Q on LAP RNY vs lap band

I'm concerned about the long term negative effects of bypass. Does the new laparoscopic techniques lessen difficulties with malnutrition and dumping? I'm considering lap band bevause I'm a bit scared of all that's involved with the bypass. Any advice or knowledge would be greatly appreciated. Thank you.

I am not an expert, but from what I know, the fact that RNY can now be done laparoscopally does not lessen any issues w/malabsorbtion and bypass.

Also, any laparoscopic procedure, including Lapband, can turn into open surgery during the procedure. It's part of the consent that I had to sign, that I was aware of that fact.

I know you said malnutrition, but you have to realise that malabsorbtion is an intended part of the RNY. Malnutrition is avoided by careful monitoring for life.

Regarding RNY vs. lapband, it's a very personal choice. Now that I am going from band to RNY, I think that a fact that I did not consider going in was what were my trigger foods. It's very east to "cheat" the band with sweets, and they are my favorite foods in the world.
(I am not having the revision because of that, I have other medical issues.)

Having said that, when my lapband was "operational" I lost over 80 lbs. and was very happy with it. Once I had problems and had to have it unfilled, I lost all my motivation and began eating all the wrong foods.

I hope this helps, and I'm sure that others will have input for you as well.

Hiya,

All of the choices we make on which surgery to have is so very personal.  I am one month out and have had such a wonderful experience with my lap band surgery it's really hard to think of my life prior to May 8th, 2007.  It truly was a rebirth for me!

Best of luck with your decision!

sbcpc1: Helo. Luckily we have multiple choices when it comes to WLS. Making the choice on what type is individual, with most feeling ine is the best (well for an individual such as uself it was best bt FOR ME!). Dumping is not all that common sadly! less than 50% reported EARLY On have it, many never dump and only on large quantities and only certain types sugar. Many look to it to help as behaior modification, my philosophy is fear it and dont try sugar....works so far for me at almost 5 yrs out....malnutrition is a fear, that is why eating and taking suppliments and f/up with care and lab is imperative, but know the band is not w/o issues, different ones but better/worse? It is individual I guess. I will post (repost) info I have on this coplications can happen w any tool andy tool can be defeated, some people choose ne then need a revision etc, just read and read and do what feels best to u! Yes I am pro WLS and bias about RNY (Actually I think BPD?DS is probably the best ot there and if I had to choose again that is what I'd choose!!!) ~~~~~~~~~~~~~~~~~~~~~~ here are some posts I have spoken to this ?? before.. read on they may apply some to you.. I am a rnyer so tha is my disclosure up front. I am pro WLS choosing is individual...Realistically 170# for 5'8'' is not realistic w/ either surgery..remember band or bypass neither are meant to get one to ideal...50% is successful bypass....INAMED reports 33-38% excess (theirs not my stats) Yes I know some say the band and bypass are same at 5 yrs. I have yet to see this data, glad if anyone has the research articles to show me so I can see it. I know rnyers regain, so have banders In my experience but then again the data is limited as its only been in us since 2001 and AMC only started in 2003. so no 5 yr pts here yet to say that......I see banders not lose, I see them lose 100% (My friend Dr Julie Dostal) but she is not typical, neither was I when I lost 100%..I see rnyers not lose 50% either I see complications w/ either surgical tool. We each think we are terminally unique but we aren't stats don't lie they tell typical.. so if your goal is 170 perhaps reframe it can u get there w band or bypass perhaps but getting to for you at being ~200# overwt losing 100# would be expected (50% loss excess) perhaps 150# loss for 75% excess......If u followed inameds data at 38% excess that would be 76# in 2 years....just fyi food for thought.. _______________________________POST #1_____________________________________ BYPASS VS LAPBAND INFO (why I chose RNY) The Bypass as well as the lapband have all of the risks that come with having an operation · Bleeding · Complications due to anesthesia and medications · Deep vein thrombosis/clots · Wound Dehiscence · Infections · Pulmonary problems · Spleen injury · Stenosis · Hernia Ø AND YES DEATH! Both can lead to gallstones & excess