From band ot sleeve, have some questions.

 

 

Hello all,

 

I have a band for 8 yrs now, and have had dilation for 4.5 yrs. So have gained almost 40 lbs of the 116 loss I had back. I also have developed reflux. and taking Nexium. I have been to 1 Dr. here by me and he says after doing the Endo, to see if any problems, he can probably do the removal/and sleeve same day. Wondering any of you band/sleeve can give me your take on this. I am self pay, so it would be great if all done in one. Also, 1 Dr. wants 2 night stay, 1 Dr. only 1 night stay in the hospital. How soon did you return to work? I have a desk job, and pretty high tollerance to pain.

Just needing to get some answers. Never thought in a million years I would be getting my band out, and going thru another WLS.

Hey Monte, 

I have no information for you regarding the revision and removal happening in one surgery because my Dr. absolutely will not do it.  But, it seems that the majority of surgeons do it in one surgery.

My question is, what does the Dr. say about the Sleeve for people with reflux?  My surgeon will not give me a Sleeve because of my reflux issues because he says its the number one long term side effect of the Sleeve.

I'm just curious before I make my final decision. 

I'm like you, I never thought I'd be revising, but with the weight I've gained just in the 3 months since having my band removed , I know that I need that tool to help me with portion control. 

Best of luck in making your decisions, 

Lisa O.

I have a lapband and just had a consultation with my surgeon to discuss revision surgery.  I was pretty set on switching to the sleeve, but she talked me out of it and I am going to do RNY bypass.  My surgeon prefers not to do the sleeve on patients with a band for two reasons: 

1. In some band patients, the vagus nerve stops functioning.  For the sleeve to function you must have a working vagus nerve.  If you are sleeved and your vagus nerve is not working you will have months of miserable recovery after surgery until, hopefully, your vagus nerve will turn back on.  If it doesn't, they have to do surgery and switch you to bypass.  There is no way of knowing beforehand whether your vagus nerve is working so it's a gamble.  

2. The highest negative reported with the sleeve is reflux.  For band patients who have reflux issues the sleeve is not optimal because they tend to have the same issues once sleeved.

The other option I was offered was to have band removal surgery, wait four months for the vagus nerve (hopefully) to begin functioning, then have a second surgery for the sleeve.  Even then, there is no guarantee it will. I did not want to have two more surgeries and want to be done with all of this!  She said if that's the case she really recommends Bypass, so that is what I'm doing.

It really depends on whether the reflux is a result of the band which in many many cases it is or if the reflux was there pre band. If it was preband you "may" have more problems with but not neccesarily some people lose their reflux after a sleeve so it is hard to tell. Myself I would much rather have a working pylorus valve and reflux (which can usually be treated with medication and often goes away after the first 6 mos.) than to have a non functional pylorus valve and malabsorption that goes away after 18-24 mos. I would strongly urge you to read the sleeve forum and the RNY forum and see what actual patients have to say about it, there are pluses and minuses for both.

I have reflux with my band and surgeon says sleeve is not the surgery for me. Said RNY will eliminate or reduce reflux. I am scheduled to have revision all at one next Tuesday. Going to do band removal, RNY and remove my gallbladder. Planning on laprascopic surgery if all looks good.

I am 2 days post op band removal revision to bypass. Still in hospital for another 3 or 4 days. No complications everything went well. They just want to be sure I heal and scar well. Sleeve was not an option due to reflux and vagus nerve.

Pain isn't as bad as with Lapband ormy previous C-sections. Just very weak from lack of food and water. Every hour it gets better.

Ashley

Docs all have their preferences for how they stage things.  If the juncture by your stomach and esophagus isn't damaged or has too much scar tissue, then one surgery should be safe.  There is a higher risk for a leak in a revision, and some docs like to get the band out, give the stomach a chance to recover, then do the sleeve.  I've seen successful revisions both ways.

On reflux, it depends on what's causing the reflux.  Many people had undiscovered hiatal hernias.  Once the hernia was fixed, no more reflux. 

I went from band to sleeve after 5.5 years and have had my sleeve for > 3.5 years.  I love the sleeve.  The quality of life compared to banded life is amazing.  The recovery is easier - they remove the part of your tummy that tells you that you are hungry which makes life more pleasant.  But now I am having to revise to RNY, not for weight issues but because of reflux.  The band really screwed up my tummy long term and where it used to be narrowed and a larger pouch formed above it (I have a pic uploaded).  I'm really sad about it because I love the sleeve so much.  I would ask your dr if he has any patients that had a similar experience to yours, banded for so long and converted to sleeve and if any required subsequent surgeries.  I am not sure if mine is a rare case or more common situation but it is something that I would talk with him about, just so you are more informed of potential complications long term.

Hello Nancy Q -

I beg to differ. I am a  lap band patient and had my surgery in 2007. I never had reflux before the surgery and after about my second fill I developed the worst acid reflux possible. When the band is unfilled I am fine and do not need to take medicine. When it is filled I have to take medicine daily which is why I am getting a revision. Not to mention due to the unfills there is no weight loss. Your doctor may be right about the reflux not being a problem if the band is not too tight, however, the whole purpose of the band is to be able to get it filled to cause the maximum weight loss which may not happen if you can't get the adequate amount of fills due to reflux. In my opinion if you have reflux now DO NOT get the band. I have talked to a few of my docs patients *****vised to sleeve after band and one still have reflux while the other two don't. While there is still a possibility that it may occur with the sleeve I do know that the band is the reason behind my reflux.

I had my band for 3 yrs and developed horrible reflux the last yr..so in june i had it taken out and had a sleeve done..im still taking my omprezole only because i take ibuprophen daily for arthritis pain..other than that i dont notice any reflux and im only taking it once a day..20mgs...of course im not losing weight either but when you have a revision from band to sleeve i guess its a risk you take..they say its slower weight loss..how about no weight loss? lol well  yeah i lost 21lbs, thats it..the band really messed with my metabolism..even on the 2 week liquid phase i only lost the fluid from the iv that was pumped into me..not much more since..im lucky that with my insurance (i work for YALE UNIVERSITY) so my healthcare is free..both my surgeries were free as long as my bmi was over 40 and it still was...so i cant complain that i paid for this and its not working..just frustrated that its so slow...but i hope everyone else has much better luck than me...i dont have co morbidities so i will not cry!! good luck :)