Please help me decide...
On October 30, 2010 at 6:00 PM Pacific Time, tcasola wrote:
Doctorman,
You’re probably going to dislike what I am going to say, but please understand I am saying this with concern and your best interest. So if I offend you, I am sorry but I don’t mean to (remember print is cold and true feeling probably won’t be conveyed)
My suggestion – you need to do a lot more research before making any decision. Whatever surgery you chose, the decision is a major one and should not be taken lightly or be expected to “be the cure all".
There is no guarantee ANY bariatric surgery will STOP the hunger feelings. In MY case (as long as I follow the rules) I rarely get hungry, but that doesn’t mean I don’t continue to get the “hunger" feeling. That’s because there is a difference between REAL hunger and HEAD hunger.
Since they put the tool around your stomach, and not around your brain, you need to (A) differ between these two hungers (B) know what to do if/when you get head hunger. The only way you learn to deal with HEAD hunger is by: speaking to nutritionists; speaking to your Doctor; speaking to a psychologist/psychiatrist; going to support meetings; reading (books; articles; web sites; etc).
There are a lot of “rules" you need to follow in order to be successful. The TOOL does not do it for you. YOU DO IT FOR YOU – the TOOL helps. Think of a hammer and nail – to drive in the nail, it’s almost impossible to do it without a tool. And when you have one, the hammer doesn’t do it all by itself. YOU need to SWING THE HAMMER. The hammer makes it a whole lot easier, but it’s STILL YOU WHO IS DOING THE WORK.
I too was one of those people who went the WHOLE day without eating – but once I came home for dinner I would eat a TRAY of lasagna & a TRAY of eggplant parmesan & have meatballs and sausage & bread and butter & DIET soda (have to have that DIET soda). Once you have the operation you learn you need to eat (at least) 3 meals a day – and drink 64 ounces of NON-CARBONATED DECAFFEINATED liquid – and never drink 30 minutes before/after or during you meal. You need to take vitamins (I never did that). Again there are a lot of RULES you need to follow.
As for which band (or procedure) is better – of course you’ll read pros & cons depending on manufacture and/or procedure desired. I like the REALIZE band better because of it’s history (as the Swedish Adjustable Gastric Band). Again, RESEARCH the difference; history; and success rates.
Your statement “ finally I want to take out the Band after 2 years. if by 2 years I have learnd and brought down my BMI good if not there is no point to keep it while the risk of complications go up." … only illustrates that you need to do more research. You need to understand (and any Surgeon who know his stuff will confirm) this DEVICE IS FOREVER!! It’s very VERY RARE for a patient to have the band removed – and even more RARE for that patient to remain SUCCESSFUL WITHOUT the tool. If you really “have your mind set" to have the device removed – what most Doctors do it UN-FILL the band and see how you do over 6 months. If you remain successful, then they discuss removing it. But even after that time (A) there is no guarantee you will remain success (B) you need to remember THIS IS ANOTHER SURGERY!!! There are risks involved, and are you willing to take it and/or PAY for ANOTHER SURGERY?
And why after GRAD school do you think it would be easier? What’s going to happen when work “gets in the way"? or if you get married? Or have kids? – remember LIFE isn’t always WILLING TO WORK with US!! It can be hard – and STRESSFUL – and how you deal with that is important.
OK – I am off my soapbox. And you may dislike me, and think I am an (_____O_____) – but I just want you to understand what to expect – and to THINK ABOUT this before making any rash decisions.
Not sure if my fellow bariatric siblings will agree with me – but this is MY opinion (and yes I know what they say about opinions) and I AM STICKING WITH IT!!
Please know I am writing this will all my best intention, and I am here if you need.
Excellent post, just freak'en excellent.
The OP doesn't have a clue about what he is getting into. For a (ahem) grad student, one would think he would know more about elective major surgery he is getting himself into.
Previously Midwesterngirl
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
I am 27 and have been suffering form being over weight all my life ever since I remember. I know the problem, I dont have an active life style and even though I eat healthy food but I eat big portions.
You will need to get an active lifestyle - WLS alone doesn't cut it - exercise is vital and required by most programs
So I started looking in to WLS and I think the adjustable band around stomach is the way to go and REALIZE seams to be the best tool out there.
