Question:
What is the difference between lapband and RNY?

   — suep13 (posted on January 31, 2009)

January 31, 2009
Sue, with the lapband, they don't cut into your stomach, they simply place the ring above/around the top of your stomach in attempts to decrease your appetite by making your stomach smaller. The RNY aka Gastric Bypass is where they pretty much rearrange your stomach & intestines & make your stomach smaller. I chose the RNY simply because I am Diabetic. With the RNY, the bypass is known to dramatically get rid of diabetes within days sometimes weeks (at times sooner) after surgery. You may want to find a Board Certified Surgeon who practices ONLY these types of surgeries. You want to find a surgeon who has perfected this surgery. You may not want to go to a doctor who performs all kinds of surgeries, that is, a doctor who does facelifts, tummy tucks and gastric bypass. I chose my doctor because this is all he does and nothing else. Counselling sessions are usually free so check out the surgeons in your local hospital. Sometimes, local hospitals offer free seminars that you could attend to get more educated. Hope I helped someway. Ruth
   — Ruth M.

January 31, 2009
The first poster is essentially correct in his (or her) statement, but there are more than just the two surgeries available to people today. The Lap-Band, and the RNY are simply the most popular because those are the ones that most INSURANCE companies are willing to PAY for, but they are not necessarily the best CHOICE for every PERSON who is looking for a surgical wight loss option. Many surgeons do not even mention the other options because the insurance companies do not want to PAY for them, but OFTEN, you can FORCE the companies to pay for these other options with just a bit of extra work on YOUR part and on the SURGEON'S part! Of course, many SURGEONS do not WANT to DO the extra work, so you have to make sure that you find one who is WILLING to put YOUR health and well being ABOVE his bottom line! As stated, the most common forms of Weight Loss Surgery are the Lap-Band, and the Gastric Bypass (RNY). Of the TWO, the Gastric Bypass is considered the "Gold Standard" in Weight Loss Surgery. This does NOT mean that it is the most EFFECTIVE or the SAFEST, however. The most EFFECTIVE Surgical Weight Loss procedure known today would be the Duodenal Switch. The SAFEST Surgical Weight loss procedure currently performed today is the Vertical Sleeve Gastrectomy. There is also a procedure known as the Vertical Banded Gastroplasty, but it is not used as much as it once was. It is essentially the old fashioned "Stomach Stapling." It is the ORIGINAL version of the Surgical Weight Loss Procedure, and has fallen out of favor with most surgeons today. The Lap Band basically is strictly a restrictive procedure, where the surgeon places an adjustable device about the top part of your stomach to restrict the flow of food and help make you feel FULL on less food. Generally, a few TEASPOONS of food will do the job to begin with. The Lap-Band is adjustable, so the surgeon can adapt to the varying needs of the patient as his or her dietary needs progress. This procedure has a FAILURE rate of about FIFTY PERCENT, and about ONE PERCENT of the patients suffer from SEVERE problems due to this procedure. SOME of those problems can be so severe as to leave these patients with little to NO stomach LEFT after having this procedure done. Now, generally, ONE PERCENT of something does NOT sound like a BIG NUMBER, but when it comes to SURGERY, when ONE out of ONE HUNDRED PEOPLE have a SEVERE PROBLEM with a MEDICAL DEVICE, there is PROBABLY something WRONG with it. I STARTED my Surgical Weight Loss journey LOOKING at the Lap-Band thinking that it was the SAFEST of the Surgical procedures. THANKFULLY, I did not GET it! Many patients that GET the Lap-Band end up getting REVISIONS to some OTHER Surgical Weight Loss Option. They either get the Gastric Bypass, or in many cases, they have no other option but to get the Vertical Sleeve Gastrectomy. Often times, their stomach is so scarred from the Lap-Band device, that the surgeons have to give them the VSG just so that they can remove the scar tissue. The Gastric Bypass, known as the "Gold Standard," is pretty much artificially inflated (in my layman's opinion) to