skin r/t wt loss, Neither is "SAFE" BOTH need to be considered carefully and not taken lightly...it must be an informed decision and used only as a last resort for people who are 100lbs overweight or have a BMI of 40 or greater, unless their BMI is 35 and they have comorbidities (DM, HTN, sleep apnea...) The surgeon really should be going over all the risk/benefits with the patient, whichever procedure they the PERSON chooses. I would though encourage anyone who is contemplating this to educate him or her to make the best-informed decision possible. Weight loss surgery is not for everyone. I am glad there are different options, because not everyone can have a bypass...and the band is an option for those that cannot/do not (want to) have their GI system altered. I promote weightloss surgery (band or gastric bypass) to those that are informed and understand the risks/benefits and have weighed them heavily!. T The bypass is what I know most about and have had. WHY? There is more research on this surgery (IN THE US), it has been around longer, perfected, esp. in regards to weight loss (depending what research you look at the band may only give the person a 38% wt. loss vs. 78% wt loss is a standard for GBP), The band has only been used in this country since June/July 2001 (In Europe 10-15 years). and long-term complications still are not all known, Can the band stay in forever? Who knows, many do opt to get a bypass after ineffective wt. loss with the band, (So why go thru 2 operations if the bypass will be your final destination? IF your insurance will pay for a SECOND operation?!), many see the band the same in terms of wt. loss as the VGB (vertical gastric band, which has almost been abandoned or revised to bypasses in this country r/t ineffective wt loss (no malabsorption). With the band, there are risks such as: stomach perforation, pouch enlargement r/t band placement/slippage, band slippage, erosion of the band, erosion of band into the stomach, body rejects foreign object (the band), access port problems (flipping etc), saline evaporating from port requiring more f/up fills, more follow-up is needed for the fills.....Also the lapband is not done everywhere yet in this country, insurance companies are still reluctant to pay for it, insurance companies are paying for the bypass, without much issue. These are the reasons I chose what I chose... I am not implying Bypass is not without risks, It has many risks...more serious? Depends which side-effect/complication you get, depends who you talk to....I had a complication, but came through it fine, I had adhesions and scarring that caused a stricture on my small bowel, this could of happened if I had the lap band, our bodies make adhesions, it is a risk of abdominal surgery...mine were in the wrong place and caused a problem! Malabsorption...which in essence means lifelong follow-up with a clinical nutritionist, for labs... and supplements of: calcium, iron (maybe), B12, folate (maybe) and a multivitamin for life. Protein also needs to be a focus of the bypass persons diet, and sometimes supplementation is needed. Hair thinning at 3 months, r/t protein deficiency, but it grows back in full after a few months (not baldness mind you thinning) Dumping syndrome...now some say this is a benefit, sort of the ultimate behavior modification..if you eat sugar/fat you feel awful, tired, nausea, diarrhea..so you don't eat that food again! I fear the lap band may be similar to the VBG lingterm and not be the surgery of choice and may fall out of vogue, I hope I am wrong on that assumption though.... What is agreed on is careful screening medically, surgically, nutritionally as well as emotionally/psychologically. Eating disorders need to be looked at, esp. compulsive eating. A good aftercare plan is key, having a multidisciplinary team to follow you (Good PCP, Surgeon, Nutritionist, therapist, support group) are all factors shown in research to lead a person to the best outcome/wt. loss possible. THERE REALLY IS NO WAY TO OUTLINE EVERYTHING THAT IS GOOD/BAD/UGLY WITH EITHER PROCEDURE. FOR ME BYPASS WAS THE ANSWER, FOR SOMEONE ELSE IT MAY BE THE BAND. GOOD LUCK! Jamie Ellis RN, MS, NPP ____________________________POST #2____________________________ WEIGHT LOSS SURGERY is a tool. The band is a type of WLS, any tool can be defeated if not used properly. I will focus on the Band but know any wls can fail *this is not bash the band ok, I could bash any surgery w/ the right articles but for your help this is what i have on lap band ok!