Out of all the tools out ther other than diet alone - gastric banding has the worst results - lowest weight loss and most long term complications - you need to do more research
I like the fact that REALIZE is reversible after I loose the weight but I am sure I will gain it if I take it out so I dont know.
Gastric bands are removable - the damage they do to your insides is permant and can be extensive - yes, you will gain back all your weight if the band is unfilled or removed.
I also use food for comfort sometimes and I am scared I will be very angry and depressed if I do the surgery.
You need counseling before surgery as the band will not keep you from grazing and at times may not keep you from binging - it requires very strict follow up and you must commit to seeing your doctor every month in the begining.
finally I realize that surgery also has its complications and it is not easy to get and it might with interfere my studies ...
P.S> any idea if NY Medicaid might cover my situation ?
For any insurance to cover WLS you need - a BMI of 35-40 with 2 co-morbidities or 40+, 5 years of documented obesity and attempts at doctor supervised diets, some require a 6 month pre op supervised diet, psych eval, and battery of tests.
No doctor will take your band out in 2 years unless there is a medical reason to do so - slip, erosion, or dilation. Since you claim to be smart why don't you read some of these through:
Reviewing the history of adjustable gastric banding, Aarts noted that initial results were encouraging when the procedure was introduced in the early 1990s. Gastric banding achieved good results with respect to excess weight loss and was associated with a low risk of morbidity and mortality.
The five-year results have been mixed, as some studies showed durable weight loss and others deterioration of initial benefits. Because of the procedure's relatively recent introduction, little information has accumulated regarding the long-term results with adjusted gastric banding, Aarts said.
Rijnstate Hospital has the most active bariatric surgery program in The Netherlands, he continued. Surgeons perform more than 800 procedures annually, and more than 3,000 patients have undergone laparoscopic adjustable gastric banding. Aarts and colleagues evaluated results in 201 patients who had laparoscopic adjustable gastric banding procedures during 1995 to 2003. All the patients had rigorous follow-up at three-month intervals during the first year and then annually thereafter. As a result, 99% of the patients had complete follow-up data, which spanned an average of 9.6 years.
The patients had a mean baseline age of 37, and women accounted for three fourths of the cohort. Baseline body mass index averaged 46 kg/m2, and 20% of the patients met the definition of super obese. Excess body weight averaged 83 kg. Using excess weight loss >25% to define treatment success, Aarts and colleagues found that adjustable gastric banding was successful in about 80% of patients during the first three years, followed thereafter by a steady decline to 64% at 5 years and 31% at 10 years.
When treatment success was defined as band in place and excess weight loss >40%, the success rate was 70% at one year, 64% at three years, 50% at five years, and 20% at 10 years. 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. Control of diabetes, hypertension, and gastroesophageal reflux disease all deteriorated significantly (P<0.01) over time. In particular, the incidence of new-onset diabetes and hypertension increased during follow-up, as did the proportion of patients requiring acid-suppression therapy. On the basis of the results, surgeons at the Dutch center have begun to re-evaluate their use of adjustable gastric banding for treatment of obesity. What role, if any, the procedure will play in the future has yet to be determined, said Aarts.
Primary source: American Society of Metabolic and Bariatric Surgery
Source reference:
Aarts E et al. "Disappointing results in the long run after gastric banding." ASMBS 10. Abstract PL-118.
Obes Surg. 2006 Jul;16(7):829-35.
A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Suter M, Calmes JM, Paroz A, Giusti V. Department of Surgery, Hôpital du Chablais, Aigle-Monthey, Switzerland.
METHODS: Prospective data of patients who had LGB have been collected since 1995, with exclusion of the first 30 patients (learning curve). Major late complications are defined as those requiring band removal (major reoperation), with or without conversion to another procedure. Failure is defined as an excess weight loss (EWL) of <25%, or major reoperation.
RESULTS: Between June 1997 and June 2003, LGB was performed in 317 patients, 43 men and 274 women. Mean age was 38 years (19-69), mean weight was 119 kg (79-179), and mean BMI was 43.5 kg/m(2) (34-78). 97.8% of the patients were available for follow-up after 3 years, 88.2% after 5 years, and 81.5% after 7 years. Overall, 105 (33.1%) of the patients developed late complications, including band erosion in 9.5%, pouch dilatation/slippage in 6.3%, and catheter- or port-related problems in 7.6%. Major reoperation was required in 21.7% of the patients. The mean EWL at 5 years was 58.5% in patients with the band still in place. The failure rate increased from 13.2% after 18 months to 23.8% at 3, 31.5% at 5, and 36.9% at 7 years.
