Question:
Looked into the lap band, now considering the bypass - pros / cons please
— Janine B. (posted on January 29, 2004)
January 29, 2004
Janine,
When you say Jeuvenile, what age are you talking about? My surgeon has
done the DS on patients as young as 15 and as old as mid-70s. I think it's
pretty much a call that the individual surgeon will want to make.
Have you checked out
http://www.obesityhelp.com/morbidobesity/m-surgerytypes.phtml and
http://www.gr-ds.com/forpatients/Comparison_Html.html yet?
Blessings,
dina
— Dina McBride
January 29, 2004
The answer could really be better if your age was known. I had Open RNY on
my 30th birthday, so I'm relatively young, and I know that I have been very
happy with my surgery. I knew that I did not have the willpower for the
lap band to work well. I would have cheated. I needed to do something
fairly drastic to insure that I could physically not eat high fat/high
sugar/high calorie foods. You may have the willpower to make the lap band
successful. Of course, the major benefit to the lap band is the
reversibility...I feel the benefit to RNY is the high success rate. Just
do your research and talk to surgeons, and you should be fine...
— vittycat
January 29, 2004
I chose LAP-RNY, my sister chose LAP-Band. One is reversed alot easier than
the other. Her surgery time was 2 hrs including anesthesia, mine 4 hrs.
Recovery was the same. She has to go for "fills", I don't. We
were both volume eaters, not sweet eaters. Weight loss is nearly the same
but hers is a little slower. We eat about the same volume. I hope this
helps - 4/03 283/183/175
— M B.
January 29, 2004
I had the lapband and I am totally happy. My surgery was less than 1 hour,
and I was up and walking around just a couple of hours after surgery. I
was back to work after 3 days.<p>
From all my research, the band is as successful as the bypass. The newer
studies are showing that the results are about the same after 2 years or
so. The band is reversible if and when they come up with an easier
solution to losing weight. And the risks of death and major complications
are so much less with the band.<p>
But whatever procedure that you choose, it is only a tool. That is so
important to really understand. You will have to be committed to totally
change your eating habits. With the band, you learn as you go. With the
bypass, if you don't learn while you lose, you will have to learn after the
window of opportunity is closed. If you don't, you may not be successful.
The band is adjustable, so you don't have to worry about the window of
opportunity. Many bypassers do not dump, and they have to revert to
dieting to keep the weight off.<p>
This is a HUGE decision. Research all the procedures and then make your
decision. The bypass is great for some, and the band is great for
others...
— Sheryl W.
January 29, 2004
As an initial matter, this is an issue that is raised every few months and
excites those of us who advocate for our own particular surgical choice--
please know that we all believe that we made the right choice because it
has proven to be successful for us, and that we are an opinionated lot with
too much spare time now that we're not waiting at various drive-thru
windows throughout the nation.
That being said, let's assume that you are an adult and not planning on
giving birth within the first couple of years after surgery and that you
have a BMI that's over 40. A recent NIH working people described
laparoscopic roux-en-y as the "gold standard" for weight loss
surgery; long-term studies show significant and sustainable weight loss
which is greater and longer-lasting than that enjoyed by lap band patients.
Gastric bypass works on several different levels. It is more restrictive
than lap band and does not loosen to the extent that the lap band does
(although, admittedly, a patient could "eat through" his pouch).
The gastric bypass promotes satiety for a host of reasons that the lap band
simply can not (one theory is that the bottom part of the stomach
essentially becomes "broken" and does not properly sense fullness
until it is sealed off when the stomach is transected from the pouch). You
don't dump after a lap band (unless you have followed a strict low-carb
diet); although not all patients will dump after gastric bypass, most will
and therefore, most will have a serious disincentive to eating sweets.
