How did you decide which procedure?
sue100194
Posts: 129
My question is how you arrived at a decision on lapband vs bypass vs sleeve vs RNY?
I'm on the 'medical managed weight loss' path to meet insurance requirements before I can get approval for surgery so I haven't even met with the surgeon yet. I've been assuming that the doctor would direct me to the procedure that's right for me but it seems like there is patient choice involved as well. I have no idea which procedure and at this point, have no strong feelings one way or another.
Thanks
I'm on the 'medical managed weight loss' path to meet insurance requirements before I can get approval for surgery so I haven't even met with the surgeon yet. I've been assuming that the doctor would direct me to the procedure that's right for me but it seems like there is patient choice involved as well. I have no idea which procedure and at this point, have no strong feelings one way or another.
Thanks
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Replies
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I'm just learning about the additional options, as I've only ever heard of gastric bypass & lapband. I knew I didn't want gastric bypass surgery, so I decided on lapband. Once I made the decision, I did some preliminary research, talked with my doctor about my options & was referred by my doctor to a lapband surgeon.
I'm still educating myself about the lapband & the changes I will need to make in order to be a successful candidate; additionally, I'm hearing many pros & cons about it, as well as other WLS options. But, I've made up my mind to have the lapband surgery, so I take it all in, share my concerns with my surgeon & continue taking the steps needed to be successful.0 -
My doctor and I spoke at length about this. We immediately knew that with my health issues (type I diabetes, hypothyroidism, hypertension, hiatal hernia, sleep apnea, asthma, etc.) that Lap Band was out. Lap Band also would have required much more frequent office visits and since I live almost 3 hours from my surgeon's office, it wasn't feasible. That left sleeve and bypass to decide on. At my top weight of only 246, I could do either one. We chose gastric bypass because he needed to do the hiatal hernia repair also and we felt that bypass would give me a better chance of long term weight control and better control of my diabetes. And it has. It has been awesome. I have had NO issues since surgery. No hair loss, no vomiting or nausea whatsoever, and minimal discomfort even after the surgery itself. I follow my diet to a "t" and exercise at least 5 days a week, often more. I take my supplements as scheduled. I believe that the decision on which procedure to choose is a very personal one and all health conditions should be weighed, as well as individual personality. Good luck and hope this helped!0
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I have a similar story to Annwaytt69. I initially was interested in the gastric sleeve, due to absorption concerns, but went with the RNY bypass instead. I had type 2 diabetes, acid reflux, and at my highest was 325. The doctor and I spoke about all three types (lap band being the third) and based on my medical history decided on RNY. I am only 5 months out, but it has been the best decision! I also follow my diet to a T, take all of my vitamins, and regularly check in with my medical team. It is a personal decision, but with a good surgical staff, you should get some guidance and help to make the decision that is best for you. Each of us here on this board chose our surgeries for a variety of reasons, and only you can decide what will be best for you in the long run.0
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You forgot DS. I knew I would eat around a lapband (so easy to do). I only know 2 successful lap-banders in real life and dozens more who were not successful and are heavier than pre-op, including my mom. My insurance gave me the choice of RNY or lapband. I wanted the best shot to be thin so I went with RNY. It was the right choice for me. The sleeve would have been my second choice.0
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I chose the sleeve because my insurance offered it and although its newer and there is less research out there, I felt that I preferred a less invasive method than the RNY. As I didnt like the malabsorption and life-long need to take vitamin. I'm not even a year out and I have already lapsed several times in taking my vitamins - its a problem I have always had in taking meds of any kind I forget or I get lazy and it stops being a priority, ect. . Knowing people who have been very ill from vitamin deficiencies because of their failure to keep up with their vitamins and labs after the RNY (one of whom was hospitalized for several months and nearly died) sealed my decision. More over the whole smelly poop/ devrom thing also turned me off to it and the fact that digestive probelsm and IBS runs in my family I didnt want to agrivate problems with the RNY. Statistically speaking I believe that outcome all depends on the person and what choices you make. As I have seen people less then a month out of surgery eating pizza, salad and burgers or someone who was eating 600 calories worth of candy a day rather then decent food and protein shakes - I will not be surprised to hear that they either do not succeed or if the do manage to lose weight they they regain it.
Also talk to your doctor and see what they recommend, based on what your situation is. In the end it not the just the surgery but what choices you make. Good luck!
