Is VSG enough after succesful band weightloss?

I am wondering if anyone can help... I am hoping to get a revision and I am a self pay.  I worry that if I get the wrong proceedure I'll be wasting my money (this will be the third self-pay WLS for me).  I was banded in 2001 at about 250 pounds, got to 125 and stabalized at 135.  In 2006 I got a revision because my band slipped and its not been working right ever since (either too restricted or not at all, etc, etc).  I had all my fill removed because of costant problems.  I was able to maintain at 145-150 after the failed revision until I was pregnant last year and now I am 180 and not losing.  I am hungry ALL the time.  I prefer not to get a malabsorptive surgery which is why I want to get a VSG.  However, I am worried that because of having had a band for so long that a VSG might not be "enough" to get me back down to 135.  I hope I'm making sense about my concern here.  I don't think I can afford a FOURTH self-pay WLS surgery.

Basically, what I am wondering is there any hard data on the VSG success as a revision surgery?  There are always success stories (which I've had the pleasure of reading) but are there any hard numbers anywhere to show that VSG works as a revision surgery too?  Or is the fact that I was succesful with the band mean I'm a shoo-in for the VSG?

Thank you JROLFSON for letting me know about this forum!

Hi There:

Good to see you here....My friends will be answering questions for you very soon...

Have you thought about an RNY....An original RNY doesn't have much malabsorption at all...it's primarily a restrictive procedure...


MWG....This lady needs your help....


All band to Sleevers....let's give some help to our new friend!!!

Or anyone who has some stats!

ajalew, I was banded on10/27/08 and have already encountered erosion.  Although I have never had a fill (due to some complications), I lost 50 pounds (321 down to 271) in 4 months.  I am now stabalized at 274 for the last 2 months.

I am having surgury this week to remove my band.  And at the same time I will have a VSG.  The insurance pays for all except any fees associated with the VSG. My doctor highly recommends this revision for me, who is also performing the VSG at a minimal charge (the hospital cost is rediculously high).

I will let you know how things are going in the future. 

VSG is great!

I had a band and hated it, absolutely hated it.  I revised to a sleeve almost a year ago and what I can tell you is that having a sleeve is like having a band that actually works and without all the risks and complications.

It really does not work to revise from band to band for the very reasons you describe.  I think part of it is that there is scar tissue under the band.  It gives you restriction you don't really want.  For most there is no sweet spot after a band to band revision.

I have all the studies and information you are looking for.  If you want to PM me your email address I will forward a great deal of information.  Stats, studies on sleeves, ghrelin, comparisons between band, sleeve, and RNY, how to research doctors, a ton of information.  Probably too much to post here.

There is a lot of information to know so that you can be prepared for this.  You want to know the size of bougie your surgeon uses, the types and number of leaks tests done, etc.  You need an actual revision surgeon and not just any bariatric surgeon (IMO) for this procedure because your risk for leaks, bleeding, and infection are triple with band to sleeve vs. working on a virgin stomach.  They have to remove all the scarring and adhesions then do a sleeve.  It can be done all in one surgery IF you go to a very good revision surgeon who has done many band to sleeve procedures as long as you don't have a slip, erosion, or a great deal of inflammation.

It's not a bad thing that you have gained a few pounds.  You can't help but to lose the first few months, so you have room to work with here.  I'm here to tell you, it is VERY hard going from band to sleeve at goal. ;o)

PM me your email address and I'll forward you a great deal of information, I believe it is just about everything you are looking for.

Keep in mind, the sleeve is actually a great deal better and more effective than the band.  If the band worked well for you the sleeve will work better.  It is obvious that you are good to go with restriction only and so there is little need to resort to malabsorptive.

Hi,

I dont have any empirical date to support this claim only personal experience, but the sleeve rocks!! So far, I am finding it easy to maintain and exceeded my losses with the band. I dont have trouble making good food choices because I really can only eat 6-8 ounces of food at time and less if it only consists of solid protein. There is no guarantee that any revision will work. My friend went band to RNY after she had gained back most of her band losses and she is not able to get even remotely close to what she lost with her band and also has severe complications as a result of the RNY. If its any reassurance, I started in 2003 with a band, had it for 5 years and lost 155 lbs, then regained 60 and had to relose the 60 and exceeded my band losses by 13 pounds for an all time low of 166 lbs. It has not been hard and I am maintaining now for about 5 months. I could lose more but I am happy with what I can eat and what I can drink, so I am complacent at the moment.