CONCLUSIONS: LGB appeared promising during the first few years after its introduction, but results worsen over time, despite improvements in the operative technique and material. Only about 60% of the patients without major complication maintain an acceptable EWL in the long term. Each year adds 3-4% to the major complication rate, which contributes to the total failure rate. With a nearly 40% 5-year failure rate, and a 43% 7-year success rate (EWL >50%), LGB should no longer be considered as the procedure of choice for obesity. Until reliable selection criteria for patients at low risk for long-term complications are developed, other longer lasting procedures should be used.
PMID: 16839478 [PubMed - indexed for MEDLINE]Free Article
Outcomes after laparoscopic adjustable gastric band repositioning for slippage or pouch dilation
AACE/TOS/ASMBS Guidelines
Study of Gastric Bypass vs. Banding Has Mixed Results
Laparoscopic Adjustable Gastric Banding in 1,791 Consecutive Obese Patients: 12-Year Results
Weight loss (kg, BMI, %EWL) for the entire series is shown in Table 3 and in Figures 2, 3 and 4.
At 10 years, the average weight was 101.4 ± 27.1 kg (loss of 26.3 kg), the BMI 37.7 ± 9.1 (loss of 8.5
points) and the %EWL was 38.5 ± 27.9.
Results of morbidly obese (BMI ≤49) and superobese (BMI ≥50) were separated into two groups for evaluation/comparison and weight loss in terms of kg and BMI is reported in Table 4 and shown in Figures 5 and 6. At 10 years the weight of the morbidly obese group was 94.6 ± 18.0 kg of the superobese group and was 123.2 ± 38.5 kg, indicating weight losses of 23.8 kg and 29.6 kg, respectively.
At 10 years, the BMI in the morbidly obese group was 35.2 ± 5.4 and in the super-obese group was 44.9
± 13.9, down 7.4 and 11.3 points, respectively. The %EWL in the morbidly and super-obese groups is reported in Table 5 and shown in Figure 7. At 10 years, %EWL was 40.3 ± 27.6 and 36.0 ± 30.2, respectively.
Table 3. Weight loss (kg, BMI, %EWL) of the entire series
Time Weight BMI %EWL*
0 127.7±24.3 46.2±7.7 ---
1y 103.7±21.6 37.7±7.1 40.3±19.7
2 y 101.5±23.3 36.8±7.6 43.7±21.7
3y 102.5±22.5 37.2±7.2 41.2±23.2
4y 104.1±23.5 37.8±7.5 38.6±24.4
5y 105.0±23.6 38.1±7.6 37.3±25.3
6y 105.3±24.6 38.1±8.1 37.4±28.2
7 y 106.8±24.3 38.5±7.9 35.9±26.7
8 y 105.0±24.0 37.8±7.9 37.7±26.7
9 y 103.3±26.2 37.5±8.5 38.5±27.9
10 y 101.4±27.1 37.7±9.1 35.4±29.6
11 y 101.2±31.9 38.1±11.5 38.4±32.8
12 y 84.0±27.5 31.6±8.5 49.2±49.5
Values are mean ± SD. *Based on Metropolitan tables (to put this in perspective my BMI is 38 right now, I'm 5'4" and 220 lbs)
Lap Band Complications (this information was at one time on Allegan's web site but has since been removed nope - found it http://www.lapband.com/en/learn_about_lapband/safety_information//)
Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. In the United States clinical study, 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. Constipation, diarrhea and dysphagia (difficulty swallowing****urred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. The access port design has been improved. Four out of 299 patients (1.3%) had their bands erode into their stomachs. These bands needed to be removed in a second operation. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications.
