ASMBS: Gastric Banding Gets Low Marks

You know what bothers me about banding? Check out the band board, see how many times people write that they didn't even research other WLS types because they only wanted a band. How stupid is that? The flat out refuse to even educate themselves on the difference in WLS types. SOME get banding because they are stupid enough to believe it is the safest WLS type. It most certainly is NOT! It is loaded with risks and complications. These idiots who run around saying it is reversible. No, it's not reversible, it is removable. Big huge difference.

Why don't we see sleeved folks, bypass or DS folks claiming they only researched their surgery type? They don't, they research them all.

A sure fire way to determine the stupidity of any WLS person is when they boast that they only researched one surgery type.

I'll add to the stupid people . . .



People who post that medical researchers and medical publications have an agenda. And what would that agenda be? Like they make money off of gastric bypass versus the band? How ridiculous. Doctors make more from these bands - they can crank them out like donuts. They get paid almost the same and can get triple the number done in the same amount of time.

Thank goodness there is medical oversight and researchers are starting to publish re lack of efficacy with the bands and well as terrible long-term complications.

As far as an agenda - the agenda is with the MILLIONS of dollars being made by the lapband companies. That's why they are pouring millions of advertising dollars into their lapbands.

And I suppose the ASBMS has an agenda by telling the people the truth - that lapband is the least effective of all WLS? And what would that agenda be? To possibly educate the public about a surgery that is not living up to the hype and is potentially dangerous?

Posters - where's your sign? Do these people not realize they are being conned by a huge money-making machine?

"People who post that medical researchers and medical publications have an agenda. And what would that agenda be?"

This is actually a problem - there are select cases where studies are paid for (and the researchers paid for) by a company who has a dog in the fight.  For example, let's say the manufacturer of the Realize Band wants to prove that their surgery is safe and effective.  They may pay 1,000,000 or more to gather up a team of researchers to study the effectiveness of the band.

On the other hand, a leading university or hospital that specializes in all forms of bariatric medicine wants to know the same thing, and pays the same amount of money.

Which one of these studies is likely to be more biased towards favorable results regarding the product studied?  Which organization is likely to be more neutral in its observations and interpretations?

It's certainly wrong to assume that every study that disagrees with your position is corrupted in some way, but in general it's very good to question who's paying for the study and if any of the researchers have anything personal to gain from the findings.

Clearly the makers of a band - a medical device slated to make millions, have more at stake. Hospitals and physicians are paid like amounts for surgery and hospital stays.

Even the loser Dr. Mark Pleatman writes:

http://www.lapbandtalk.com/1189828-post18.html

~~Today I was chatting with the company rep from Covidien, who partners with Allergan, makers of LAP-BAND®. Even she said that they are predicting that the LAP-BAND® will soon be obsolete!

Mark Pleatman MD~~

It would appear that even their 'best of the best' advertising company isn't fooling everyone anymore.

I've been told by two different bariatric surgeons that they expect lapband to go the way of vertical banded gastroplasty. Obsolete. It simply doesn't work as well, and they are also running into a fair amount of lawsuits now (although they do manage to keep it quiet with confidentiality agreements pursuant to settlement).It's not going to fly long-term. Thank goodness.

The real question is this? Why are the lapbanders so scared about factual information being put on the main board forum? I honestly think it is because it is frightening. I agree - no amount of defending the band and trying to stop the truth from being told is going to change the fact that it's a ticking bomb in your body. Most of the lapbanders are this forum are really new with lapband - I haven't seen anyone over about 5 years. Come back in 10 and we'll see how much this band is loved.

The thing that is telling to me also, is if you read on the lapband forum and actually read the posts and threads, it's literally peppered with people having trouble with band complications, reflux, not losing weight. While you also find it on the other forums, where other people have had their lapbands removed and are now happy with their revisions, just half an hour reading in the actual lapband forum just bore out everything the researchers are saying.

BLR,

I am glad to see that we’re basically on the “same page" when it comes to “factual reporting". And while I do agree my weight loss is considered the exception (I TELL EVERYONE THIS WHEN I TALK ABOUT MY SUCCESS), I must also note that many folks who have had the "band" operation from my Doctor's practice have "exceptional" success. So the question becomes, is it the tool, the patient, or the education & Doctor's care before/after the operation, or and combination of factors?

If using "studies" are a barometers; studies have shown that initially folks who lose with a band lose up to 60% of their excess body weight compared to 80% with bypass; 70% with Duodenal Switch and/or sleeve. So ANY of these operations are GREAT choices. Long-term success depends on the patient's "follow-up".

