VSG vs. Band?

I know this question must have been asked many times before and I did some research online but am still sooo confused.

The good news is that my insurance approved my lapband today! So, I was ecstatic with the news until I saw this information and my family doctor (not my bariatric doctor) asked me why am I not considering VSG instead of the band. I did enough research to understand the pros and cons... but I have a very hard time making this decision.

I know that ultimately it’s my decision what procedure to pick but any words of wisdom, reassurance, or advice are greatly appreciated.  

 

"with 3-year follow-up reported, 88% of the 299 patients had one or more adverse events, ranging from mild, 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 gastric banding 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."

A third of patients had undergone reoperation after five years, increasing to 53% at 10 years. The incidence of band removal increased from 0.5% at one year to 11% at five years and 35% at 10 years. Conversion to Roux-en-Y gastric bypass accounted for half of all reoperations, according to one AMSBS report

 

Why are you confused? No one should make this decision but YOU, not your doctor or surgeon. My surgeon suggested I get RNY over 6 years ago and NOT the band. I chose the band because I did not want a life time of dumping syndrome and other possible complications related to that surgery. My surgeon would not have to LIVE with that surgery I would. Possible faster weight loss was not a decision maker for me.

That said, you should not be asking strangers on the Internet to pick a surgery for you, you will get variety of responses, some responses will be bitter by those who did not have a great experience with the band and some responses will be positive for those who had a great outcome and success with the band.

Because I did not want my insides re-arranged I KNEW that I would have to be more disciplined by taking a long hour walk each day, I limited my sugar intake, and focused on proteins and veggies in my first year for optimal weight loss with my band, it was not hard for me, the band just made sticking to a diet easier by limiting my portions.

Here is a guide on how the lap band works for success and to avoid complications

http://www.laplose.com/Media/Forms/LapBandDietGuideNew.pdf

If you were ecstatic and STILL WANT the band, you should still GET the band, it's your body and your life. If your surgeon is pushing the Sleeve on you, then you may want to find a band friendly surgeon, the band works best with a surgeon that will follow your journey and fill your band properly and provides excellent aftercare, if your surgeon can't provide superior aftercare and fills your banded life will be horrible and you WILL experience some of those problems you listed in your research, your lap band and success WILL BE AS GOOD AS THE SURGEON WHO INSTALLS IT and how your fills are given.

Have you thoroughly researched the downside of the Sleeve as well? Many people do well with with the Sleeve and many people do not, the SAME as the lap band, the Sleeve and Band are both restrictive surgeries, and they BOTH do the same thing. You may get faster weight loss with the Sleeve because of the mere fact that 80 percent of your stomach will be removed and MOST people have a very hard recovery which will result in fast weight loss in the first 6-8 months, but once the stomach heals and your appetite returns in full force, the Sleeve may not be as powerful than the band long term.

My philosophy is why go through removing your stomach or rearranging your insides when you will eventually have to exercise, watch your carbs with these surgeries and once these more invasive surgeries run their course of effectiveness and then you still may have to live with long term side effects.

Most Lap Banders that keep their band adjusted properly, NOT TOO TIGHT, don't experience those symptoms that you listed in your study, if the band is filled to tight and saline is not removed promptly ALL THOSE SYMPTOMS and issues that you listed WILL OCCUR AND MORE.

I am going on 7 years post and I have still have all original parts of my band and I have not required a second surgery, I have no adverse symptoms, no issues that you listed in your study, my life is totally normal, I don't have to worry about vitamin deficiencies and I am not in and out of the hospital, I went from a size 28 to a size 10 by 18 months post op and I am grateful for my health, and if my band ever slips or any mechanical problem occur, I would get it replaced that is how much I love my band.

While you are researching possible bad things with the band to keep things balanced in your research here are a few things you may need to know about the Sleeve.


http://www.weightlosssurgerychannel.com/breaking-wls-news/ga stric-sleeve-procedure-under-scrutiny-at-bariatric-surgery-c onference.html/

Here is recent studies indicating Dumping aka gastric emptying with Sleeve patients and some Sleeve patients dump like RNY people, just want you to be aware of this.

What is rapid gastric emptying?

Rapid gastric emptying, also called dumping syndrome, occurs when undigested food empties too quickly into the small intestine.

What are the symptoms of rapid gastric emptying?

Early rapid gastric emptying begins either during or right after a meal. Symptoms include nausea, vomiting, bloating, cramping, diarrhea, dizziness, and fatigue. Late rapid gastric emptying occurs 1 to 3 hours after eating. Symptoms include hypoglycemia, also called low blood sugar; weakness; sweating; and dizziness. Experiencing both forms of gastric emptying is not uncommon.