Adverse events that were considered to be non-serious, and which occurred in less than 1% of the patients, included: esophagitis (inflammation of the esophagus), gastritis (inflammation of the stomach), hiatal hernia (some stomach above the diaphragm), pancreatitis (inflammation of the pancreas), abdominal pain, hernia, incisional hernia, infection, redundant skin, dehydration, diarrhea (frequent semi-solid bowel movements), abnormal stools, constipation, flatulence (gas), dyspepsia (upset stomach), eructation (belching), cardiospasm (an obstruction of passage of food through the bottom of the esophagus), hematemsis (vomiting of blood), asthenia (fatigue), fever, chest pain, incision pain, contact dermatitis (rash), abnormal healing, edema (swelling), paresthesia (abnormal sensation of burning, *****ly, or tingling), dysmenorrhea (difficult periods), hypochromic anemia (low oxygen carrying part of blood), band system leak, cholecystitis (gall stones), esophageal ulcer (sore), port displacement, port site pain, spleen injury, and wound infection. Be sure to ask your surgeon about these possible complications and any of these medical terms that you don't understand
the lapband and realize band do the same thing, there are slight design differences but these statsitics really apply to all gastric banding operations
You will need to get an active lifestyle - WLS alone doesn't cut it - exercise is vital and required by most programs
So I started looking in to WLS and I think the adjustable band around stomach is the way to go and REALIZE seams to be the best tool out there.
Out of all the tools out ther other than diet alone - gastric banding has the worst results - lowest weight loss and most long term complications - you need to do more research
I like the fact that REALIZE is reversible after I loose the weight but I am sure I will gain it if I take it out so I dont know.
Gastric bands are removable - the damage they do to your insides is permant and can be extensive - yes, you will gain back all your weight if the band is unfilled or removed.
I also use food for comfort sometimes and I am scared I will be very angry and depressed if I do the surgery.
You need counseling before surgery as the band will not keep you from grazing and at times may not keep you from binging - it requires very strict follow up and you must commit to seeing your doctor every month in the begining.
finally I realize that surgery also has its complications and it is not easy to get and it might with interfere my studies ...
P.S> any idea if NY Medicaid might cover my situation ?
For any insurance to cover WLS you need - a BMI of 35-40 with 2 co-morbidities or 40+, 5 years of documented obesity and attempts at doctor supervised diets, some require a 6 month pre op supervised diet, psych eval, and battery of tests.
No doctor will take your band out in 2 years unless there is a medical reason to do so - slip, erosion, or dilation. Since you claim to be smart why don't you read some of these through:
Adjustable gastric band to sleeve conversions/revisions
September 18th, 2010 Posted in Bariatric surgery, LapBand, Realize Band, Vertical gastrectomy, Weight loss surgery results, surgical weight loss, weight loss plan, weight loss surgery As the popularity of adjustable gastric banding has increased in the United States, so have the problems associated with this approach to weight loss. Issues with band slips, erosions and most commonly inadequate weight loss surgery results or weight regain have become an increasing problem which weight loss surgery physicians must now address. Long-term data on the success of the adjustable gastric band (LapBand® and Realize® Band ) has shown consistent results with regards to surgical weight loss. Published studies in bariatric laparoscopic surgery report average percentage excess weight loss (%EWL) of 30%-60%, but vary widely. The most accurate reports appear to indicate a range of 40%-55% EWL in patients who have been followed for more than 5 years. Perhaps a more important issue (and more neglected) is the long-term complication and failure rate of these devices. Some reports in the literature looking at results in patients 8-10 years after surgery report up to a 25% explantation (removal) rate, 6-10% rate of reoperation to address complications and 40% failure rate. With more than 400,000 adjustable gastric bands implanted worldwide, this stands to become a sizable problem. Because of these issues, forward-thinking bariatric surgeons have implemented strategies and algorithms to deal with failures and complications of these devices. Dr. Paul Cirangle, a pioneer of and one of the world’s experts on the Vertical Sleeve Gastrectomy (VSG), deals with conversions from the adjustable gastric band (AGB) to the Sleeve Gastrectomy on a frequent basis. He has recently reviewed his extensive bariatric surgery experience with these conversions and has found some very interesting findings. The incidence of patients complaining of “troubled eating" (pain with swallowing, regurgitation, heartburn or reflux) was extremely high (>60%), even in individuals who were successful in losing weight with the band. Among those who were not successful in losing an adequate amount of weight, many stated that dense foods were so uncomfortable to consume. This results in gravitating towards softer foods such as mashed potatoes and pasta, making it essentially impossible for them to reach their surgical weight loss goals. In the time period between July 2005 and July 2010, 69 adjustable gastric bands have been revised to a Vertical Sleeve Gastrectomy. The results in terms of %EWL, reduction of appetite and overall sense of satiety have been excellent – essentially the same as in patients undergoing a sleeve gastrectomy as a primary procedure. When asked about the subjective difference, all patients concurred that the VSG produced little or no episodes of “troubled eating" and was universally superior in regards to satiety and suppression of appetite in comparison to the AGB.27 June 2010
ASMBS: Gastric Banding Gets Low Marks
ASMBS: Gastric Banding Gets Low Marks, for your patients," said Aarts, of Rijnstate Hospital, Amhem, The Netherlands.Reviewing the history of adjustable gastric banding, Aarts noted that initial results were encouraging when the procedure was introduced in the early 1990s. Gastric banding achieved good results with respect to excess weight loss and was associated with a low risk of morbidity and mortality.
