Question:
DO YOU THINK DOCTORS RATHER DO BYPASS RATHER THAN LAP, BCAUSE LAP IS MORE COMPLICATED
THE DOCTOR THAT I SAW TONIGHT AT HIS SEMINAR, SEEMED TO NOT WANT TO DISCUSS LAPBAND VERY MUCH---AND I FEEL AS THOUGH THIS PROCEDURE IS MUCH LESS INVASIVE. PLEASE SEND YOU ANSWERS---WHAT DO U THINK? — bmw (posted on December 20, 2005)
December 20, 2005
Hello, Maria... The reason that surgeons tend to dislike Adjustable
Gastric Lap Banding is 1) it does not make them as much money per patient,
2) fewer insurance companies pay for it, but will pay for Gastric Bypass
surgeries. Cash patients who want Lap Banding will often go looking for a
cheaper price in Europe or South & Central America, 3) Bandsters are
considered "annoyances" by traditional Bypass surgeons because
surgeons are not used to having contact with patients after the surgical
wounds are healed. However, Bandsters will continue to seek contact,
needing fills, unfills, advice, support. Great support groups like Smart
Bandsters help patients achieve this when their surgeon's practice is not
set up to provide "full services". So don't let his attitudes
sway your decision. Come join our group and make your own decisions when
you feel you have enough information. Feel free to write me. ----
Theresa from South Texas
— SouthTX LapBand
December 20, 2005
Having seen for 14 years both sides of the issues may I make some imformed
comments. I am a trained nurse in 8 post graduate feilds and am a consumer
of Weight loss surgery for the past 15 years. I have had both banding, and
after complications had it revised to BPD. I can say that this is not a
money issue really. banding is easier to do on the whole, but the weight
loss is slower and more after care is required in the way of fills and
deflations. With the BPD it is set and forget. But as with both types of
surgery foillow up and support groups are vital. There are more failures
out there by patients who decide to go it alone. So which ever you decide
make sure that you contact patients who have had all kinds of W.L.S so you
can give consideration to the side effets and consider if you can do the
work required in exdercise and nutrition.
— Lise K.
December 20, 2005
its also been my experience that many doctors don't know all that much
about the band, because its relatively new. if you want the band, go to a
doc that is supportive of it, not just the doc might happen to be local.
aftercare is key, and if this doc is dodging the issue now, you don't want
him as your surgeon later. yes, the surgery is less invasive--one of many
reasons i chose it. if this is the right surgery for you, find a surgeon
who thinks its a great as you do--they are out there!
— jessicamegan
December 20, 2005
South TX Lapband, unfortunately, provided you misinformation. First, the
adjustable gastric banding tends to be more of a money-maker for surgeons
because of the need for regular fills (called "insulflations") of
the tube that is inserted around your stomach. However, I do not believe
that the majority of surgeons who perform adjustable gastric banding do so
solely because of profit motives.
Secondly, the typical Lap band procedure is far less complicated than the
RNY-- which is why, on average, given surgeons of equal skill, the Lap band
procedure will be quicker. Although a skilled RNY surgeon can probably
perform the RNY laparoscopically in less than 70 minutes.
Thirdly, surgeons who engage in any bariatric practice, at least in my
experience, have tended to want long-term contact with their patients. Of
the four surgeons who practice at the hospital where I lead some of the new
patient informational meetings, whether they prefer Lap band or RNY they
are each dedicated to particpating in long-term aftercare with their
patients. In fact, you would be hard-pressed to find a gastric bypass
surgeon who would not tell a new patient that they would not need to be
committed to long-term follow-up with the surgeon.
Many surgeons have a preference-- whether it's the RNY (because the
National Institute of Health deemed it the "gold standard" for
weight loss surgical methods) or the Lap band (because it is a less
invasive and less complicated procedure). Few would argue that each
procedure has its advantages and complications.
Within the medical literature, there is growing awareness that not only
must the Lap band patient contend with the need for frequent fills (which
are uncomfortable) but that the Lap band procedure provides fewer
disincentives for overeating and for poor food choices; therefore, the
procedure tends to not offer the same longer-term sustained weight loss for
the morbidly obese. In addition, notwithstanding the popular spin,
Lap-banders do face post-operative complications and the risk of
re-operations. For instance, among the Lap band patients, the rate of
slippages and ulcerations is about 5%, which frequenty requires
re-operation; this is about comparable to the combined rate for
re-operation among laparoscopic RNY patients.