As I stated, when a “procedure fails" one must research WHY it failed, and additionally ponder WHAT CRITERIA does the author/researcher use to declare a FAILURE rate. And then one must look into what CAUSED the failure – was it a patient’s lack of following what is required of them, or was it the procedure or device itself.

Again, not to belabor this discussion, but I did some “superficial research" concerning other bariatric procedure failure rate, and found articles that stated RNY has a 40% to 60% failure rate. Are these finding’s true or not, I don’t know – however just because it’s been published doesn’t mean it’s a non-biases factual report. Now, with those “facts" would I sway someone away from RNY – NO!!  

I whole heartedly agree with your assertion concerning report agenda. And thinking that SOME hospitals and/or physicians aren’t compensated by medical manufactures is naïve. Ask anyone who does medical sales, to see if using one product over another doesn’t have monetary value. I am not saying ALL DOCTORS do this, but some do.

When I was researching different Doctors, I found one who promoted BYPASS over Band. I found out the reason he did that was (A) because he did more BYPASS operations compared to band, so he was more comfortable with bypass (B) A band operation cost about $17,000.00 and the bypass was $30,000.00. If money isn’t a factor then why not charge the same amount for either operation?

I also met with another Doctor who promoted one-band over the other. I did some more research (ok, my friend works for the band manufacture), and I found that this Doctor was “well known" within the Manufacturing company, and is “prominently flaunted" at corporate functions and/or within company literature. This made we wonder how truly impartial was this Doctor’s recommendation.

So all I am staying, is just because “it’s in print" doesn’t mean it’s necessary accurate. I always advise folks to do as much research as they can when they are deciding on a procedure. There is ton of literature that promotes one procedure over the other, and one can be swayed if they don’t their do diligence.

 

 

Here's a published article from PubMed stating RNY has a 40% failure rate: Revision bariatric surgery: laparoscopic conversion of failed gastric bypass to biliopancreatic diversion with duodenal switch.

Trelles N, Gagner M.

Department of Surgery, Mount Sinai Medical Center, Miami Beach, FL 33140, USA.

With more than 40% failures of gastric bypass in Body Mass Index>50 kg/m2, a successful alternative has to be proposed. Laparoscopic conversion of failed Roux-en-Y gastric bypass to biliopancreatic diversion with duodenal switch is technically feasible, safe and can be performed in 1 or 2 stages. This revision surgery is the most effective treatment to date, and should also be proposed for failed vertical-banded gastroplasty, adjustable gastric banding and Magenstrasse and Mill procedure, as it may provide the most durable weight loss of all revision surgeries with acceptable morbidity. This may result in lesser degrees of hypoproteinemia, commonly seen after distal gastric bypass.

PMID: 19536053 [PubMed - indexed for MEDLINE]
www.ncbi.nlm.nih.gov/sites/entrez 

 

The Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric procedure in the US. However, the long-term failure rate after RYGB is 20 to 35 percent.[1] Particularly in superobese patients (BMI≥50Kg/m2), this failure rate can be as high as 40 to 60 percent, depending on how failure is defined.[2]

 

http://bariatrictimes.com/2007/09/10/revision-procedures-for-failed-gastric-bypass/

 

 

  

I'm confused about the point you're trying to make with the two links you posted. Both show that RNY is less effective for those with a BMI of 50+ - this has been proven true on numerous occasions.

Jill,

 

If I was PRO-BAND and ANTI-anything else, I could tout these statistics as “PROOF the bypass doesn’t work, especially with folks who have a BMI over 50 (which I was).   

 

Do these studies mean that EVERY person, with a BMI over 50, will NOT be successful with a bypass? Of course the answer is NO!! However if one was just to believe the facts, and if they had a BMI over 50, then according to these studies they should forget bypass. How inane!!

 

And the 2^nd article states that RNY failure is 35% for those under a BMI of 50, and up to 60% from those BMI over 50. Is this REALLY true ?!?!?!?!? If so, why are the “ethical" Doctors performing an operation that has a 35% to 60% failure rate?

 

Again, we need to look deeper into who performed the study, and what their beginning “hypothesis" was. Many researchers conduct tests that bolster their hypothesis, and disregard this results that don’t.

 

I can almost guarantee if you went to Allergan, they have “independent medical research results" which shows the Lap Band has more successful patients than By-pass. In the same vein, I bet Ethicon has “proof’ their patients are more successful than Lap band, while Lap Band has proof their patients are more successful then Realize – who is right ?!??!?!

 

What I am trying to show is that if one looks hard enough, they will find validation that a specific procedure isn’t 100% successful or has 100% long-term positive results.

Nevermind, I see you're not thinking logically. I will not attempt a rational discussion with you.