Bypass or Lap Band

You might want to check with your insurance too.  My insurance only covered RNY.   From what I have noticed, people that are more disciplined tend to do better on Lap Band, but it is much slower and not unlike a regular diet.   If you have found that you have tried diets over and over and wasn't able to keep it off, then you might want to consider RNY, it is more restrictive.  That is what I did.  But, both carry a risk of gaining all the weight.  They are only tools and you will have to go with what fits you best.   Good luck. 

Z, Any particular reason they "pushed" the LAP-band over RNY? Or, what- "Why" did they give you? Did it "seem" that way? Or did they come right out and favor one over the other? RNY, Lap-Band, DS, VSG, etc…all seem to work. All can be "defeated" with improper maintenance. All have various risks. Some procedures are a "better fit" for some patients…. Perhaps something about your specific Weight gain history Led them to conclude the LAP-Band was "better" for you? Research them all, but do figure into the mix- "What is your surgeon most experienced with?" for example- if a doc has 1000 Bariatric patients, and of those- 850 were RNY and 150 were LAP-Bands, then I’d lean toward what he has the most experience with… The exception… 1000 patients, 700 were RNY, and half of them reached and maintained a successful goal weight… Complications with 10% of them… 300 were LAP-Band, and 95% of them reached an maintained successful goal weight… Complications with none of them… In that case, pure "number of surgeries" of a particular type Loses out to "successful track record." Yes? Do your research and set up some more Q&A time with your Doctor or his clinic. If along the way, you find you are more likely to succeed with a procedure that isn’t Your Doctor’s "Specialty," Don’t think twice about shopping around for a doc who does the type you really want. Sort of like figuring out that you really want a Toyota and realize you’re talking to a Ford Dealership…. Yes? Take your time and do your research. In the end they are all just procedures that allow YOU to make the difference in your life. Best Wishes- Dx

The above advice is all right on.  There is one more thing that I think you should factor into your decision.  I do not believe that Kaiser has been doing LapBand for very long.  It was important to me to find a surgeon who has done a bunch of my operations....more than 100.  I suggest that you inquire into how many of each type of surgery your surgeon has done and how many of his patients have not survived.  Good luck in your decision. Mike

Thank you to everyone for their great insight!!  Let me explain this situation a bit more of what was told to me yesterday.... I am a Kaiser of Northern California patient.  With that, Kaiser covers and does both RNY and Lap Band.  Now, Kaiser has only started doing the Lap Band in February of this year, before that only RNY was covered by them. Now when I spoke to the Medical Director of the Bariatrics department she asked me why I wanted Bypass..   Being that I had not even looked into the band, that was one reason.  Another was that I don't know how I feel about having the band in my body. Due to my body size, successful weight loss since orientation, and age she recommended that I have the band.  One reason being the vitamins that have to be taken by RNY patients for the rest of their lives.  She said if I was forty she would recommend RNY, but since I am twenty can I see myself taking the vitamins for the next 40 to 60 years?  But if I am not mistaken, you still have to take vitamins with the band too... The Nut really said the same thing as the MD. The Psyc said that right now, with the RNY, the success rate is 50% at ten years out, and that the other 50% has regained almost all body weight back.

