RNY to Lap Band.

Hi Everyone i was wondering if anyone has had the surgery i am going to have... a little explanation... I have a RNY gastric bypass 7 yrs ago... i lost 100 lbs. Had 2 kids. Had a pretty serious autoimmune illness and have since gained back about 95lbs... yuck! I sought out a new surgeon, he did an upper GI series and found that my stomach pouch is a good size still however the connection between my stomach pouch and intestines is too wide. So im pretty much always hungry. i eat, an hour later im starving like i havent eaten all day! Hes going to place the band there between my stomach pouch and intestines. Has anyone heard of this or had this done?  im just wondering how it works and what exactly post op is going to be like. will i feel full like my original surgery? Thanks

Nichole.

I have seen a woman posting that had this done and she has lost a lot of weight. Other then that I don't know too much about it.

 Hello, I also had a gastric bypass almost 8 yrs ago and hv gained back alot of weight, I am now seeking revision to a lap band, my consult is monday...I have posted it on here awhile back and got some negative feedbacks, alot of people suggested the DS instead, but I dont want to have major surgery again. Did your surgeon suggest the band?

I just had an endoscopy last week because I had gained so much of my weight back.  The surgeon (not my original surgeon) found that my pouch was at least 50% larger than it should be and the opening to my small intestine is over 3 times too large - so the food is going straight through.

He told me that I had 3 options - redo the RNY, put a lap band on to help the restriction part, or do the ROSE procedure. Since I'm going to have to pay for this myself, the redo of the RNY (which I had never heard of) is not on the boards - 30-40 thousand

His concern with the lap band is the complexity of getting it in the right place and not taking care of the opening - but it is a valid option.  Also, he believes in frequent fills which would cost me a fair amount, and I'm also thinking about moving out of the area.  Good luck at finding somebody else to do the fills unless that has changed.

His recommendation was to do the ROSE which would take care of both problems - the size of my stomach and the opening.  It is also the cheapest option, but that is not my priority.  The good and bad of the ROSE are well documented so I am "thinking". 

But the lap band is definitely a valid option for you.  It is supposed to act just like you had never had the original surgery - definitely they can adjust it so that you can't eat very much.

Good luck

 
Especially if you are self pay please don't waste money on ROSE.  It does not work.  Read these very boards.  100% of the time it does not work.  People typically lose about 20# on the post op diet and as soon as they start eating solids the 20# comes right back.  Most doctors decline to do the ROSE or Stomaphyx because they simply do not work.

You might want to get a quote for RNY to DS from Ungson in Mexico.  DSers will have more info on him.  But you know, the band isn't a great option either.  I have been posting here for 4 years and I've only met one person that had a band over their bypass that did well.

I'm so sorry about your illness AND "connection" problems, the result of which has been weight gain. Keep asking and researching. Things have developed in WLS in the last 7 years and you certainly owe yourself, and your family, to get the best revision possible. No one can answer that for you. Please search all the boards, not just one. Good Luck! 

Before you consider the band I would suggest that you all go to the lap band forum and see all the ppl that post there with complicaitons. Every day someone new is posting with a slip..........port problem....leak.........etc.!

Good luck ladies!!!

Of all the current WLS options, the lap-band had the highest rate of reoperation and the least amount of weight loss. The reason RNY stops wroking is because the malabsorption goes away. My RNY surgeon told us long ago, at a support group meeting, that the intestines become more efficient at absorbing. Some people even grow back part of the intestine. It becomes harder & harder to keep the weight off.  My RNY surgeon absolutely refused to do lap-bands, saying they were just a money maker for cutters. He said the surgeon was almost guaranteed 2 procedures per patient. Judging by friends who have had the lap band, 4 out of 5 have needed to have some sort of correction (slipped port, leak in band, slipped band, and flipped port). The 5th never got anywhere near goal but is comfy where she is.

The lap-band does nothing to correct that. If your only issue is overeating, then it might work, but if your issue is metabolic it won't work at all. Many people who posted here on this board about how happy they were with their band over bypass suddenly stopped posting at about the 5 month mark, stopped answering questions about why it was working, etc.

The studies cited by one poster on here were mediocre at best, and showed very little compliance/weight loss at the 5 year mark.

Studies for the lap band on its own, not even over a bypass, are looking more & more abysmal. Most of the revisions on this board are people revising away from a lap band.

Copied from a post by Diana Cox:

Three years out, Bandsters lose only 50% of their excess weight on average.  Can you imagine what that means the actual FAILURE rate is?  At LEAST 50%, because the average is AT THE FAILURE LINE (below 50% EWL is considered failure by the ASMBS).  They lose less than 12 BMI points!  And diabetes resolution is only 60% vs. the DS’s 98.9% -- that is unconscionable.

1: Surg Obes Relat Dis. 2008 Jan 31 [Epub ahead of print] Links

Studies of Swedish adjustable gastric band and Lap-Band: systematic review and meta-analysis.

Cunneen SA, Phillips E, Fielding G, Banelb S D, Estok R, Fahrbach K, Sledge I.

