Dr Roslin's assessment of the band

my son is considering the sleeve and this is something i would not even of thought to have him check out without your input. thank you! with all this info in recent years on band I am worried about him considering the sleeve but he is VERY obese and does need to do something. 

I had a endoscopy test.  Nothing every showed up wrong on the UGI.

I had horrible reflux at night and had to sleep sitting up.  The totally unfilled me three times.  The first at a year, than as two years, and than for the last nine months they keep doing unfills.  Each time I would feel better for a short while, it would get worse and than they took more out this went on until I was totally unfilled.  I also had trouble with getting stuck and throwing up. 

Two things to consider with band and sleeve is they are both "high pressure systems".  Sleeve is a bit less pressure, but when considering either of these surgeries, esophageal manometry testing should be done.  My GI doctor also says that manometry testing should be done prior to HH repair, since the type of repair will influence esophageal function AND may mean a pt with early asymptomatic motility issues is not a candidate for these two surgeries.  RNY and DS are ok for these pts...tho DS involves a sleeve, it is larger than a vsg sleeve, therefore less back pressure on the EGJ.

The reason I chose NOT to revise was because of this very thing you talk about. I know that my esophagus does not work properly after banding. I wasn't about to exacerbate the problem by revising to the sleeve. All I could picture was having the same left shoulder pain all over again and I'd rather be fat than to go through that again. 

Yes, the chances of esophageal damage with LB > Sleeve if the band caused any damage are huge.