The five-year results have been mixed, as some studies showed durable weight loss and others deterioration of initial benefits. Because of the procedure's relatively recent introduction, little information has accumulated regarding the long-term results with adjusted gastric banding, Aarts said.
Rijnstate Hospital has the most active bariatric surgery program in The Netherlands, he continued. Surgeons perform more than 800 procedures annually, and more than 3,000 patients have undergone laparoscopic adjustable gastric banding. Aarts and colleagues evaluated results in 201 patients who had laparoscopic adjustable gastric banding procedures during 1995 to 2003. All the patients had rigorous follow-up at three-month intervals during the first year and then annually thereafter. As a result, 99% of the patients had complete follow-up data, which spanned an average of 9.6 years.
The patients had a mean baseline age of 37, and women accounted for three fourths of the cohort. Baseline body mass index averaged 46 kg/m2, and 20% of the patients met the definition of super obese. Excess body weight averaged 83 kg. Using excess weight loss >25% to define treatment success, Aarts and colleagues found that adjustable gastric banding was successful in about 80% of patients during the first three years, followed thereafter by a steady decline to 64% at 5 years and 31% at 10 years.
When treatment success was defined as band in place and excess weight loss >40%, the success rate was 70% at one year, 64% at three years, 50% at five years, and 20% at 10 years. 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. Control of diabetes, hypertension, and gastroesophageal reflux disease all deteriorated significantly (P<0.01) over time. In particular, the incidence of new-onset diabetes and hypertension increased during follow-up, as did the proportion of patients requiring acid-suppression therapy. On the basis of the results, surgeons at the Dutch center have begun to re-evaluate their use of adjustable gastric banding for treatment of obesity. What role, if any, the procedure will play in the future has yet to be determined, said Aarts.
Primary source: American Society of Metabolic and Bariatric Surgery
Source reference:
Aarts E et al. "Disappointing results in the long run after gastric banding." ASMBS 10. Abstract PL-118.
A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Suter M, Calmes JM, Paroz A, Giusti V. Department of Surgery, Hôpital du Chablais, Aigle-Monthey, Switzerland.
Abstract
BACKGROUND: Since its introduction about 10 years ago, and because of its encouraging early results regarding weight loss and morbidity, laparoscopic gastric banding (LGB) has been considered by many as the treatment of choice for morbid obesity. Few long-term studies have been published. We present our results after up to 8 years (mean 74 months) of follow-up.METHODS: Prospective data of patients who had LGB have been collected since 1995, with exclusion of the first 30 patients (learning curve). Major late complications are defined as those requiring band removal (major reoperation), with or without conversion to another procedure. Failure is defined as an excess weight loss (EWL) of <25%, or major reoperation.
RESULTS: Between June 1997 and June 2003, LGB was performed in 317 patients, 43 men and 274 women. Mean age was 38 years (19-69), mean weight was 119 kg (79-179), and mean BMI was 43.5 kg/m(2) (34-78). 97.8% of the patients were available for follow-up after 3 years, 88.2% after 5 years, and 81.5% after 7 years. Overall, 105 (33.1%) of the patients developed late complications, including band erosion in 9.5%, pouch dilatation/slippage in 6.3%, and catheter- or port-related problems in 7.6%. Major reoperation was required in 21.7% of the patients. The mean EWL at 5 years was 58.5% in patients with the band still in place. The failure rate increased from 13.2% after 18 months to 23.8% at 3, 31.5% at 5, and 36.9% at 7 years.
