To Sleeve or RNY after the Band?

I had the band placed in Nov 2007.  Experienced minimal success, went from 308 pre-surgery diet to 247 lowest band loss.  My surgeon left his practice pretty quickly after surgery and his alternate could not help me find the sweet spot.  I didnt realize the band was so finicky and finding that right fill level was difficult.  PLUS, my surgeon had huge difficulty hitting the port, they would poke me for long periods.  One time they couldnt hit it after 20 minutes, they told me to reschedule at no charge.  Finally the doctor told me he thought the band had a leak because there was no fill in my band.  I decided to go to a new surgeon, they hit the port first poke and withdrew a done of fluid, my band was 75% full, ie to full.  They took out all fill, I went for an upper GI, and although I am not slipped or eroded, my stomach hurts all the time.  It has for years.  And weirdly enough, I can feel the connection between the stomach and the port and every inch of the tube inbetween.  I feel it every second of every day.  I a want it out and I am seriously considering a revision to either a sleeve or RNY. I am really fretting over this decision for many reasons, insurance covering band removal and revision, DRAMATIC life change under RNY.  Can folks share their revision successes or challenges to help me fully understand the pros and cons?

Molly, I'm sorry to hear about your band struggles, but at least you've found a surgeon who knows what the heck he's doing.

I was banded in September 2007, but had some problems (long story, and none of them like yours) and my band was removed in April 2012. I was sleeved in August 2012. I loved my band and am finding it hard to live with my sleeve. The advantage of the sleeve or RNY versus the band is that neither of them require fills, which would be good news to me if I'd been having trouble with fills. In my view, there are dramatic life changes after VSG. For starters, about 80% of the stomach is removed and discarded. It's gone forever, so there's no going back. The sleeve has worsened my type 2 diabetes, I have numerous vitamin/mineral deficiencies, I'm constantly hungry, I must take omeprazole to deal with the reflux, I dump when I eat sweets or too much of anything, just like a lot of RNY patients do. I've had some complications from the sleeve surgery, including duoneitis, a gastric polyp, and gastric bleeding. I'm happy to have lost the weight I regained while waiting for my sleeve surgery, but now I'm in the peculiar position of having lost too much weight. I'm now 20 lbs below my goal weight and still losing despite eating more protein and going back to eating full-fat dairy. Recently I read a news tidbit (I wish I could remember where) that researchers now suspect that there is macro as well as micro-nutrient malabsorption with the sleeve. That could account for my unintended weight loss.

I have 3 friends *****vised from the band to RNY, One of them has lost no weight since then. One was hospitalized because of gastric bleeding. The other one has been in the hospital for a month now, since a week after her RNY, with so many complications that I could write a book about them.  She was in a medically-induced coma for a few weeks and even now is heavily sedated, and has a vent tube down her throat so I can't talk with her about her experience.

So, in my opinion, choosing the sleeve or RNY is pretty much 6 of one, half-dozen of the other. Anecdotal reports about WLS procedures that you get online are only part of the information you need to gather in order to make a decision. If you haven't already done so, I think you should talk in depth with your surgeon about the pros and cons.

Good luck!

Jean

Thanks Jean!  I am sorry you are having a difficult time with the sleeve.  I will continue to read, research, and talk to my surgeon.  If anyone else out there has experiences to shar, please do, good or bad. 

I've had problems with my band too since it was put on in 2006.  I'd never do it again.  Now, I want to have it removed.   If anyone has any stories of band removal and what to expect I would sure appreciate it.  Thanks.

I had problems with pain with my band.  You may have the same issue.  The body just doesn't like the foreign object.  My body built a scare capsule around the port.  I told the doctor it flet like my body was trying to pu**** out and it pained all the time as did my stomach.  I had also developed scare tissue between the band and stomach and the tube touching organs.

Everything showed normal until they got inside to see what was going on.  Good luck.

There's a third option you should also consider, called the Duodenal Switch. The DS has the same stomach as the Sleeve---i.e., still fully-functional, including the pylorus---plus an intestinal bypass similar to, but more effective than, that of the RNY. Both the DS and the RNY will cause life-long malabsorption of certain vitamins and minerals, but ONLY the DS gives permanent malabsorption of calories as well.

I'll be ten years post-DS come Dec. 11th. I couldn't be happier with my choice. The post-op quality of life is wonderful, and I've had zero regain. I love my DS!