*, some are more forgiving the Lap band is probably the least forgiving of any cheating or non-lifestyle changes. Meaning the band can slow digestion, reduce amount of food taken in at one time and possibly decrease hunger; but without a motivated and committed person using the band making lifestyle changes in diet and exercise yes people can and do not lose ANY wt, some have gained wt! Or many won't lose the potential wt or regain. Lap band has been around since June 5, 2001 in US: *In Europe 10-15 + yrs but remember we can not compare as we have different lifestyles! http://www.fda.gov/cdrh/mda/docs/p000008.pdf History: http://www.lapband.com/lapband/lapbandhistory.do ############################################### Defeat the band by: ~Not going for fills to get perfectly adjusted ~Grazing on small snacky-meals all day long ~Eating high calorie dense foods, things like candy M&M seem to be a favorite, nuts, peanut butter, chips, crackers, ice-cream ago right through easy many times ~Drinking calories such as lattés, milkshakes, soda, soups they slide right through and the calories add up ~Not exercising s part of a regular habit almost daily to preserve metabolism and lean muscle mass and strengthen bones etc ~Not doing the emotional work needed, or choosing to see WLS as magical and something that gives them a get out of obesity jail free card or an emotional bypass, we all have issues to some degree, many times they intensify when we do lose wt, they do not usually go away as we hope, the reality is life did not get perfect once we lost wt as we so wrongly think most of our lives.... ~Case reports in literature of some adjusting their on bands for surgically induced bulimia! Yikes unfill when u want to binge and fill when u want to purge.. not common but happens! Again any wls/tool can be defeated even highly malabsorbtive such as distal RNY bypass of BPD/DS!!! ~~~~~~~~~~~~~~~~~~~~~~~~ 2 BOOKS ABOUT LAPBAND: Laparoscopic Adjustable Gastric Banding : Achieving Permanent Weight Loss with Minimally Invasive Surgery (Paperback) by Jessie H. Ahroni Ph.D. A. R. N. P. $12.48 on amazon.com http://tinyurl.com/zfno9 ISBN: 0595311148 Paperback: 130 pages Publisher: iUniverse, Inc. (May 31, 2004) Lap-Band for Life (Paperback) by Ariel Ortiz Lagardere MD FACS Price: $13.57 on amazon.com Paperback: 331 pages Publisher: LM Publishers (December 5, 2005) ISBN: 187913666X http://tinyurl.com/kkrou Sites w/ diets in PDF http://www.sabariatric.com/assets/forms/AGB_Diet_000.pdf http://www.cornellweightlosssurgery.org/pdf/diet_guid_lap_ba nd.pdf http://www.lapbandforlife.com/postsurgerydiet.htm A site I have looked at before http://www.waynesmith.net/lapband/ A few groups/forums: http://health.groups.yahoo.com/group/UpstateNY-Bandsters/ http://health.groups.yahoo.com/group/GraduateBandsters/ http://health.groups.yahoo.com/group/Bandsters/ http://www.obesityhelp.com/morbidobesity/surgtype-forums/Lap Band/ ************************************************ RESEARCH and knowledge is powerful. Inamed has stats from 2001, 2003 brochures I have. They report the majority in 2-3 yrs lose 33-38% excess wt with some losing 100% some not losing any and some gaining wt!!! THIS IS THEIR DATA: *EMAIL ME IF YOU WANT THE PDF FILE Those who: Gained over 5% EWL 2% 4 people No Change ± 5% EWL 5% 9 people Lost at least 25% EWL 62% 110 people Lost at least 33% EWL 52% 93 people Lost at least 50% EWL 22% 39 people Lost at least 75% EWL 10% 18 people ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total # of patients 178 http://www.lapband.com/lapband/resultsandstatistics.do this shows 55% at 5 yrs! http://www.lapband.com/lapband/riskinformation.do http://www.obesity-online.com/Pat_and_docs_info/index.html check out al the links to the left... http://www.asbs.org/html/story/chapter5.html Complications also are an issue: *With any surgery but I am focusing on band here for your ????/we know bypass risk of nutrient and vit deficiencies usually treated if caught though, s f/up is improtant. Pregnancy after either is safer than when Morbidly obese and neither is prohibitive of pregnancy, yes band may need deflation and rnyers may need more suppliments etc.... *Lap band states/INAMED: In the United States clinical study, with 3-year follow-up reported, 88% of the 299 patients had one or more adverse events, ranging from, moderate, to severe. Nausea and vomiting (51%), gastroesophageal reflux (regurgitation) (34%), band slippage/pouch dilatation (24%) and stoma obstruction (stomach/band outlet blockage) (14%) were the most common post-operative complications. In the study, 25% of the patients had their band systems removed, two-thirds of