New Study and FINDINGS ON DUMPING AKA...GASTRIC EMPTYING WITH THE SLEEVE AS OFJanuary 10, 2012

http://thesagesmeeting.org/comparison-study-of-gastric-empty ing-after-performing-sleeve-gastrectomy-with-two-diffierent- techniques/

Long Term Failure rate of the Sleeve

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

Ultimately it's your decision, but I can tell you that I had the lapband in May 2001 and had great success with it until about 7-8 years out when I started experiencing issues.  Just recently had it removed and converted to RNY.

I was always hungry with the lapband, but could never tolerate fills, so I just ate larger portions of healthy foods and had no issue maintaining goal weight.  However, if I were to do it over, knowing that VSG is available, I'd choose VSG simply because you don't have constant maintenance, don't freaking have the band inside you (which I could definitely feel), and you don't have the issue with hunger much since the VSG removes the part of your stomach that produces ghrelin (the hunger hormone).

Good luck in whatever surgery you choose.

MustangMama....strange you mentioned that you could feel your band "inside of you" do you mean feel the port? If I press on my lower abdomen I can feel my port, but it does not bother me, a few years ago when my band was accidently filled dangerously too tight, I could actually feel it squeezing me..lol, but a quick visit to my surgeon and him removing saline relieved that uncomfortable feeling immediately.

Also in a previous post you mentioned that you got your band placed during the FDA trials back in 2000 or 2001? I don't believe most US surgeons was using the improved technique of the "Par Flaccida" method to properly sutured the band in place, the band has greatly improve in technique since the early 2000's, however I don't believe patient compliance has improved, in fact I think it has gotten worse, since many people don't fully research the band to really know how it works.

P.S. regarding hunger? If you do a search at the top of the page and type in "VSG hunger" you will find many posts of angry VSgrs complaining they still experience hunger despite getting part of their stomach removed, some people don't have hunger with the band either, so I guess it's not a black and white issue of who will experience hunger with the Band or Sleeve, and you can't generalize who will be successful or who will fail with either surgery since they are both tools and both require eating right and exercise to be successful.

You're right that it's not all black-and-white in regards to either procedure.  I personally would give VSG a try over lapband (knowing what I know from my own personal experience) because the removal of the hunger hormone would be a pro (for me) when considering that procedure over the other one.

Would it work for me?  I don't know, but it would be a selling point since constant hunger was an issue for me with the lapband.

I got my lapband in 2001 after the trials had ended.  My insurance company initially denied the procedure because it was deemed "experimental," but after an appeal it was reversed.

My band was placed by a surgeon who participated in the trials.  The port was not the issue, I could feel it, but it didn't hurt. though sometimes it felt uncomfortable  What hurt was the actual tubing.  I could feel it pushing on other organs in my abdominal cavity...you could even see it on CT scans, so I'm not certain if it just wasn't sutured properly or what, but that was an issue I personally encountered.  

Sorry to hear about that, I am sure it must have been a very unpleasant experience for you, I believe most US surgeons widely adapted the "Pars Flaccia" method of suturing the band in place after "lessons learned" of many band slippages during the early placements and many did not use the Pars Flaccida method until after 2004.

Then they started with bigger bands in 2007, since many got bands that were too small for their anatomy, I think there are a lot of reasons why the band fails or people have complications, there are so many variables involved, but for those who get the band size "right for their body" and have excellent aftercare seem to have optimal success and no complications, but sadly that does not happen to a lot of people.

Strange you mention you could feel your tubing....that must have been horrifying, I don't feel nothing inside my body, I would not know I have a band unless I tried to shove food down my throat, I feel bad for those who experience very unpleasant problems with the band, I guess I have no clue of how horrible the band can be, but again, complications occur with ALL weight loss surgeries these are risk we take. It's good that you are doing well with the gastric bypass and I wish you well and an uneventful journey with it.

I would suggest you visit the VSG and revision board.

You'll see more band revisions than any other weight loss surgeries.

Here's the link to the revisions board. Read it carefully before making your choice.

http://www.obesityhelp.com/forums/revision/a,messageboard/bo ard_id,5360/


http://abcnews.go.com/Health/Wellness/lap-band-surgery-half- patients-complications/story?id=13187452

 Had lapband almost 4 years and the happiest day of my life is the day I got my revision to sleeve.

Since I have had both........they are NIGHT and DAY.   IMHO the sleeve is so much better.

Why don't you go to the VSG forum and just browse the forum.  If you post there you will get more replies from those that have been revised from the band to a sleeve.

Regardless of what you decide I wish you much success.

 Having had both, and almost dying from complications from my band, I would choose the VSG hands down. Also, my quality of life is MUCH better with the VSG then it was with the band, and I really didn't have that many issues with my band ****il the major complications started).