As you can see, there are many legitimate why a surgeon might advocate the
RNY over the Lap band, which have absolutely nothing to do with
profit-motives or a desire to avoid complicated surgical procedures.
But, just remember, that the decision you make should be your own, as you
can find success with the method you choose provided you are an educated
consumer and dedicated patient.
— SteveColarossi
December 20, 2005
My sister and I have both had weight loss surgery, she had the bypass and I
had the band. In my opinion, I had a very speedy recovery compaired to
hers. I am almost 2 months post op and have lost 34 lbs already, which is
great according to my doctor. I also have had 2 fills already, expected the
worse and worried for nothing. It did not hurt, only a needle pinch and I
have a very low pain tolerance. there was a show on TV recently about both
surgerys and the lap band according to the show is so much safer. Yes you
can eat sugar and other things you should'nt, but I feel if you are paying
all this money, why do it?
I have cheated, but still lose weight, I don't do it every day.
It is a big decision to make but remember, one is reversible and one is
not. If I stop lossing weight, they can always make my band tighter, not so
with the other. Plus the other thing is, the slower you loss the weight the
better off you might be with not having problems from such a quick loss. My
doctor says in 2 years we should be the same, so what if it takes me a year
longer, I have been big all my life! So thats my opinion, for what it's
worth, I hope it helped. Best of luck to you and please email me with any
questions.
Diane P.
— noboat4u
December 20, 2005
The initial procedure is less invasive; your anatomy is not permanently
altered and the risks are not as serious as they are with gastric bypass.
In the long run, I guess it could be argued that it's more invasive to have
a foreign object in your body and that the required fills mean a continuing
need for medical attention that the bypass doesn't require.
But I think the real issue here is that this doctor doesn't feel
comfortable with the lapband - whether he's inexperienced with it, hasn't
had good results with it or isn't comfortable with laprascopic surgery.
(Does he doe his bypasses laproscopically or open?)
In the end you need to decide which operation is right for you and if you
want the lapband then you probably don't want this doctor. There's a
learning curve for both operations and you want a doctor who's successful
at and believes in the operation YOU want.
— sandsonik
December 20, 2005
My surgeon does both but prefers the bypass because he says the success
rate is higher and the revision rate lower. W/ a bypass you lose about 70%
of your excess body weight as opposed to 50-60% with the lap band. He said
it was our choice and showed us a film on both but for him it was a success
issue.
— boonikki29
December 20, 2005
Maybe he feels it is a better option for you?
— Novashannon
December 21, 2005
I originally sought the Lap Band but when I found out the possible problems
decided on the Duodenal Switch. Look at all the surgeries and get as much
information as you can. The success rate for each is different for each
proceedure and each person. This is a life altering surgery. Do your
homework.
— Tuxedo Katz
December 21, 2005
my take is that the band is a great tool to get you to come to the seminar
for a switch the the better operation the rny that is more successful.
Unfortunately most doctors are unable to provide the real platinum of
weight loss the DS, for lack of skills, and the lack of insurance approval
, the DS provides a much higher success rate,much easier life style,post
op, but requires a higher skill set of the surgeon, so it is not offered,
check it out on the DS forum, its a life time decision. only 12 k in
Mexico, by one of the worlds best. I will have it for 12k instead of a free
rny.
— walter A.
December 21, 2005
The DS does provide the most significant, long-term sustained weight loss
results. However, there is a much higher rate of nutritional issues from
it; consequently, although post-DS, less care need be given to particular
food intake (which in some ways makes it easier to live with), greater care
(vis-a-vis the RNY) needs to be given to vitamin and mineral
supplementation. For many people this is a fair trade-off. However, it
is simply not accurate to minimize the health consequences of the DS. But,
all of the surgical means of weight loss carry risks, and neither RNY,
gastric banding nor DS are as risky as being morbidly obese.
— SteveColarossi
December 21, 2005
While Lapband is less invasive and weightloss can be achieved, my decision
to have RNY was based on NIH findings regarding the maintenance of that
loss. I have lost more than 100 pounds several times in my life, only to
add it back on. I know that I need a tool to help me lose and maintain the
loss. The statistics for gaining the weight back are much higher with
Lapband. That is not to say GB patients can't gain weight, but with
restrictive and malabsorption, I feel I have two tools helping me.