which were following adverse events. Esophageal dilatation or dysmotility (poor esophageal function****urred in 11% of patients, the long-term effects of which are currently unknown also unknown if reversible or permanant. Constipation, diarrhea and dysphagia (difficulty swallowing****urred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. ________________________ Locally I have had folks w/ flipped ports, eroded bands into stomach lining needing removal, enlarged pouches/dilated esophagus from frequent vomiting, tubing leaking, tubing disconnection, tube strangulation of bowel and obstruction of bowel needing surgery, port infection, band rejection w/ high fevers over a yr until removed, insufficient wt loss (none to very little), band failure needing replacement with a VANGUARD 'big boy' larger 10CC band in two individuals vs original INAMED lap band. Some of the complications lessen w/ the experience of the surgeon so do not be anyone's first 50-100 cases to minimize your risk!!! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Study Shows LapBand® Surgery May Have Long-Term Complications San Francisco, CA (PRWeb) October 21, 2006 -- Overall, 33.1% of patients had at least one long-term complication related to gastric banding. Long-term complications related to LapBand® included leaking, progressive food intolerance, and band erosion. *Email me for full article if you want it is PDF I cannot cut/paste here. I am biased I chose the rny proximal bypass over the band for ME based on my extensive research. So my honest opinion and you now know I am biased. I do not feel the Lap band is the way to go for most people; especially those w/ higher BMI's over 45-50. I think in the long term it is going to fall out of vogue just as the VBG did (it failed to help those lose the wt needed and maintain & had too high compilation rate....) It is a similar surgery except it is adjustable. It is common now as being touted as safe, reversible (like anyone would want it taken out after they lose wt!?)...I am pro WLS and am glad their are choices given the choice in 2002 for a BPD/DS locally and via my insurance I probably would of gone that route, don't get me wrong the bypass is awesome but I feel long-term for ME the BPD/DS might of been a better choice to live a more normal life in the way of eating and with higher wt loss/maintanence..But the RNY gave me through motivation, education 100% excess w/ 15# REGAN SO FAR AT ALMOST 5 YRS, I have beat the odds and made it past 50% excess which is typical. BUT it is only though my lifestyle that I maintain not the RNY at this point its all about choices in the emotional work I do, the exercise near daily and the diligent food choices! Do you want to know more about failure check out the revision sites, I have seen many failed Lapbands as well as failed rnys I have seen a failed VBG go to lapband then rny then BPD DS! I have seen rny to DS I have seen band over bypass, vbg to bypass etc. I also know OH has 2 different Revision Forum. http://www.obesityhelp.com/morbidobesity/amosforums/failed_wls_second_time_aroun\ d http://www.obesityhelp.com/morbidobesity/surgtype-forums/Rev ision/ Yahoo has: http://groups.yahoo.com/group/WLSrevisionsupport/ So again choose wisely so not to need a revision or 2nd surgery where the risks and complications are higher and sometimes u get one payment from insurance and that's it! Most of our lives we have set RIGID, UNREALISTIC WEIGHT LOSS GOALS for ourselves that are BOTH UNATTAINABLE and CHRONICALLY DISAPPOINTING and lead to DEVASTATION & the slippery slope of self-sabotage...Review the UNDERLYING lifestyle change such as exercise, food choices, self-awareness/monitoring, avoidance of emotional eating, adherence to living self responsibly in a CONSISTENT way that is the foundation to our long-term success. ANY WLS can help us change our lifestyles, and any tool/wls we can cheat its benefit, the choice i ours. Be well in your decision and take as much time as u need! Talk to succesful bandsters AT LEAST 3 if not 5 years out see what they do and say to be successful! For that mater talk to 3-5 yr out bypassers Duodenal switchers and Gastric sleevers.....http://en.wikipedia.org/wiki/Sleeve_gastrectomy *the last one may not e easy to find longer term postops yet.Te bypass has been around since 1967, more data, more statistics, more time to perfect technique and reduce complications, BPD/DS around since 1988 when Dr. Hess http://www.asbs.org/html/story/chapter3.html changed the BPD a little. http://www.duodenalswitch.com/; Dr. Gagner in NYC was 1st to do it