Z, "The Psyc said that right now, with the RNY, the success rate is 50% at ten years out, and that the other 50% has regained almost all body weight back." Then the "Psyc" is wrong. or un-knowing talking BS! Ask what study he/she is pulling that from? The actual statistics put the "success rates" at the approximate numbers of- DS- (approx.) 80%. (5 to 10 year goal weight maintenance) and the 20% "fail rate?" Very rarely regain "almost ALL" of there initial loss. RNY- (approx.) 70%. (5 to 10 year goal weight maintenance) ...the 30% "fail rate?" rarely regain "almost ALL" of there initial loss. LAP-Band- (approx.) 60%. (5 to 10 year goal weight maintenance) ...the 40% "fail rate?" rarely regain "Almost ALL" of there initial loss, and with the Band, many will have an adjustment to their fill level That can "re-new" their loss rate, even further out Post-Op Those are averages combining several different studies, But are the "Round Figures" presented by the ASMBS. (American Society for Metabolic and Bariatric Surgery) http://www.asbs.org/ Your youth and lower BMI do lean toward LAP-Band, But not necessarily. If RNY was "the right choice" according to your Insurance a few years ago, But now, both procedures are covered….. Then ask- "What has changed since then?" Ask for a study or paper they can direct you to. So much info floating around, even among Professionals in the field Is speculative, and biased to put the procedure that best serves "Their Needs" in a fairer light sometimes, Than the procedure that best serves ‘Your Needs.’ For years, doctors who hadn’t trained to perform a DS (and that would be the majority) Would say the most ridiculous, unsubstantiated crap about the procedure Just to make sure "It was off the table" in their patients mind. If their patient wanted/needed a DS, that meant they lost their patient To another doctor who actually performed that procedure. Same was true of the LAP-Band. Docs are people with mortgages to make same as all of us. If they feel confident they can meet your needs (even with a less than perfect fit for you) And keep you as a patient rather than sending you down the street to another doc… What do you think they will do? Talk, ask, fact check…. And know that your doc most likely has your best interests at heart as well. Just because they "are people too" In no way makes them "shysters." People are, by and large, a pretty good bunch as long as they are Well paid, un-abused, and get their rest. Most docs fit that category. Best Wishes- Dx

 

There is a place for a medical opinion in WLS...and there is a place for you to make the decision about which WLS is best for you.   Medical opinions are often not objective, but they are subjective.  They are based on a very short meeting with you, with or without a medical history, and may be monitarily based...yes medicine is big business.  A doctor can perform 2-3 lap band sugeries...and perhaps 2 RNYs  in the time it takes to perform one DS.  Which would you push if you were the surgeon and your livlihood depended on how many surgeries you performed?  Would you choose a new BMW convertible over you're patients best interests?  In an ideal world...no doctor would...but lets face reality they are people.  Also surgeons "opinions" can be clouded by their ability to perform different surgeries.  If a surgeon is very skilled at the lap band, and not so skilled at the RNY or the DS....guess which one they will push?  I'm sorry to say, very few sugeons will push you out the door to find a surgeon who can meet your needs (thankfully i have a surgeon who is like that...but it's rare).   I wanted the DS...the first surgeon I went to (not my  current surgeon)..told me it was a terrible surgery and spoke so poorly of it, that I said "omg why would anyone want that surgery, I'll take the RNY" .....anyway turns out, he doesn't even perform the DS.  HELLO, information he should have shared...no?   The DS was the best surgery for me, but he based his "opinion" on a factor that had nothing to do with me....that was his surgical abiilty. Now there are medical reasons to have one surgery over another...and a surgeons opinion in that case may need to outweigh your desire for one surgery or another. Personally (barring any major medical issue)....I'd say look at the tabs on the top of this screen.  Go to the forums tab..and read about every surgery that is availlable. Then find out which surgery you want to have...and consult with a surgeon who actually performs that surgery.  I was fortunate to find a surgeon *****ally was skilled at all 3 of the major WLS's ..and he helped me narrow down the selection to the RNY or the DS...and left the decision up to me.  Scott

Paul,  Your page was very helpful!  Thanks!

great advic from everyone AS ALWAYS around here. DX hit it with the read about all of them and figure it out from there. I started wanting one and am now completely focused on another. Even though I know I will an extra batte with my insurance. IMO its whats BEST FOR ME, in the end thats all that matters.

ask you DR something for me next time you see him/her. if a person weighs 500Lbs and get a RNY and loses 300Lbs BUT puts 100 back on is that a failure? he still down 200 Lbs and in a  far better position that when he/she started.