Babs

Wow, thanks gals.  :)  That does make me feel more confident about getting a VSG.  Midwesterngirl, thanks for the info!!  I'll pm you now!

Hopefully I won't have any problems shedding this dreadful 50 pounds.  It seems my appetite has gone through the roof! 

Thank you again for the help!

Honestly, I really think you will find 50# is nothing with a sleeve.  You'll do great!

I don't know if it would work for you or not. (Not helpful, I know). 

I know of one failed Band to VSGer, LuzCeleste.  She was revised near her goal and ended up gaining 50 pounds because the VSG did not provide enough restriction.  Part of the problem was that her revision surgeon gave her a larger sleeve, because she was at goal. 

I was successful with a Band too (banded in 2001), but the VSG only worked for about 4 months for me.  I can eat so much more than I ever could with my Band... and I really depended on restriction.  Even though I kept off a majority of my weight with no fill, I haven't been a smashing VSG success story.  (Of course, I wouldn't have lost 50 pounds without my VSG... but I think a DS or RNY would have gotten me much closer to goal).

Thing is... at your weight... you have a really good chance of being very successful with a VSG...even with my two horror stories.  People with BMIs in the low 30s and below almost always reach goal and are quite happy.  I also would definitely NOT be comfortable with you having a DS... maybe an RNY.. but even that seems like overkill at your weight.  I think if you sought out a very very experienced Lap-Band to VSG revision surgeon, such as Alvarez or Acevez.... you could be successful.  Just make sure your surgeon has an idea as to how much restriction you were used to, so he can give you a tight enough sleeve.  I thought my surgeon understood that.... and he gave me a 34F sleeve.... but I've always been able to eat way more than many VSGers with similar sleeve sizes.

Alveraz is not nearly as experienced as he claims.  He is combining his stats with that of Jose Rodriguez.  His advanced lap training was long after he started doing sleeves.  Tell me how he did sleeves before he was trained? ;o)

Alveraz  is the surgeon that claims 2-3 people cannot have a revision to anything with a staple line because of damage to the stomach from banding.  Total BS.  The better surgeons can do it with no problem.  It's ALVERAZ that can't do it.  The better surgeons can do it.

I really think the reason you are not doing well is because your sleeve was made too large.  If we CAN eat, we DO eat.  That's the nature of the beast. It's our demon.  If you had true restriction I'll bet you would lose well.  I'm just sorry you have such a large sleeve.  If I had a large sleeve I'd be gaining, no way around it.  I wouldn't just be stuck at a given weight, I'd be gaining.  If I can eat, I do.  Period, the end.

I'm sorry this didn't work for you.  It's just not fair.

You did awesome with the band! I'm sure you will do even better with the sleeve, especially since you do not have that much to lose.

I was banded on June 10, 2008 and lost 50 lbs within 5 months. I did have a lot of complications the following 3 months...vomiting, nausea, bad acid reflux, and no more weightloss. The doc and I made the decision to remove the band, and do a revision to the VSG. I had the procedure done about 7 weeks ago on March 18th, and I've lost an additional 25 lbs (bringing my weightloss total to 75 lbs). I have hit 3 stalls over the past 7 weeks, and its a bit discouraging. I do not expect the weight to fall off in 7 weeks, but my doctor said I should average about 5 lbs a week the first few weeks/months. I am just afraid that this second weightloss surgery might not be enough for me to reach my personal goal of 150 lbs.

I was approved to have the DS after the sleeve procedure, but my doctor does not recommend it. He wants me to try to lose the weight with the sleeve alone. The only problem is that the sleeve holds more food than my band did, so I'm having difficulty not having enough restriction. In that case, I may need the DS for the malabsortion part of the procedure and not only have restriction.

I'm not sure if my situation will help you make a decision, but in my opinion if I had a choice between a sleeve and a RYN...I would take the RYN. It has a higher success rate, and more long term weightloss success numbers. The Sleeve is fairly new to the US and doesnt have as much supporting evidence of the long term success and like I mentioned it holds more food than the band does. The main reason I chose it was to alievate the problems I had with the band, and also for the removal of the hunger hormone...but I'm one of the few people that still get hungry.

I would suggest reading up on the revision forum, and the Sleeve & RYN forums. Ask questions, and write down all your concerns for your doctor to answer.

Good luck! I know you will reach your goal soon enough.