Lap Band vs. Roux en Y Gastric Bypass

Please tell me about your experiences. I’ve been looking into lap band and I heard there was a new endoscopic version. I posted a thread in GQ requestion information and got no response. But I know that there are dopers who have had one of the two kinds of surgery that are currently available. I’d like to know your experiences, the good, the bad, the ugly.

Thanks,

PKC

This is a hot-button topic for those who have had any type of WLS. There are pros and cons to every surgery, so please take what I am about to write as my opinion, based on my experiences and research and nothing more or less, ok?

Disclaimer out of the way, I had RNY surgery in April of 2005. I researched the different options (lap-band, RNY, DS) available around me starting in 1999 – this was no quick decision for me. What I found was that while some people experience excellent weight loss with the lap-band, it tends to be quite slow (we’re talking averages) and there is a very high incidence of regain. Plus, we’re talking high-maintenance, having to go for fills/unfills regularly to find your comfort zone. While people tend to lose more quickly with RNY, there is still a relatively high incidence of regain, plus all the possible issues with dumping, strictures, etc. The DS is the “platinum standard” the weight loss is tremendous, and extremely quick. The incidence of regain is exceedingly low, there is no dumping, and a person can eat pretty normally from the time they get home from the surgery.

Since I had 200+lbs that I needed to lose, I originally wanted the DS. I was a perfect candidate for that surgery, being SMO and otherwise fairly* healthy. Unfortunately, my insurance at the time would only cover the band or RNY. I interviewed and researched local surgeons, decided on one and had the RNY.

I came through the surgery very well, but had a scare day 3 – my hematocrit and hemoglobin bottomed out as did my pulse and BP. I was prepped for a transfusion and given a volumiser just in case. It turned out to be nothing more than a weird fluke because of where they had drawn the blood, and not a leak or internal bleeding. Once I got home, I was up and about very quickly. I am a fast healer, do not think that I am “typical” – I am not. I lost very very very quickly, due to 1) my surgeon is very strict with his diet plan, and I followed it to a T, 2) I exercised like mad, as I got smaller and could, 3) when my body works right, it works RIGHT. I lost 191 lbs in 13 months and an additional 30 or so in the next several months (the additional really was the result of my gallbladder shitting out and then having a tummy tuck, but I will get to that). I got down to 117, which on me looks “too small” (according to everyone else – me, I liked it) even though it is very much a healthy BMI, but have brought myself back up to a more “normal looking” 130 or so.

Complications:
Having to buy new clothes every couple weeks because my pants would literally be too tight on Monday and fall off me on Saturday.
My gallbladder, which passed all pre-op testing just fine decided to shit out at around 16 months post-op. If your surgeon can just go ahead and take it out when he/she does your WLS, do it – trust me.
Gout. Gout is hereditary, but I had no idea I was at risk for it, as no one in my family ever exhibited symptoms. The only reason we ever discovered I have it is that the things that trigger a gout episode are: 1) rapid weight loss (check), 2) a high-protein/low-carb diet (check) and 3) foods high in purines (beans are a staple for most newly post-op RNY patients, I was no exception, so check). This is treated with a daily regimen of Allopurinol, and I get my Uric acid levels checked regularly.
Excess/saggy skin. This is going to happen if your skin is damaged – if you have stretch marks, you will have issues, no matter how slowly or quickly you lose the weight. I had a tummy tuck to deal with my hanging panni – the insurance covered it. Boobs are pathetic, but they don’t cause medical problems (well, ok, they do – backaches and all, but that’s just because they’re still huge, even after the weight loss). My husband has promised that we will figure out how to pay out-of-pocket for a boob lift/reduction.

Ok, I think that about covers my experiences. If you have specific questions, feel free to ask me via the board, PM or email. Remember, WLS is not for everyone – and is a HUGE decision that can and will affect the rest of your life.

For the sake of brevity because it’s late :smiley: I’ll say my experiences more or less mirror those of Litoris, except I’ve had zip in the complication department. I had the RNY in November of 2004 and it was the best thing I ever did for myself. I was so compliant as to be Stepford Patient-ish, but I wanted to make the tool work for me as best it could - and it has.

Good luck with your decision.

VCNJ~

I, too, am in the beginnings of researching WLS. I am an emotional overeater and the thought of a Stepford-type diet plan scares me to death. Do any of these surgeries allow you to eat smaller portions of regular food to maintain the weight loss?

Bolding mine. There are more than the two options listed. Duodenal switch comes immediately to mind, and it certainly sounds less restrictive than a lap band or a RNY.

Well, the whole idea of the lapband surgery is that you cut your portion sizes down - but still eat normal food (not diet food or protein shakes). Obviously there are certain foods that are just plain a bad idea (like sodas, milkshakes, and such - because they slide right through the band)…but in general, I eat like anyone else - just smaller portions.
I had lapband surgery in 2003. I chose the band because, in spite of being fat, I was pretty healthy overall, so wasn’t prepared to go for something as drastic as the bypass, and was worried about the complications (although I definitely feel the bypass is the right choice for some people, especialyl those with serious medical issues who need to lose weight rapidly to save their lives).
I lost about 150 lbs. over the course of two years (yes, the weight loss with the lap-band is slower, but in teh long run it’s pretty close to the weight loss with the bypass).

I had four “fills” (the process where the doc injects saline into the band) over the course of the first two years, then a slight unfill last May (0.5 ccs taken out of the band because I decided it was too tight for my liking). Now that my weight is stable and I’m comfortable with the level of restriction the band gives me, I haven’t needed any fills since.
I haven’t had any major post-op complications. I live a pretty normal life and nobody can tell that I have the band just based on how I eat.
http://www.lapbandtalk.com/ is a great place for advice and info about the band if that’s the way you decide to go.
Good luck!

Honestly, everything you need to know is all over the net. But, I almost had the Roux en Y back in Jan. Long story-short, I was prepped for surgery and they heard that I had a cold and had been coughing up green phlegm all week, so it was postponed. In the end, I got in an argument with the nurse who happened to be kingshit in the office and I didn’t have it. So for the fourth time, if I want the surgery, I have to start all over again.

But, the bypass is more major of a surgery, there is more weight loss and at a faster rate, but it’s “irreversible” and has a few more major complications.

The LapBand is basically a band around your stomach, there is no cutting of the stomach, it’s just restricted. There are complications such as the band slipping, tearing and few others. Check out www.obesityhelp.com

Heh. Forgot to give my own background story. I know lots and lots about RNY. My dad had it about 3 years ago and it changed all of our lives. For the worse. But that’s a whole other story. He’s lost about 150lbs all in all. Recently he’s starting eating more again than the rest of us think he should. But that’s also neither here nor there.

Anyways, I guess I was just looking for perspectives from others on what they’d had done and how it went.

Thanks,

PKC

Never heard of the duodenal switch before, thanks.