Although the lap band will eventually loosen (and patients can stop seeing
their surgeons to have the band tightened through the port), it is not
removable in most circumstances as adhesions form between our organs and
foreign bodies that are placed on or in them. Also, although surgery time
for lap band tends to be less than 60 minutes, a skilled surgeon can
perform a laparoscopic gastric bypass in about one hour; so there is simply
not an appreciable difference in the time a patient is under anesthesia
when a lap band procedure is compared to a laparoscopic procedure performed
by a skilled surgeon. Admittedly recovery time is quicker for the lap
band, but for a laparoscopic gastric bypass, you could probably return to
work within about 7 days after surgery, assuming you had adjusted to the
limited caloric intake.
Good luck in your decision.
— SteveColarossi
January 29, 2004
If you are very young PERHAPS the lap band is the way to go. Personally I
wish I had had the option of the band.
I found out about the band just as the TRIALS had ended. AND by the time I
fought my insurance company nine months for approval for the RNY... the lap
band was approved! Sheese. I was about to cancel the RNY and fight again
for the band. You are lucky in that YOU have the choice I did'nt have as I
was unfortunate to be seeking surgery at just the wrong time for free
choice. Oh well. Keep researching. Seek your parents advice too. Good luck!
:)
— Danmark
January 29, 2004
Sorry... typo. IT should read "I was'nt about to cancel the
RNY...".
— Danmark
January 29, 2004
The lap-band is definitely reversible; the whole point of its design is to
be reversible and minimally invasive.
I know of a few people who have had a band removed (some of them later had
another band put in) and I've *never* heard of someone who couldn't have
their band removed due to adhesions. Adhesions can happen after any
abdominal surgery, but they seem to pose a much greater danger after bypass
surgery than lap-band surgery, because of the risk of intestinal
involvement with the bypass. There are cases of long-term RNY or DS
post-ops having part of their bowel strangled by adhesions, which requires
emergency surgery, so if you do get the bypass, educate yourself on the
symptoms of bowel obstructions so you can get treatment right away.
As for the sense of satiety from a band, well, I've never had the bypass so
I don't know how that feeling of fullness differs, but I can say that the
band does change one's sense of satiety. I no longer get truly hungry like
I did pre-op. I just occasionally become aware of my stomach gurgling and
realize I should eat.
All of these surgeries require some willpower. The first year or so after
an RNY is called "the honeymoon phase" and most people can lose
weight pretty easily then, BUT after that point the stomach pouch stretches
and the intestines adapt to absorb more calories and it's not quite so
easy. If you don't develop good habits, all that weight you lose during the
honeymoon will come piling back on within a few years. The duodenal switch
is a little harder to defeat than the lap-band or RNY because it involves a
very distal bypass. But even with the DS, you still have to have the
self-discipline to take your vitamin supplements every day or you could
have serious malnutrition problems.
The lap-band is used widely in Australia and Europe with good results, so I
feel success with the band is really just a matter of finding a good
surgeon who has experience with it. It's so much safer than the bypass,
that I feel that it is well worth trying first before going to the more
radical surgeries.
Especially for those of us who are young, since there is a good chance that
some new and easier treatment for obesity will come along in the next few
decades.
Good luck with your decision.
— K M.
January 29, 2004
As far as the satiety issue, the nerves that sense satiety are located in
the upper part of the stomach that is why we all have the samll pouch to
keep food in the upper part of the stomach LONGER signals the brain that we
are full so we eat less and less often. This is the same for both RNY and
Lap Band so there should be no difference as far as satiety.
— Lisa F.
January 29, 2004
As a juvenile, I think the lapband is probably best because it is easily
reversable and the others are right,future obesity research may discover
even better ways to keep the weight off that you could take advantage of
with a lapband that you would not have the option with if you had the RNY
or the DS. A big issue though is insurance. If you cannot afford the
surgery on your own ($20K and higher), then you may be limited in your
choice. The lapband was not approved by my insurance company and the RNY
was, so my choice was made for me. Check to see what your insurance company
allows.
— Cindy R.
February 3, 2004
One more thing, I had to pay for the lapband because it was not covered
under my insurance (though the RNY was...) I went to Mexico where the
surgeons are VERY experienced. The cost was $10,000 (though there are less
expensive surgeons)... I got a loan and I am making payments. I feel that
I am totally worth this. I am happy with my decision... Good luck...
— Sheryl W.
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