LAP! http://wo-pub2.med.cornell.edu/cgi-bin/WebObjects/PublicA.woa/6/wa/viewService?s\ ervicesID= 635&website=wmc+weightloss&wosid=nF2NVDBh3tpHnSp2SzHvTg The question should be do u think u can change your life? Can you accept it will take an extraordinary amount of effort every minute of every day to be successful, if you can say yes with confidence and accept the responsibility then WLS ma be for you, it is not the easy way out it is probably the mot challenging thing any of us has done and maybe the most difficult choice to make take the risk of death during surgery to promote a healthier life. Focus on health not the scale it helps as well. WEIGHT LOSS SURGERY is a tool. The band is a type of WLS, any tool can be defeated if not used properly. I will focus on the Band but know any wls can fail *this is not bash the band ok, I could bash any surgery w/ the right articles but for your help this is what i have on lap band ok!*, some are more forgiving the Lap band is probably the least forgiving of any cheating or non-lifestyle changes. Meaning the band can slow digestion, reduce amount of food taken in at one time and possibly decrease hunger; but without a motivated and committed person using the band making lifestyle changes in diet and exercise yes people can and do not lose ANY wt, some have gained wt! Or many won't lose the potential wt or regain. Lap band has been around since June 5, 2001 in US: *In Europe 10-15 + yrs but remember we can not compare as we have different lifestyles! http://www.fda.gov/cdrh/mda/docs/p000008.pdf History: http://www.lapband.com/lapband/lapbandhistory.do ############################################### Defeat the band by: ~Not going for fills to get perfectly adjusted ~Grazing on small snacky-meals all day long ~Eating high calorie dense foods, things like candy M&M seem to be a favorite, nuts, peanut butter, chips, crackers, ice-cream ago right through easy many times ~Drinking calories such as lattés, milkshakes, soda, soups they slide right through and the calories add up ~Not exercising s part of a regular habit almost daily to preserve metabolism and lean muscle mass and strengthen bones etc ~Not doing the emotional work needed, or choosing to see WLS as magical and something that gives them a get out of obesity jail free card or an emotional bypass, we all have issues to some degree, many times they intensify when we do lose wt, they do not usually go away as we hope, the reality is life did not get perfect once we lost wt as we so wrongly think most of our lives.... ~Case reports in literature of some adjusting their on bands for surgically induced bulimia! Yikes unfill when u want to binge and fill when u want to purge.. not common but happens! Again any wls/tool can be defeated even highly malabsorbtive such as distal RNY bypass of BPD/DS!!! just graze or eat and drink together or drink calories or dont exercise etc. ~~~~~~~~~~~~~~~~~~~~~~~~ 2 BOOKS ABOUT LAPBAND: Laparoscopic Adjustable Gastric Banding : Achieving Permanent Weight Loss with Minimally Invasive Surgery (Paperback) by Jessie H. Ahroni Ph.D. A. R. N. P. $12.48 on amazon.com http://tinyurl.com/zfno9 ISBN: 0595311148 Paperback: 130 pages Publisher: iUniverse, Inc. (May 31, 2004) Lap-Band for Life (Paperback) by Ariel Ortiz Lagardere MD FACS Price: $13.57 on amazon.com Paperback: 331 pages Publisher: LM Publishers (December 5, 2005) ISBN: 187913666X http://tinyurl.com/kkrou Sites w/ diets in PDF http://www.sabariatric.com/assets/forms/AGB_Diet_000.pdf http://www.cornellweightlosssurgery.org/pdf/diet_guid_lap_ba nd.pdf http://www.lapbandforlife.com/postsurgerydiet.htm A site I have looked at before http://www.waynesmith.net/lapband/ A few groups/forums: http://health.groups.yahoo.com/group/UpstateNY-Bandsters/ http://health.groups.yahoo.com/group/GraduateBandsters/ http://health.groups.yahoo.com/group/Bandsters/ http://www.obesityhelp.com/morbidobesity/surgtype-forums/Lap Band/ ************************************************ RESEARCH and knowledge is powerful. Inamed has stats from 2001, 2003 brochures I have. They report the majority in 2-3 yrs lose 33-38% excess wt with some losing 100% some not losing any and some gaining wt!!! THIS IS THEIR DATA: *EMAIL ME IF YOU WANT THE PDF FILE Those who: Gained over 5% EWL 2% 4 people No Change ± 5% EWL 5% 9 people Lost at least 25% EWL 62% 110 people Lost at least 33% EWL 52% 93 people Lost at least 50% EWL 22% 39 people Lost at least 75% EWL 10% 18 people ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total # of patients 178 http://www.lapband.com/lapband/resultsandstatistics.do this shows 