dump, don't have any restriction, and can gain as much as 3 lbs. in a few days.  This is while I am "dieting" and exercising.

So I had my guts rearranged, and I'm still not able to lose weight like I *should*.  I did initially lose about 120 lbs., and I'm glad for that.  But just don't think that having RNY is the end-all be-all of weight loss.  There are some people that it just doesn't work for like it does for others.  I throw this out there because I wish I had wanted to hear this before my surgery.  If someone told me that they were having issues, I probably wouldn't have listened and thought they just weren't doing what they were supposed to.

Good luck in picking the right surgery for you!

Thank you. Yes, I've been reading and researching for months.  I've already been in the program and have progressed the point where I am seeing the surgeon soon so I need to decide on a surgery.  I went in saying "lap band" but have been asked to keep my ears and heart open about RNY.  Yes, it's an insurance issue that these are my only two options.

The truth of the web is that (out side of this site) it seems more people report the negative than the positive so I just have to be careful about what sinks it without letting it scare me to death.   I'm glad you told me about your experience though; because it is something to consider.

when you say "revision", what does that mean - revision to vsg or lap?

Thanks again.

I had kind of a second RNY, meaning that the surgeon tightened up my pouch and stoma after seeing it was stretched out more then would be expected.  So I'm still an RNY patient.

I chose RNY because I had a lot to lose, and I'm a total squeamish baby.  I knew I could never go for fills and have a port and all that stuff.

One thing I also considered was the supplement factor.  It is just routine for me to pop a million supplements a day, but in the beginning it feels like it is consuming your life.  It is also something you can't ever slack on, so ask yourself if you will be able to financially and mentally stick to this regimen forever.  

You will find a lot of people here that love whatever surgery they had, so you should have a lot of positive experiences to consider.

There is no one "right" surgery. Everyone has different needs and what works for one may not work for another. All surgery has risks and failure rates. What you need to decide is what are YOU comfortable with. For me the decision was an easy one, I was not willing to rearrange my organs so I went with the Realize Band. I know that I will lose weight slower than the RNY people and I am ok with that. The goal is to lose the weight, I didn't put it on quickly and I won't take it off quickly. Have a discussion with your surgeon to see if there is some reason that one surgery would be better for you than another. Get all the facts and then when you feel comfortable make a decision.

you should either attend some informational seminars or consult with a surgeon who can help with your decision.

the actual RNY surgery sounds worse that it actually is and the risk are about equal and the weight loss is about the same over 18 month period just you will loose more in the beginning after RNY and lap band is gradual over time.

but your surgeon will know what the best is for your situation and eating habits.

 

I've gone to two seminars, a support group meeting, counseling, and several appointments at the weight loss center.  I feel very informed about the two surgeries.  I guess the issue is, in all honesty, that I'm being pulled in two directions by professionals.  As I said earlier - I came in expecting lap band but was told by staff, etc to consider RNY.  And everytime I come back to the thought - no I think lap band is for me; someone gives me a reason to re consider rny.   I'm just trying to "talk it out" on this board because this will be my main source of support.   Sometimes just saying things out loud (or typing them outloud, lol) will give clarity....so that's why I'm asking these questions.

i've heard from so many people on this board who say they agonized over the decision right up until surgery "did I choose the right one" or "should I go through with this"...and maybe I'm just one of them.

I chose RNY because I did not want to have to go get fills for the rest of my life

yes you need to go get checked out by the surgeon at 2 week 3 months 6, months and 1 yr and 2 yrs. but that is expected. but that band can shift and cause erosion's. and you need to get fills or unfills sounds inconvenient to me. personally.

I don;t know how it is if you choose to move out of state or need to change Dr. can you take your band form one Dr. to a different one for a fill or unfill.

say if you find that your Dr. leaves and you get a new one at that office you don't care for are you stuck with that one because you have to go to that clinic for a fill. for life.

I was like you I thought that the band would be better cause it was revers able. but it is difficult to get a Dr to reverse it unless there are complications and the RNY is also reversible under extreme cir****tances too. Just not as publicized.

the rate at which you loose depends on you your metabolism and the amount of exercise you get. and like Brenda said some are not as successful for unknown reasons. That dosen't mean that they don't loose they just don't loose as well.

both are a tool.
good luck.

I think that the idea of the lap band as less invasive is a bit misleading. It is major surgery, you are leaving a foreign object in your body, and you will have regular follow up visits to fill/unfill the lap band. Also, I think it is very likely that you will have to have a second surgery with the lap band because I don't think that device will last a lifetime. I think eventually for one reason or another (pregnancy, band failure, slippage, erosion, etc) it will need to come out. If you are a lightweight (and with a BMI of 40 I believe you are) and do not need to lose a lot of weight than the lap band may work for you. As I'm sure you know, without the malabsorption and the time it can take to find the lap band's "sweet spot" filling you will have to work harder to lose and maintain the weight than with the other WLS options.

Besides the lap band and RNY there is also the sleeve and DS surgery. Like the lap band the sleeve is restriction only and I'm fairly certain that it doesn't cause dumping. I'm not sure if strictures are a possibility with the sleeve.  With the sleeve the surgeon removes about 70-80 percent of your stomach so that they leave a smaller, banana shaped stomach. Have you considered the sleeve? With everything I've heard on OH  I would probably go with the sleeve over the lap band if I wanted a restriction only procedure. The weight loss acheived with the sleeve is typically less than the RNY or DS, but more than the lap band, and is newer procedure.

Both the RNY and DS have malabsorption. The DS surgery is kind of like the sleeve  (smaller, banana shaped stomach) plus malabsorption (a lot more than the RNY). The people on the DS board can go in better detail than I can about that procedure. The risk of nutritional defiency with the DS is higher than the RNY and requires a dilligent vitamin/supplement regiment but the weight loss with the DS is higher.