that standard because many of the insurance companies refuse to pay for either the Duodenal Switch, which is in many ways SIMILAR to the Gastric bypass and is MUCH MORE effective than it, or the Vertical Sleeve Gastrectomy which is almost exactly as EFFECTIVE as the Gastric Bypass, and has far FEWER side effects. The Vertical Sleeve Gastrectomy has been used for DECADES as a treatment for severe stomach ulcers and stomach cancer, and has been PROVEN to be safe and effective at helping patients lose weight when performed for those reasons, but since the procedure has NOT been performed as a WEIGHT LOSS SURGERY in the UNITED STATES for more than ten years, most INSURANCE COMPANIES consider the procedure to be EXPERIMENTAL. The procedure has been performed OUTSIDE the United Stated quite successfully for more than a decade with GREAT results, but the United States medical accreditation entities, and the insurance companies will not ACCEPT data acquired from OUTSIDE the US as accurate. As if US data is beyond question when it comes to manipulation! Canada, Great Brittain, most of Europe, and Australia should be allowed some measure of credibility if the accreditation agencies do not trust the data that comes from Central and South American and Asia. There is PLENTY of data from THOSE countries that would CORRABORATE that the VSG is QUITE safe and effective as a Weight Loss Surgical option. Great Brittain ALONE would be able to provide ample data, since their Socialized medical system has been using it to great success to help MANY obese patients lose weight when other options fail to work. The British Medical system turned to the VSG as a LOW COST and SAFE alternative to the Gastric Bypass because they discovered that there were FAR FEWER side effects, and it was almost nearly exactly as effective! They also discovered that the surgeons spend far less time performing the surgeries than they did with the Gastric Bypass! It was a Win-Win for the socialized health care system. The PATIENT got a BETTER procedure, and it COST less for the HOSPITAL! If only the AMERICAN Insurance Companies would figure this out! There IS no continuous after care for the VSG patient. NO constant blood work. No special dietary supplements. There are no FILLS either. There is no dumping syndrome. There is usually no excess gas. No diarrhea. No stinky stools. No issues with medications. There are none of the typical side effects that come with the Gastric Bypass or the Duodenal Switch. The short of it? If I had to CHOSE between just the two, I would go for the Gastric Bypass, unless there was a VRY GOOD reason that I needed the flexibility of the Lap-Band. I would have to be a WOMAN of child bearing years who wanted a baby, or in need of chemo or radiation therapy and needing the flexibility of an ADJUSTABLE system that would allow more sustenance to flow into my body as needed. OTHERWISE, the risk would be too great, and I would opt for the Gastric Bypass: If those were the ONLY two options available. I would CERTAINLY try to get something ELSE first. If I wanted the most EFFECTIVE weight loss procedure, I would opt for the Duodenal Switch. Why get the Gastric Bypass, which is about 81 percent effective, when I could get the DS which is about 10 percent or MORE effective? The DS is CERTAINLY the most effective Weight Loss Surgical option available today. If I wanted something SAFE and LOW Maintenance that was ALMOST NEARLY EXACTLY as effective as the Gastric Bypass, I would opt for the VSG. The ONLY reason I would get the Gastric Bypass is if I was FORCED to get it by the insurance company. I would try to PAY for it, MYSELF if I had to. I actually DID, or rather, I should say that my WIFE did. She used money from a bonus at work and BORROWED money to pay for my procedure so that I could have this done. I have lost 110 pounds since March 2 in 2008. I have been COMPLETELY satisfied with the results of my surgery, and have had NO ill effects what-so-ever from the surgery. If you want to find out more about the various surgical options, check out my profile page at: http://www.obesityhelp.com/member/hubarlow/. Look for my post titled "Surgical Comparisons." If you don't see it on the main profile page, look for it in the March 2008 archive. I hope this helps. Hugh
   — hubarlow