55% at 5 yrs! http://www.lapband.com/lapband/riskinformation.do http://www.obesity-online.com/Pat_and_docs_info/index.html check out al the links to the left... http://www.asbs.org/html/story/chapter5.html Complications also are an issue: *With any surgery but I am focusing on band here for your ???? *Lap band states/INAMED: In the United States clinical study, with 3-year follow-up reported, 88% of the 299 patients had one or more adverse events, ranging from, moderate, to severe. Nausea and vomiting (51%), gastroesophageal reflux (regurgitation) (34%), band slippage/pouch dilatation (24%) and stoma obstruction (stomach/band outlet blockage) (14%) were the most common post-operative complications. In the study, 25% of the patients had their band systems removed, two-thirds of which were following adverse events. Esophageal dilatation or dysmotility (poor esophageal function****urred in 11% of patients, the long-term effects of which are currently unknown also unknown if reversible or permanant. Constipation, diarrhea and dysphagia (difficulty swallowing****urred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. ________________________ Locally I have had folks w/ flipped ports, eroded bands into stomach lining needing removal, enlarged pouches/dilated esophagus from frequent vomiting, tubing leaking, tubing disconnection, tube strangulation of bowel and obstruction of bowel needing surgery, port infection, band rejection w/ high fevers over a yr until removed, insufficient wt loss (none to very little), band failure needing replacement with a VANGUARD 'big boy' larger 10CC band in two individuals vs original INAMED lap band. Some of the complications lessen w/ the experience of the surgeon so do not be anyone's first 50-100 cases to minimize your risk!!! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Study Shows LapBand® Surgery May Have Long-Term Complications San Francisco, CA (PRWeb) October 21, 2006 -- Overall, 33.1% of patients had at least one long-term complication related to gastric banding. Long-term complications related to LapBand® included leaking, progressive food intolerance, and band erosion. *Email me for full article if you want it is PDF I cannot cut/paste here. I am biased I chose the rny proximal bypass over the band for ME based on my extensive research. So my honest opinion and you now know I am biased. I do not feel the Lap band is the way to go for most people; especially those w/ higher BMI's over 45-50. I think in the long term it is going to fall out of vogue just as the VBG did (it failed to help those lose the wt needed and maintain & had too high compilation rate....) It is a similar surgery except it is adjustable. It is common now as being touted as safe, reversible (like anyone would want it taken out after they lose wt!?)...I am pro WLS and am glad their are choices given the choice in 2002 for a BPD/DS locally and via my insurance I probably would of gone that route, don't get me wrong the bypass is awesome but I feel long-term for ME the BPD/DS might of been a better choice to live a more normal life in the way of eating and with higher wt loss/maintanence..But the RNY gave me through motivation, education 100% excess w/ 15# REGAN SO FAR AT ALMOST 5 YRS, I have beat the odds and made it past 50% excess which is typical. BUT it is only though my lifestyle that I maintain not the RNY at this point its all about choices in the emotional work I do, the exercise near daily and the diligent food choices! Do you want to know more about failure check out the revision sites, I have seen many failed Lapbands as well as failed rnys I have seen a failed VBG go to lapband then rny then BPD DS! I have seen rny to DS I have seen band over bypass, vbg to bypass etc. I also know OH has 2 different Revision Forum. http://www.obesityhelp.com/morbidobesity/amosforums/failed_wls_second_time_aroun\ d http://www.obesityhelp.com/morbidobesity/surgtype-forums/Rev ision/ Yahoo has: http://groups.yahoo.com/group/WLSrevisionsupport/ So again choose wisely so not to need a revision or 2nd surgery where the risks and complications are higher and sometimes u get one payment from insurance and that's it! Most of our lives we have set RIGID, UNREALISTIC WEIGHT LOSS GOALS for ourselves that are BOTH UNATTAINABLE and CHRONICALLY DISAPPOINTING and lead to DEVASTATION & the slippery slope of self-sabotage...Review the UNDERLYING lifestyle change such as exercise, food choices, self-awareness/monitoring, avoidance of emotional eating, adherence to living self responsibly in a CONSISTENT way that is the foundation to our