CONCLUSIONS: LGB appeared promising during the first few years after its introduction, but results worsen over time, despite improvements in the operative technique and material. Only about 60% of the patients without major complication maintain an acceptable EWL in the long term. Each year adds 3-4% to the major complication rate, which contributes to the total failure rate. With a nearly 40% 5-year failure rate, and a 43% 7-year success rate (EWL >50%), LGB should no longer be considered as the procedure of choice for obesity. Until reliable selection criteria for patients at low risk for long-term complications are developed, other longer lasting procedures should be used.
PMID: 16839478 [PubMed - indexed for MEDLINE]Free Article
Outcomes after laparoscopic adjustable gastric band repositioning for slippage or pouch dilation
AACE/TOS/ASMBS Guidelines
Study of Gastric Bypass vs. Banding Has Mixed Results
Laparoscopic Adjustable Gastric Banding in 1,791 Consecutive Obese Patients: 12-Year Results
Weight loss (kg, BMI, %EWL) for the entire series is shown in Table 3 and in Figures 2, 3 and 4.
At 10 years, the average weight was 101.4 ± 27.1 kg (loss of 26.3 kg), the BMI 37.7 ± 9.1 (loss of 8.5
points) and the %EWL was 38.5 ± 27.9.
Results of morbidly obese (BMI ≤49) and superobese (BMI ≥50) were separated into two groups for evaluation/comparison and weight loss in terms of kg and BMI is reported in Table 4 and shown in Figures 5 and 6. At 10 years the weight of the morbidly obese group was 94.6 ± 18.0 kg of the superobese group and was 123.2 ± 38.5 kg, indicating weight losses of 23.8 kg and 29.6 kg, respectively.
At 10 years, the BMI in the morbidly obese group was 35.2 ± 5.4 and in the super-obese group was 44.9
± 13.9, down 7.4 and 11.3 points, respectively. The %EWL in the morbidly and super-obese groups is reported in Table 5 and shown in Figure 7. At 10 years, %EWL was 40.3 ± 27.6 and 36.0 ± 30.2, respectively.
Table 3. Weight loss (kg, BMI, %EWL) of the entire series
Time Weight BMI %EWL*
0 127.7±24.3 46.2±7.7 ---
1y 103.7±21.6 37.7±7.1 40.3±19.7
2 y 101.5±23.3 36.8±7.6 43.7±21.7
3y 102.5±22.5 37.2±7.2 41.2±23.2
4y 104.1±23.5 37.8±7.5 38.6±24.4
5y 105.0±23.6 38.1±7.6 37.3±25.3
6y 105.3±24.6 38.1±8.1 37.4±28.2
7 y 106.8±24.3 38.5±7.9 35.9±26.7
8 y 105.0±24.0 37.8±7.9 37.7±26.7
9 y 103.3±26.2 37.5±8.5 38.5±27.9
10 y 101.4±27.1 37.7±9.1 35.4±29.6
11 y 101.2±31.9 38.1±11.5 38.4±32.8
12 y 84.0±27.5 31.6±8.5 49.2±49.5
Values are mean ± SD. *Based on Metropolitan tables (to put this in perspective my BMI is 38 right now, I'm 5'4" and 220 lbs)
Lap Band Complications (this information was at one time on Allegan's web site but has since been removed nope - found it http://www.lapband.com/en/learn_about_lapband/safety_information//)
Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. In the United States clinical study, 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. Constipation, diarrhea and dysphagia (difficulty swallowing****urred in 9% of the patients. In 9% of the patients, a second surgery was needed to fix a problem with the band or initial surgery. In 9% of the patients, there was an additional procedure to fix a leaking or twisted access port. The access port design has been improved. Four out of 299 patients (1.3%) had their bands erode into their stomachs. These bands needed to be removed in a second operation. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications.
