Deciding between the lapband and the sleeve.

Hello I am new to this. I am starting my way to have WLS, but I am now trying to decide between the lapband or the sleeve. I have researched both but would like others opinions. Thanks!

We suggest you read all you can (see information to the right) speak to members and surgeons that do "both" procedures  

Good luck and keep us posted on your progress  

I opted for the lap band in 2007. I was 320 pounds and very sedentary. I lost between 60-80 pounds, but never the other 100 I needed to lose. Some people get complications with the band. I was one of them. I could not eat the very foods I needed to in order to be healthy and had a lot of reflux and aspiration. My activity level was way up, and I will always thank the band for that! But I was basically a band created bulemic. I had the band removed a couple weeks ago as a result. So while researching ask a lot of questions and consider the potential problems carefully. I am not going to tell you what to do. My own choice based on my own experience was to remain unbanded without a revision. My Doc said with what he knows now he would not suggest the band to me. He does a lot of revisions over to the sleeve. I simply was unwilling to have any other surgery, so will be going it on my own now.   Good luck and Good Health!

My Band History

  My first year with the band was trouble free...little did I know that following the rules, I would not avoid serious and potentially life threatening complications!  

May 2010 Realize Band implanted, hiatal hernia repair, uneventful recovery Aug 2010 fill 3 cc March 2011 fill .5 cc Summer 2011 began to have epigastric pain at night. Sept 2011 stomach virus Sept 2011 pain upper right quadrant, duration 2-5 hours increasing, then subside quickly Oct 2011 barium swallow, band fine, slow esophageal emptying Oct 2011 upper abdominal ultrasound positive for gallstones Oct 2011 gallbladder removal Feb-May 2012 increasing GERD symptoms, nighttime epigastric pain radiating to shoulder, neck, jaw, back.  Palpitations gradually increasing in frequency May 2012 had cardiac work up, stress test, echocardiogram, negative for heart disease.  BP was elevated, so new drug Rx, resolved palpitations/hypertension.  Epigastric pain persisted. June 2012 upper GI with barium shows stoma at band is nearly closed.  Barium drips through, but no stream.  Barium is backed up into esophagus.  PA removes all saline (3.5 cc confirmed, clear, no sign of infection).  Under flouro, barium is still in esophagus, emptying slowly.  PA and Radiologist are concerned, but decide after I drink 8 oz water to schedule me for follow up 5 @ weeks. July 2012 follow up, lost 4 lb.  still having problems eating anything fibrous, but able to eat, at least.  Barium swallow shows smaller than expected stream thru band, but also shows slow esophogeal motility, but not so slow as to require follow up.  PA states that since I'm tolerating food, losing and have a bit of a motility issue, she won't fill me, but cautions me to stay on the band diet and if I'm able to eat everything and quantity increases over 1 cup, to come in for another evaluation. Oct-Dec 2012 In early October, became very intolerant to most foods and started having nighttime pain again, GERD symptoms.  Symptoms subsided for two weeks, then returned.  Taking PPIs for GERD, probiotics and experiencing extreme constipation. BMs only every 8-10 days.  Bloated miserable, having pain, feeling like food is stuck.  November, saw GI doctor and he ordered EGD, soft low fiber diet.  December EGD negative for Hpylori, celiac, erosion, Barrett's.  Prescribed Amitiza for constipation.  Antispasmodic for GI spasms. Symptoms improved. Feb symptoms (intolerance of meals, feeling stuck, etc) returned.  Consult with GI doc, schedules GES.  Results normal gastric emptying times, but abnormal esophageal retention.  GI doctor follow up in 2 weeks. March 2013: barium swallow:Dx achalasia, severe esophageal dilation due to LES failure to open in response to swallowing.  Discussed options for removal/revision and further testing. April 2013:  esophageal manometry test to determine if achalasia is primary or secondary.  If secondary, band IS the problem and it will have to come out.  If primary, surgery may exacerbate the condition. Update: GI doctor has done all he can for me.  I'm scheduled in late May for evaluation with one of the top esophageal surgeons in the nation to discuss band removal, redoing my HH repair and looking to see if my vagus nerve has been damaged. May 30: met with Dr Carlos Pellegrini, a world renowned esophageal specialist to determine the next steps.  He was appalled that no manometry testing was done prior to my HH repair/Lapband and that pledgeted sutures were used.  Apparently these are never used in areas where you don't want scar tissue to form, such as the esophagus.  He was confident that the combination of the two procedures is responsible for my achalasia. May 31: call from Dr Khandewal, head of Bariatrics at University of Washington and my removal/exploratory lap is scheduled for June 7, pending pre authorization. June 3: surgery is approved.  Preop appt on the 5th, surgery on the 7. June 7: check in at 5:30am, I'm the first case of the day.  11am, wake up in recovery, told its out and lots of scar tissue removed.  Surgery duration was 3+ hours.  Feel like a truck ran over me, very nauseous. June 8: I'm able to drink just fine, they're going to put me on full liquids.  Cream of wheat, yogurt and ice cream go down with NO regurgitation.  I'm discharged at noon...:) June 13:  my entire GI tract has awakened.  I'm eating, swallowing, farting, pooping, no problem.  No regurgitation on a soft diet, no puking up my meals. I'm having esophageal spasms and have redness around incisions, so have appt with Dr K on Tuesday.  Spasms aren't frequent, but are very painful, lasting 15 min or more.  Hyoscyamine + h20+ gaviscon help, but he wants to check me out.  Nurse thinks its the esophagus nerves waking up.  Lets hope!   High weight 290 lb Surgery weight 281.5 Band emptying weight 225 Current weight 199 Goal weight 170   At all times my PCP, Gastroenterologist, Cardiologist and Bariatric Surgeon were in communication.  Procedures, records and test findings were shared. Copies of this history are scanned into my charts and updated.     Preexisting IBSd. Hypertension, hyperlipidemia, sleep apnea, GERD. Sacroiliac Joint Dysfunction/Spinal Stenosis Left knee osteoarthritis-replacement recommended    Still taking all medications I was taking pre-band +antispasmodic and additional hypertensive drug   