PS I'm very happy with my choice. I have had no complications but I have had hair loss and acid reflux, both of which are common and also improving as time passes.0 -
I investigated lap band and went so far as to schedule the apt tp set up proceedure. I decided it was not forme. I waited 3 years to decide, doing tons more research and decided rny was my choice. Best decision of my life, other than marriage, children and career. Now retired and thin enough to have regained my health and energy to real
Y live0 -
My story is similar to Turtle13 (5 months out as well). I met with two surgical groups and sat thru over 4 webinars (called emmi's) as well as my own research. For me, the RNY (or Gastric Bypass) was the option that statistically offered the most weight loss. I think the average is 60% of the weight you need to lose. By working with my medical team (nutritionist, surgeon, and nurse/mentor), I have surpassed the 60% mark and am at 75% of the weight I need to lose to reach a "healthy" BMI. Exercise is a big part of my program and I was counseled to make the most of my first 6 months. I write a blog about this for a local magazine. If you would like to read more of my story feel free to check it out. http://www.fredericksburgparent.net/blogs/weigh-in/
Also, I had a cousin who was unable to keep the weight off after having the sleeve procedure. Having my own experience now I saw how she did not change her eating or exercise habits, which was a big contributor.0 -
I was leaning towards the sleeve but wanted to ask my WLS surgeon what he thought would be best for me. He told me the sleeve so that is what I went with. I lost 47 pre op and have lost 94 post op since 6/11/12 for a total lose of 141 pounds. I didn't like the rerouting of the RNY and messing with my bowel connection either. I did have a hital hernia they found when they did the sleeve that they fixed. I had another hernia that will need to be fixed if it causes me problems that was also found when they did the sleeve.
I love my sleeve and don't regret the decision at all. I went from a size 24 to a size 4 pants/jeans and size 3XL to small in tops! I have never been this small in my entire life. I never have weighed the correct amount for my height/age ever. I was born obese at over 11 pounds and have been obese my entire life till now. I do follow my WLS program eating plan of 80-100 grams of protien a day and 80 or more oz of liquids a day. I work out 5-6 times a week also. Currently at my personal goal weight of 129 for my 5'4" and working on maintence. 24 % body fat which is at "fitness level" and goal is now to lower that to around 20-22%.
Only you can make the decision of what to have. My insurance would cover all three. My program doesn't hardly do anymore lapbands. Just RNY and Sleeves. I see alot more sleeve people also at our support groups monthly.
Good luck!0 -
Let me just say it is huge decision. At the time I had my lap-band done it was a big hype about it and how it works and my doctor didn't do any real consulting as far as the the choices he just basically let me decide. At the time it was the safest, least invasive, totally reversible option. Well now it is causing a lot more damage to people than originally thought. I advise anyone on their surgery journey to join www.obesityhelp.com and just browse through the different surgery forums so you can get an idea of what to expect. Well after more years of research there are many more people just like me that the lap-band has failed. I never lost weight from the band at all and had to stop getting fills because it was the reason my acid reflux became so severe and extreme vomiting. I used to be scared to eat at a restaurant because I knew it would result in me flying to the bathroom to vomit. I am now unfilled and am in the process of getting a revision.0
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My surgeon explained how his clinic decided on which procedure to recommend based on how over weight the patient is. I had over 200lbs to lose so he recommended the RnY. He explained that if I had less than 100, he would recommend the GS, and the Lap Band for someone with less than 50lbs. He went on to explain that the DS was for folks who had much more than 200lbs to lose.
It made sense to me and I didn't really question it, although now, after I've had my RnY, I've very curious about guys like me, who started at 411, and who had the GS procedure.
I'm about 7 weeks post RnY, feel great, no physical issues.0 -
I did my first WLS seminar in 2005, then all they had was RNY, bypass and the band. They all seemed so drastic to me and so I decided I would do it myself. So I struggled with my weight for 5 1/2 more years. I then heard about the sleeve. I did my research again on all of them and decided that if i did it, that would be where I would go. So I met with a surgeon and he decided that the sleeve was my best option. I could make healthy choices, but my quantity was not so good. I didn't have a whole slew of medical issues, so it was the best choice for me. It left me about as normal as I could be.....internally. I had heard a lot of scary things about all of them, but you know, I am 2 1/2 years out...and I feel amazing. I am about 130 pounds down, give or take, and I would do it again tomorrow if I had the choice to make again. It is a tough and scary decision to make, but be educated and be your own advocate. A good doctor will listen to your concerns and help you find what is best for you. Ask questions!! How many of each procedure he has done and his success rate. If you aren't comfortable, go with your gut! I think we all feel like our choice is a rewarding choice. Good luck to you! :happy:0
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I am at 10 weeks post op from RNY and it was the best decision I have ever made. I made the choice after reading everything i could find on all the options and writing down all my questions (good bad and ugly, all the rumors, truths and myths) and had a 2 hour appointment with my surgeon and went over everything. He initially suggested sleeve for me but he told me that in some patients, they have to go back in and do an RNY anyways if the restriction doesn't work. I told him that after everything is said and done, i want the most successful and ONE TIME SHOT surgery. I was leaning towards the RNY and after I gave him my reasons and he gave me his, we discussed and both agreed RNY. I also had a hiatal hernia to be repaired and I had a silastic band put in (to prevent pouch stretching in the future). I have not once had dumping, vomiting or any side effects to the surgery (hair loss, dry skin, all that never happened) other than the inital pain for 3 days after the surgery (which all went away). I have lost almost 70 lbs so far and about 16" on my body and I feel great! I can play sports and work out (like a maniac) and i'm eating healthy and definitely glad I made the choice.