long-term success. ANY WLS can help us change our lifestyles, and any tool/wls we can cheat its benefit, the choice i ours. Be well in your decision and take as much time as u need! Talk to succesful bandsters AT LEAST 3 if not 5 years out see what they do and say to be successful! For that mater talk to 3-5 yr out bypassers Duodenal switchers and Gastric sleevers.....http://en.wikipedia.org/wiki/Sleeve_gastrectomy *the last one may not e easy to find longer term postops yet.Te bypass has been around since 1967, more data, more statistics, more time to perfect technique and reduce complications, BPD/DS around since 1988 when Dr. Hess http://www.asbs.org/html/story/chapter3.html changed the BPD a little. http://www.duodenalswitch.com/; Dr. Gagner in NYC was 1st to do it LAP! http://wo-pub2.med.cornell.edu/cgi-bin/WebObjects/PublicA.woa/6/wa/viewService?s\ ervicesID= 635&website=wmc+weightloss&wosid=nF2NVDBh3tpHnSp2SzHvTg The question should be do u think u can change your life? Can you accept it will take an extraordinary amount of effort every minute of every day to be successful, if you can say yes with confidence and accept the responsibility then WLS ma be for you, it is not the easy way out it is probably the mot challenging thing any of us has done and maybe the most difficult choice to make take the risk of death during surgery to promote a healthier life. Focus on health not the scale it helps as well. _________________________________________________________________ Surgical Risks Weight loss surgery is MAJOR ABDOMINAL SURGERY. There are many important and potentially lethal complications known to be associated with this operation, and surgery in general. Some of the dangers are the same that are present in any operation that includes sedation of the patient. These operative risks are therefore not unique to this surgery, however, it is still important to review these risks. Please review these risks with your family or support system, and feel free to ask your doctor any questions that may arise. Complications Description Allergic Reactions From minor reactions such as a rash to sudden overwhelming reactions that can cause death. Anesthetic Complications Anesthesia used to put you to sleep for the operation can be associated with a variety of different complications up to and including death. Bleeding Surgery involves incisions and cutting that can result in bleeding complications, from minor to massive, that can lead to the need for emergency surgery, transfusion, or death. Blood Clots Also called deep vein thrombosis and Pulmonary Embolus that can sometimes cause death. It is imperative that you get up and walk around the evening of your surgery day to help prevent clots from forming in your legs. Infection Including wound infections, bladder infections, pneumonia, skin infections and deep abdominal infections that can sometimes lead to death. Leak After an operation to bypass the stomach, the new connections can leak stomach acid, bacteria and digestive enzymes causing a severe abscess and infection. This can require repeated surgery, and intensive care and even death. Narrowing (stricture) Narrowing (stricture) or ulceration of the connection between the stomach and the small bowel can occur after the operation. This can require emergency operation, intensive care and can sometimes lead to death. Indigestion, Reflux or Ulcers The operation can sometimes lead to severe nausea, vomiting, indigestion, abdominal pain, gastritis or ulcers. This can be severe and can last for days, weeks or possibly even longer. This is especially likely if you have had previous problems with nausea, abdominal pain or ulcers. Bile reflux is also a possibility, and may necessitate additional surgery. Dumping Syndrome Dumping Syndrome (Symptoms of the dumping syndrome include cardiovascular problems with weakness, sweating, nausea, diarrhea and dizziness) can occur in some patients after gastric bypass. This can be so severe that the surgery may have to be reversed. Bowel Obstruction Any operation in the abdomen can leave behind scar tissue that can put the patient at risk for later bowel blockage or obstruction. The bowel can twist, obstruct or even perforate leading to serious complications and even death. Laparoscopic Surgery Risks Laparoscopic Surgery use*****tures to enter the abdomen and this can lead to abdominal injury, bleeding and even death. Side Effects of Drugs All drugs have inherent risks and complications and in some cases can cause a wide variety of side effects, reactions and rarely cause death. Loss of Bodily Function The performance