Adverse events that were considered to be non-serious, and which occurred in less than 1% of the patients, included: esophagitis (inflammation of the esophagus), gastritis (inflammation of the stomach), hiatal hernia (some stomach above the diaphragm), pancreatitis (inflammation of the pancreas), abdominal pain, hernia, incisional hernia, infection, redundant skin, dehydration, diarrhea (frequent semi-solid bowel movements), abnormal stools, constipation, flatulence (gas), dyspepsia (upset stomach), eructation (belching), cardiospasm (an obstruction of passage of food through the bottom of the esophagus), hematemsis (vomiting of blood), asthenia (fatigue), fever, chest pain, incision pain, contact dermatitis (rash), abnormal healing, edema (swelling), paresthesia (abnormal sensation of burning, *****ly, or tingling), dysmenorrhea (difficult periods), hypochromic anemia (low oxygen carrying part of blood), band system leak, cholecystitis (gall stones), esophageal ulcer (sore), port displacement, port site pain, spleen injury, and wound infection. Be sure to ask your surgeon about these possible complications and any of these medical terms that you don't understand
the lapband and realize band do the same thing, there are slight design differences but these statsitics really apply to all gastric banding operations
Lynn C ~
Banded 9/12/2005 ~ Revision to VSG on 9/7/2010 ~ Losing again with a Keto lifestyle
I know I should change my life style and I will hopefully by summer I am done with the intense part of grad school and I can have more active life style but I dont want to diet just to loose 20-30lb and then stop I need good 80lb off so I can get rid of this owerweight issue I have had ever sisnce I was little.
if not band what do you guys recomened?
I have tried diet I fail at it unless I have a new tool that helps me and then I see the weight loss and I get more encouraged.
how do you feel after dieting for couple of weeks and watching what you eat and then see no weight loss or even weight gain.... depressed and give up on diet and focous on other things in life to keep you going. I am tired of that
I need a TOOL to help loose this weight and give me back control .. I am sure when I am at ideal weight I have mor ecourage and hope to continue a good diet and life style...
Makes sense?
and please for g-d sake dont post another band problem if you dont have a better solution.
if not band what do you guys recomened?
I have tried diet I fail at it unless I have a new tool that helps me and then I see the weight loss and I get more encouraged.
how do you feel after dieting for couple of weeks and watching what you eat and then see no weight loss or even weight gain.... depressed and give up on diet and focous on other things in life to keep you going. I am tired of that
I need a TOOL to help loose this weight and give me back control .. I am sure when I am at ideal weight I have mor ecourage and hope to continue a good diet and life style...
Makes sense?
and please for g-d sake dont post another band problem if you dont have a better solution.
There are three better solutions - DS, RNY or VSG. When I had my band removed I switch to VSG.
The band does not teach you to eat right, it does not teach you to eat smaller portions - it cinches down your stomach and forces you to eat less, forces you to vomit, forces you to starve and then when you unfill it or remove it (because it has caused your stomach to become misshapen or has slipped) you go right back to eating like you did preop- doesn't make sense at all IMO. Ask anyone who has had their band unfilled for more than 30 days - I'll bet 80% of them had significant weight gain.
Pretending band problems aren't prevalent doesn't make them go away. Time to act like an adult and make an informed, adult decision. If you can read all of the studies I've posted and still think the band is a good choice then go for it.
The band does not teach you to eat right, it does not teach you to eat smaller portions - it cinches down your stomach and forces you to eat less, forces you to vomit, forces you to starve and then when you unfill it or remove it (because it has caused your stomach to become misshapen or has slipped) you go right back to eating like you did preop- doesn't make sense at all IMO. Ask anyone who has had their band unfilled for more than 30 days - I'll bet 80% of them had significant weight gain.
Pretending band problems aren't prevalent doesn't make them go away. Time to act like an adult and make an informed, adult decision. If you can read all of the studies I've posted and still think the band is a good choice then go for it.
Lynn C ~
Banded 9/12/2005 ~ Revision to VSG on 9/7/2010 ~ Losing again with a Keto lifestyle
Year 1 - lost 80lbs
Year 2 - lost 20lb (with 2cc in a 4 cc band)
Year 3 - stayed the same
Year 4 - gained 29lbs, went in for a fill
Year 4.5 - lost 12 lbs post fill, gained reflux - went in for an upper GI - lateral pouch dilation - my doc wanted to take the band out then. We settled for an unfill so I could do some research.
Edited to add - 12 weeks unfilled band waiting for revision surgery- gained 30lbs in the first 30 days
My research showed:
After 5 years complications with the band increase - a lot
Once you have a complication they reoccur
Because I started with a high BMI I was still obese, I had documentation of a complication coupled with inadequate weight loss so my insurance would cover conversion to another surgery type. I picked VSG because like the band there is no intestinal bypass - no vitamin or bathroom issues.
I talked with a lot of people who had started with the band and ended up with the VSG - some of these people had horror stories, I didn't but thought that getting out while the getting was good was a smart thing.