Good luck to you on your journey!0 -
research....research....research..... then decide
6 years post Op and never regretted my RNY0 -
I knew the lap band was the choice for me before I even began my research, it's so different for every person though. Top reasons I chose the lap band:
1. Removable
2. Not a serious surgery that requires cutting of the stomach
3. Fluid can be removed during pregnancy so that the baby can get enough food
4. It's a slower weight loss, so I had to be very committed to this lifestyle change
I know myself, and I knew that if I had one of the surgeries that the weight fell off fast, I wouldn't have pushed myself as hard like I had to for the lap band. I wanted a lifestyle change, and the band gave that to me. This is my story though, everyone is so different.
Everyone you talk to will tell you different stories, about how they don't know very many people successful with the lap band, and then others will say the same thing about gastric bypass. You can't rely on what other people say, it really comes down to your own research and what your gut feeling is.0 -
I had the sleeve because of long term post op issues. The long term statistics on WLS aren't really their since it keeps evolving so much. It used to be such a bigger procedure. anyways....
Im 19 so in 70 years with a plastic lapband in me or with my stomach rearrange. With rny your stomach is re attached and floats around in there. I wasn't sure if that would give me issues also. Depending how over weight you are I recommend doing the sleeve first then doing the rny. They have had great results with it.
One clinic I talked too stopped doing bands because of complications.
I had friends and family have RNY and the DS. Neither of them have had issues years after. Another one had the band but she never fills it. I don't know why she wont fill it she could stand to lose weight.
Anyone can add me. I know how anti WLS people are here.0 -
If anyone lives near Oregon I went to a place in Portland that does an excellent job. Everyone I know that's had surgery through there has done great with no complications. The surgeon is AMAZING0
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I ended up going with RNY for a couple reasons:
1. Lapband isn't performed anymore at the surgical group I used because of its high failure rate.
2. VSG I felt was too drastic for me, being that I would lose a large portion of my stomach. I also heard stories of people having it done and stretching their sleeve out, defeating its purpose. I also felt that the procedure was too new, therefore with no longterm stats available
3. RNY was the better for me in the long run because I felt I needed consequences for eating poorly, based on past eating habits. Dumping SUCKS but I feel that if I didn't have that safeguard I wouldn't make any progress.
So far I'm two months out (surgery April 17) and I've lost 31 pounds. Nothing tremendous but it's working so far.
edited for spelling0 -
Research led me to the sleeve, but insurance took me to RNY. Why? Because while my insurance pays for all the procedures, it does not cover the assisting surgeon during the sleeve procedure, and my surgeon's office only does procedures with an assisting surgeon present. I felt that I could use the sleeve to get the results I needed but that excess cost was just too much to handle at the time, and I knew RNY would work for me as well. I knew not to use the band because I did not want the ability to cheat for the first few months. I didn't trust myself to learn what I needed to know in that time period. And thank goodness I didn't try that, because at about month 4, I started craving foods that were not yet approved on my diet, and of course I considered a bite to not be cheating, and I paid for it! Thank goodness some of those things made me sick because I had to get the head problem out of the way before I could handle the correct way to eat. Finally I can say that I feel like I have learned how to manage my mind which is my personal biggest obstacle to weight loss!0
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research....research....research..... then decide
6 years post Op and never regretted my RNY
^^^^^^^THIS!!
Except I am only 6 months post op and Sleeved.
Read, ask questions, talk to others. Then decide what is best for YOU, this is YOUR journey0 -
I worked with my therapist to understand which plan I could follow (been in therapy for a food disorder for 6 years), talked to surgeons at a variety of hospitals (I work with docs so this was easy) and I talked to people who had gone through the procedures. Lap Band required the biggest commitment and lifestyle change but offered the least invasive, lowest complication rate at the hospitals I reviewed (all in the Boston area). For those who are committed and otherwise good medical canidates, the band is a great option. The ultimate deciding factor was that it is 95% reversible, nothing is 100%. The other options are not reversible at all if they are not good matches or there are complications.
Frequent follow ups (I am 5 months post op) are important for me, I picked a surgeon that offers online and in person support groups, and one who only does lap band but has a pretty strict criteria for elligibility, more restrictive than insurance. He is frank with you, if you can't stay on the pre-op diet, you will fail at the band. But at the same time, if you fall off the wagon, he and his team will help you get back on with dietician visits, pschyology visits and of course fills.0