Surgeons want their patients to be sucessful and the stats show RNY GB
to be the more sucessful of the two in losing the weight and maintaining
the loss.
— LauraA
December 21, 2005
While Lapband is less invasive and weightloss can be achieved, my decision
to have RNY was based on NIH findings regarding the maintenance of that
loss. I have lost more than 100 pounds several times in my life, only to
add it back on. I know that I need a tool to help me lose and maintain the
loss. The statistics for gaining the weight back are much higher with
Lapband. That is not to say GB patients can't gain weight, but with
restrictive and malabsorption, I feel I have two tools helping me.
Surgeons want their patients to be sucessful and the stats show RNY GB
to be the more sucessful of the two in losing the weight and maintaining
the loss.
— LauraA
December 21, 2005
its somewhat misleading to quote statistics and success rates for banding
as it hasn't been around long enough for accurate data. the first few
years of any procedure has a something of a learning curve associated with
it....the fact that many surgeons aren't informed about the band is exactly
why some people might not succeed--the surgery itself isn't going to do it
for you, it's what you do with it. in every other country in the world,
banding is considered the gold standard (whatever that means) and if you
check their stats, they are very different. also, why so many bypasser's
have an opinion on the band is beyond me....would you go to a christian to
explain the hindu religion? no, go to a practicing hindu. also be aware
the stats quoted so far in this post are inaccurate. please, talk to other
bandsters and do you own research-good luck!
— jessicamegan
December 21, 2005
Just want to add my $0.02 worth. I work for an insurance company and the
surgeons don't get paid for doing the fills - it is considered part of the
aftercare included with the surgery fees. Surgeons also sign contracts with
insurance companies and they get paid for doing a procedure, and generally,
surgeons are offering different procedures as a service and not as a money
making venue. If a surgeon did any bariatric surgery, no matter what type,
purely for making money, I would run away from that surgeon in a hurry on
my fat little legs. Personally, I feel the Roux-en-Y is the gold standard
of bariatric procedures, but that being said, "one size does not fit
all" and that is why various procedures exist. I would not consider
the DS, but that is for ME, and I know that it works quite well for other
people.
As far as invasive, well, there is the laparoscopic gastric banding and the
laparoscopic RNY. Both procedures are done by inserting the trocars,
(instruments) through small openings in the abdominal wall, so they are
equally invasive. The RNY unquestionably involves more extensive surgery
and more education of the surgeon to perform, than the lap band. I
personally wanted to have the surgery and be done - I wanted the additional
benefit of the malabsorbtion due to the relatively small, but significant,
amount of intestine that is bypassed, as well as the restrictive benefit of
the pouch. And I did not want to go back and have a needle poked in my
stomach (and into a port placed under the skin) to get the band filled.The
argument can also be made that having the lap band also involves having a
foreign body placed inside you, and thus can potentially cause infection
and possible rejection. My own personal opinion is that some people who
have the lap band haven't totally made up their mind that surgery for
weight loss is the last possible solution and maybe, since the lapband is
potentially more easily reversible, it might be a less "scary"
option than the permanence of the RNY.
— koogy
December 22, 2005
It is important to look at the studies from foreign countries where the Lap
band (or other versions of adjustable gastric banding) is performed. Most
of the Australian studies indicate about 4.6% rate of band failure or
slippage. One of the leading Italian studies showed (within 3 years
following banding) a failure rate of 14% and weight regain among 20% of the
nearly three hundred patients studied.
— SteveColarossi
December 26, 2005
I had the RNY and had MANY MANY complications. I had tubes from October
until April. Yes, I feel better and have lost 150 lbs, but I DO NOT ever
recommend the RNY to anyone. I wish my doc had offered the lapband or at
least given a better view of it. He made it sound like it would not be
successful. At this point many friends and family members want and need
bariatric surgery, but I always tell them..I am one of the few, but after a
year I still would not do it again. Yes, after 25 years of uncontrolled
blood pressure, I have a rather low blood pressure and yes I feel good, but
it was not worth the risk I took. Find a doctor that will do the lapband
and supports the lapband, for your own good. It may take you longer to
lose, but that is ok.
— debi327
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