Should I have lap band revision or bypass?

I was banded 5 years ago and I am unable to maintain restriction without pain, throwing up and reflux.  Dr.  has said band should be replaced.  Should I have band replaced or convert to bypass?  I have gained 65 lbs and never made it to goal.  Thanks

Please consider duodenal switch.  The band has failed many, but so has bypass. 

I chose duodenal switch because of all the weight loss surgeries, it has the best resolution of comorbidities like diabetes, sleep apnea, etc., It has the best statistics for the greatest amount of weight lost and kept off long term.  Weight regain is a huge issue with gastric bypass AND lap band - not so with DS, because we only absorb 20% of the fat we eat, and about 60% of the protein and complex carbs we eat.  We can eat larger meals than lap band and RNY - what amounts to a normal, but smaller, meal.  Finally, for me, it had the most attractive  postop way of life with NO dieting, NO counting fat or calories, NO dumping, NO vomiting, NO foamies, NO stuff getting "stuck" and NO chewing food into mush.  The keys to DS are these few, very critically important rules:

1.  You must eat at least 90 grams of protein every day;
2.  You must take your vitamins and supplements every day;
3.  You must drink at least 64 ounces of water every day; and
4.  You must get regular lab work to make sure you are taking enough vitamins.

Most of us watch our carbs during the weight loss phase because we absorb 100% of simple carbs like sugar and it can slow the weight loss.  Most of also can't go hog wild on carbs after we reach goal, but no food is off limits in moderation, as long as we have no individual intolerance to it.  Many of us get stinky gas when we eat certain carbs, like those with white flour such as bread and pasta.  And our poop smells pretty bad. That's pretty much it. Sound too good to be true?  That's what I thought too, but the DS is the best decision I ever made! 

Check out www.dsfacts.com and www.duodenalswitch.com for more information, and hang out on the DS forum here on OH to ask any questions you have. 

You may have seen from the Revisions forum that there lots of folks revising to DS from other surgeries.  There are NO folks revising FROM DS to anything else.  I think that speaks volumes.

Good luck!

 

Hello Liz - I too was banded 5 years ago....My band has slipped for the 2nd time. I have just starting researching "revision Surgery" the doctor I went to see...said that no matter what I had to have my band removed and that either Gastric Sleeve or Gastric bypass would be an option but he would not want to put the band back in. I am really confused on what to do....In researching tonight and finding this site is the first time I have heard of Duodenal surgery...My Dr didnt mention it. Of course I want the best possible weight loss. My band the first time did reall good for me - I lost 85 lbs, but after the first slip I have had NO luck and in the last 6 mths started gaining weight. For over a year I have had no restrictions. Its really frustrating...and now the 2nd slippage. I am hoping by joining here I can get a better understanding and opinions.

Best of luck to you

Stephanie

Hi, Stephanie,

Your doctor didn't mention duodenal switch because he doesn't DO duodenal switch, and he wants to keep you as a paying customer.  Do yourself the biggest favor of your life and look into it.  You won't regret it.

I responded to this on the band board.

I would not get another band.  I promise you, it will be a short term answer.  When the scar tissue begins growing under the band you'll have restriction you do not want with no fill.

If you are good to go with restriction only I would consider a sleeve.  No malabsorption and it's like a band that actually works without all the risks and complications.

If you need malabsorption then bypass or DS.  But absolutely no to another band.

Since the band has about the same long-term results as the bypass, you may need a more metatolic -based surgery, like the DS.   To get more info on it, ask on the DS forum on this website.   You can also check out www.duodenalswitch.com or www.dsfacts.com.  

A lot of people do very well at first when they get converted from band to bypass, but then at 3+ years out, many of them start gaining again.   If you gained the 65 lbs after you lost the restriction of the band, but did well with it when you still had restriction, then the sleeve would be an option - it provides a similar restrictive modification, but without all of the band's problems.  

Just be sure that the surgeon makes the sleeve small enough for your particular situation.   Ask MidwesternGirl about the sleeve sizes - she's very knowledgeable and was a conversion from band to sleeve herself.

You may also want to look into the recent research on women of color and obesity.   Some women have "type-B" fat cells which are particularly resistant to the effects of weight loss surgery.   I read about it on OH about two months ago in a thread someone posted.   I think it was Dr. Husted, so if you can find his old posts, you can read it.   Someone from the DS forum came on and actually posted the research articles about African-American women and obesity.  

The DS provides a stronger "correction" to the metabolism, so it  may be a "stronger" choice for weight loss for you.   If you do get a sleeve, than revising it to the DS is easy.   If you get an RNY, it is very difficult to revise the pouch into a sleeve (which is the first part of the DS surgery) and there are only a handful of surgeons in the world who actually do that revision, so getting the RNY may prevent you from actually getting the surgery which would be the most effective for you in the long run.     You need to think about all of this and decide what is the best option for you.