Bottom line: don't get a band, there are dozens of people I know with this same scenario.  3 months after band removal I'm 95% symptom free.

Reading the Revisions forum is a good place to start. You'll notice that there a LOT of revisions FROM the Lap Band to other forms of WLS. 

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

Also, the Mayo Clinic is not doing gastric banding anymore. We'll see many other surgical centers following suit in the near future due to the poor outcomes overall with banding.

I haven't had a sleeve, so I can't offer advice on it. But I did have the band and I still consider it the worst decision I ever made. 

The Statistics show that If your going to get a Sleeve the weight loss is BETTER on a Virgin stomach. With that being said I can't recommend a Band to any one. The Failure rate is too High, why have 2 WL Surgeries if you don't need to. The Facts are if you have a Band you will eventually need another form of WLS.

Check out the Failed band Forum in my Signature line to read other ppl's experience with the band were 800 + members.

There other Forums here  on OH have other groups that also have ppl that have had BANDS and then had to revise . Good luck in your Decision. 

I have had both!  I had trouble with the band and revised to a sleeve.  It has been so much easier and does what I thought the band would.  It helps with hunger and portion control.    I am down 40 pounds lower than I ever got with the band at 8 months out.

I had the sleeve done about 2 weeks ago. The docs in my office strongly recommended AGAINST the band. They said they take out more bands than they put it.

I would go with the sleeve. After 2 weeks with mine I feel great and only regret it when I am having "food depression" but then I step on the scale and feel 1000x better. :]

Long term sleeves are far superior to bands.  Bands are temporary, sleeves actually help you fix the problem.  Long term sleeves are also safer than bands, cheaper long term as well.