of surgery and anesthesia can stress the body's systems leading to a variety of complications including stroke, heart attack, limb loss and other problems related to operations and anesthesia. Risks of Transfusion Including Hepatitis and Acquired Immune Deficiency Syndrome (AIDS), from the administration of blood and/or blood components. The illnesses are serious and can be fatal. Hernia Cuts and incision in the abdominal wall can lead to hernias after surgery. Hernias can lead to pain, bowel blockage, obstruction and even perforation and death in some cases. Treatment of hernias usually requires another operation. Hair Loss Many patients develop hair loss for some period of time following an operation. It usually occurs 3-4 months following surgery, and resolves at 7-9 months. This usually responds to increased oral intake of protein and vitamins, but it may be permanent. Vitamin and Mineral Deficiencies After gastric bypass, there is a malabsorption of many vitamins and minerals. Patients must take vitamin and mineral supplements forever to protect themselves from these problems. You also need to have yearly blood tests to measure the blood levels of these vitamins and minerals. Common deficiencies that can occur after gastric bypass include iron and calcium deficiency, B12 and Folate deficiencies.This is very important: Patients must take vitamin and mineral supplements forever. In some cases the deficiencies are so severe that they can lead to nerve and brain damage and the bypass must be reversed! Excessive Weight Loss Some patients sustain excessive weight loss after the operation and may require reversal of the bypass to prevent severe malnutrition, nausea or vitamin and mineral deficiencies or death. Complications of Pregnancy Vitamin and mineral deficiencies can put the newborn babies of gastric bypass mothers at risk. No pregnancy should occur for the first one to two years after the operation. Gastric Bypass has been shown to cause multiple types of vitamin and mineral deficiencies including: iron, B12, Folate, calcium and many others. Many of these deficiencies have been shown to cause birth defects or are suspected to cause birth defects. We also know that many patients who lose weight feel that they are well after surgery and forget to take their vitamins. Patients MUST be certain not to miss any of their vitamins if they decide to go ahead with pregnancy later. Unplanned Pregnancy Warning to women using oral contraceptives (birth control pills): More than 80 million women worldwide take "the pill" to prevent pregnancy. Studies have shown that oral contraceptives affect a woman's hormones. This surgery also affects hormones, and interferes with the bodies ability to regulate hormonal levels. Thus oral contraceptives or other hormonal types of birth control (i.e. Depo Provera) are NOT RECOMMENDED as a reliable prevention of pregnancy following a gastric bypass. A barrier method is recommended, but be aware that your body changes rapidly during the initial weight loss period, and a diaphragm would not be especially reliable, either. Other Major abdominal surgery, including the Laparoscopic Gastric Bypass, is associated with a large variety of other risks and complications, both recognized and unrecognized that occur both soon after and long after the operation. There is also a risk that you may not lose all of your excess weight before your body adapts to the bypass, and causes your weight loss to slow or even to stop prematurely. Depression Depression and anxiety are common medical illnesses and have been found to be particularly common after gastric bypass surgery. You must have a mental health plan in place, and make your family or support system aware of the signs and symptoms of depression, so that they can get you the help you need. Death This is a major and serious operation. It may lead to death from complications in some cir****tances, despite our best efforts on your behalf. ~~~~~~~~~~~~~~~~~~~~~~ Try to get info from as far out postops as ou can w/ any surgery to know what it is like to live with it good bad ugy after 3, 4, 5 yrs if possible, not to say newbies as we all are at one point are not helpful it is just a different time, a glorious time for most the newness is awesome the enthusiasm strong. It just is not the time many issues pop up like emotioanl issues, addiction swithing, regain, complications etc....If you had talked to me at 6 mo, 1 yr, 2 yr even 3 yrs out I would of had much different info to tell than at 4, 5 yrs......it is always changing, not good or bad just that is reality.hugs......