My revision surgery took 5 hours, I had adhesions on my liver and was in the hospital for 5 days with an NG tube and JP drain. It took 5 weeks for me to feel human again. That is how reversible the band is. Now that I can eat I realize that living with the band had not been ideal. My family is so surprised when I don't get up from the dinner table after a bite or two to throw up.
I no longer map out a path to the bathroom in every restaurant that I visit. No pulling over on the side of the road to vomit. I can eat bread, meat, veggies, fruit with skin, citrus fruit, just less.
The VSG is really what the band was advertised to be, and honestly - I don't need the part of my stomach they removed - it helped to make me fat - why the hell would I miss it?
Year 2 - lost 20lb (with 2cc in a 4 cc band)
Year 3 - stayed the same
Year 4 - gained 29lbs, went in for a fill
Year 4.5 - lost 12 lbs post fill, gained reflux - went in for an upper GI - lateral pouch dilation - my doc wanted to take the band out then. We settled for an unfill so I could do some research.
Edited to add - 12 weeks unfilled band waiting for revision surgery- gained 30lbs in the first 30 days
My research showed:
After 5 years complications with the band increase - a lot
Once you have a complication they reoccur
Because I started with a high BMI I was still obese, I had documentation of a complication coupled with inadequate weight loss so my insurance would cover conversion to another surgery type. I picked VSG because like the band there is no intestinal bypass - no vitamin or bathroom issues.
I talked with a lot of people who had started with the band and ended up with the VSG - some of these people had horror stories, I didn't but thought that getting out while the getting was good was a smart thing.
My revision surgery took 5 hours, I had adhesions on my liver and was in the hospital for 5 days with an NG tube and JP drain. It took 5 weeks for me to feel human again. That is how reversible the band is. Now that I can eat I realize that living with the band had not been ideal. My family is so surprised when I don't get up from the dinner table after a bite or two to throw up.
I no longer map out a path to the bathroom in every restaurant that I visit. No pulling over on the side of the road to vomit. I can eat bread, meat, veggies, fruit with skin, citrus fruit, just less.
The VSG is really what the band was advertised to be, and honestly - I don't need the part of my stomach they removed - it helped to make me fat - why the hell would I miss it?
Lynn C ~
Banded 9/12/2005 ~ Revision to VSG on 9/7/2010 ~ Losing again with a Keto lifestyle
makes a lot of sense that VSG is a better option
and make s alot of sense that a foreign object in body passed 3 years can cause problem.
If I go with VSG I will go with a bigger pouch, I just hate the idea of having all the staples in there but I guess my surgeon can help me decide.
I am very happy for you, and everyone else who lost the extra weight and can enjoy sexy clothing and feel good about themselves.
and make s alot of sense that a foreign object in body passed 3 years can cause problem.
If I go with VSG I will go with a bigger pouch, I just hate the idea of having all the staples in there but I guess my surgeon can help me decide.
I am very happy for you, and everyone else who lost the extra weight and can enjoy sexy clothing and feel good about themselves.
On November 2, 2010 at 6:09 PM Pacific Time, doctorman wrote:
makes a lot of sense that VSG is a better optionand make s alot of sense that a foreign object in body passed 3 years can cause problem.
If I go with VSG I will go with a bigger pouch, I just hate the idea of having all the staples in there but I guess my surgeon can help me decide.
I am very happy for you, and everyone else who lost the extra weight and can enjoy sexy clothing and feel good about themselves.
~~If I go with VSG I will go with a bigger pouch, I just hate the idea of having all the staples in there but I guess my surgeon can help me decide.~~
//slowly shaking head//
I now fully understand the reasoning behind the six month medically supervised diet
Previously Midwesterngirl
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
The band got me to goal, the sleeve will keep me there.
See my blog for newbies: http://wasabubblebutt.blogspot.com/
There is NO pouch with the VSG. U really need to do further research.
If u are trying to refer to sleeve size bigger sleeve is NOT advised! The VSG was made with a larger bougie initially. Weight loss was good with that. However, there was a lot of regain. Since the bougie size was changed to a smaller one regain is seldom an issue from my understanding.
If u are trying to refer to sleeve size bigger sleeve is NOT advised! The VSG was made with a larger bougie initially. Weight loss was good with that. However, there was a lot of regain. Since the bougie size was changed to a smaller one regain is seldom an issue from my understanding.
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