Cedars Sinai Medical Center, Los Angeles, California.

BACKGROUND: This is the first systematic review and meta-analysis of the large body of data describing the Swedish adjustable gastric band (SAGB) and Lap-Band (LB). METHODS: A systematic review was performed that included screening of studies published in any language (January 1, 1998 through April 30, 2006) identified through MEDLINE, Current Contents, or the Cochrane Library. Studies with >/=10 SAGB or LB patients reporting >/=30-day efficacy or safety outcomes were eligible for review; the data were extracted from the accepted studies. A weighted means analysis and random-effects meta-analysis of efficacy outcomes of interest were conducted. RESULTS: A total of 4592 bariatric surgery studies met the initial criteria. Of these studies, 129 (28,980 patients) were accepted (33 SAGB and 104 LB studies); most had a retrospective single-center design. For 4273 patients (36 treatment groups) in 33 SAGB studies and 24,707 patients (111 groups) in 104 LB studies, the mean baseline age (39.1-40.2 yr), body mass index (43.8-45.3 kg/m(2)), and gender (women 79.2-82.5%) were similar. A laparoscopic technique was used in >/=88% and a pars flaccida technique in >/=41% of both groups. Early mortality was equivalent for SAGB/LB (The 3-year mean SAGB and LB excess weight loss (56.36% and 50.20%, respectively) and body mass index reduction (-11.99 and -11.81 kg/m(2), respectively) from baseline were statistically significant (P <.05), as was the resolution of diabetes (61.45% and 60.29%, respectively) and hypertension (62.95% and 43.58%, respectively). Although scant and inconsistently reported data precluded direct statistical comparisons, the complication rates for the 2 devices appeared comparable. In 8 directly comparative studies, meta-analysis found a significantly greater absolute weight loss (P <.05) with the SAGB at 2 years (48.4 versus 41.9 kg, mean difference -4.84, 95% confidence interval -9.47 to -0.22), although no difference was found in the percentage of excess weight loss or change in body mass index. CONCLUSION: In a systematic review of the published world SAGB and LB data, at 1, 2, and 3 years, the weight loss, resolution of diabetes and hypertension, and complications appeared comparable.

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Here’s another one:  After 2 years, Lapbanders are on average still SEVERELY OBESE (BMI of 35).  Their average EWL is only 56%.  And the SMOs on average are FAILURES with an EWL of only 44%.

1: Arch Surg. 2007 Oct;142(10):958-61.

Laparoscopic adjustable gastric bandings: a prospective randomized study of 400 operations performed with 2 different devices.

Gravante G, Araco A, Araco F, Delogu D, De Lorenzo A, Cervelli V.

Department of General Surgery, University of Tor Vergata, Italy. ggravante@hotmail.com

OBJECTIVE: To evaluate potential differences between 2 devices used to perform laparoscopic adjustable gastric bandings (the Swedish adjustable gastric band and the Lap-Band). DESIGN: The following groups were considered eligible: (1) patients with a body mass index (calculated as weight in kilograms divided by height in meters squared) of greater than 40; (2) patients with a body mass index between 35 and 40, with associated comorbidities; and (3) patients with a body mass index of greater than 60 who could not undergo derivative procedures. RESULTS: We recruited 400 patients. The mean +/- SD body mass index decreased to 40.6 +/- 3.0 after the first year and to 35.2 +/- 7.0 after 2 years. The average excess weight loss reduction was 48.2% after 1 year and 56.0% after 2 years. The excess weight loss reduction was inversely related to the initial weight: patients with an estimated weight excess of 50 kg or less (108 patients [27.0%]) had an excess weight loss reduction of 55% after 2 years; those with a weight excess of greater than 50 kg (292 patients [73.0%]) had an excess weight loss reduction of 44% (P = .004). We recorded 1 death (0.2%). Transient gastri****lusions (24 patients [6.0%]) and slippages (12 patients [3.0%]) were the most common complications. The devices used (Swedish adjustable gastric band and Lap-Band) were similar in terms of correction of obesity and morbidity. CONCLUSIONS: Laparoscopic adjustable gastric banding is a safe and feasible technique with specific indications in moderately obese patients and, secondarily, in highly obese patients who are unfit for more invasive techniques. No differences were found among the devices examined.

Banding isn't really a great option. It provides the slowest weight loss, the least weight loss, the highest regain, and the most mechanical complications. The only way to fix a mechanical complication such as a flipped port, kinked tubing, etc., is another operation. Keep in mind, you are already metabolically challenged just from having bypass. You'll lose more slowly and less than a virgin bandster.

I had a band and it caused Esphageal problems. With all the issues you have digestively you certainly don't want another issue caused by a Lap Band.

As the other's pointed out, The Lap Band is on it's way out, do a Bing Search for Lap Band Lawyers, they are coming to get them.....

I would do a DS if that was my only real choice. I know nothing of the ROSE procedure and too much misery first hand by the Lap Band to recommend it.

Best of luck to you.