Gastric bypass or Lap-Band??? - ThinnerTimes

AirForceWife · 02-12-2007, 08:19 AM

Hello,

I've been "lurking" on this website for sometime now, and I feel like I know everyone so well that it feels weird to just now be introducing myself.

I was recently approved for surgery and had completely decided on bypass, but when I sat down to talk to my surgeon, she is convinced I should have Lap-Band. I'm 33, 5'4", 250lbs., BMI 42. I know that the Lap-band part of this group is new, but I really wanted the opinion on the bypassers. Where you faced with this choice? if so, what were the deciding factors for you? I'm really confused and any advice would be very grateful.

Thank you.
AirForceWife

Rachel · 02-12-2007, 08:42 AM

Hello and welcome!! Just like you, I needed to decide which surgery i wanted to have done. After meeting with my GB Staff, I determined that for me the bypass would be the way to go. I decide to go with the bypass since from the information that I was given the success rate is higher with the bypass, especially if you have a higher BMI.

But that was just me

Good luck with your decision and anything you choose will be better than what you have now

Welcome Again!

Bella · 02-12-2007, 09:25 AM

I agree with my mate down above.

I wanted the lap band at first two. Mainly beccause it's less envasive, reversable etc. But .. when you go to the forums and read about all the problems - I got turned off.

In a nutshell:

Lapband - least successful of all WLS - so you will loose the least amount of
weight
- of all the WLS you will have the hardest eating problems with
all the throw ups etc
- with the lap band you can eat sweets and fried things so yes, you
can sabotage your own weight loss. Frankly none of us are in this
position because we were able to control our bad eating patterns
- You have to go in for the fillls and unfills so maint. is a trip
- If you have problems - they will be late ... like the erosion issue.
That's where the band erodes into stomach so it's gotta come out
- In fact, lots of things can cause you to have to go under the knife
to have it removed ... like slippage
- lastly... I just can't imagine I'd have a plastic ring around my
tummy for the rest of my life. It seems like at some point it would
have to come off ... and then pow .... you'd get fat all over again.

RNY
- Is the GOLD STANDARD of weight loss surgery. Meaning it has the the BEST RESULTS .. with only a slightly higher complication rate than the lap band.
- It has the 'restrictive' method like the lap band but it also has the malabsorption method. Meaning your body will not absorb about 30% of what you eat. So you have two ways of promoting your weight loss.
- If you have complications - they will mostly be early over within the first few months
- the RNY IS reverable so it's not the end of the world
- You cannot eat sweats or fried things which helps you eat well
- you loose weight much faster and it's CERTAIN you will lose.

There's more but these are just my thoughts for now.

StacyBee160 · 02-12-2007, 09:39 AM

For all the reasons Bella listed above, I have abandoned the LapBand idea, even though it was initially what I was all gung-ho for. Just way too many complications and major inconveniences with a relatively low long-term success rate AND knowing that it won't stop me from eating my major trigger foods.

If you're interested, look around www.lapbandtalk.com for a few days... reading about all the problems people were having there, along with looking at long-term success/complication rates in Europe (where they've been using the band much longer) is what turned me off to it.

BUT, if you have a good measure of self-control and don't have much of a sweet-tooth, it may be the thing for you... you're the only one who can make that decision, so good luck to you whichever way you go!

LisaM · 02-12-2007, 10:27 AM

If you are an Air Force wife, as your user name implies, as of a year ago, Tricare insurance would not pay for a lap band, only for a gastric bypass. Don't know if you're working with an on-base surgeon or off-base, which would also affect that determination. This may have changed, but you might want to check it out before you go too far down the road to changing your mind. I'm a retired Air Force MSgt's wife, and in checking the Tricare handbook online, it still says gastric banding isn't covered. Note: when they refer to "vertical banded," they're referring to a vertical banded gastroplasty, or VBG, NOT a lapband.

Here's the quote--it wouldn't let me link to it:

A TRICARE beneficiary who is interested in having gastric bypass surgery to lose weight for health reasons needs to undergo psychological evaluation and meet one of several conditions to be eligible for the surgery.

The beneficiary first has to undergo a Gastric Bypass Surgery Psychological Evaluation, a specialized appointment for all patients being considered for gastric bypass surgery. This can involve psychological evaluation and up to one hour of psychological testing, as well as support group activities for patients both pre- and post-surgery. This specialized patient care service is part of a multidisciplinary approach and preauthorization is required.

If the psychologist determines that there are no psychological contraindications to surgery, gastric bypass, gastric stapling or gastroplasty (to include vertical banded), gastroplasty may be covered when one of the following conditions are met:

The patient is 100 pounds over the ideal weight for height and bone structure and has one of the following associated medical conditions: diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian syndrome (and other severe respiratory diseases), hypothalamic disorders and severe arthritis of the weight-bearing joints.
The patient is 200 percent or more of the ideal weight for height and bone structure. An associated medical condition is not required for this category.
The patient has had an intestinal bypass or other surgery for obesity and, because of complications, requires a second surgery (a takedown).
In determining the ideal body weight for morbid obesity (using the Metropolitan Life Table), TriWest must apply 100 pounds (or 200%) to both the lower and higher end of the weight range. Payment will be allowed when the patient meets all requirements for morbid obesity surgery, including the ideal weight within the newly determined range.

Additionally, laparoscopic procedures are distinct and different procedures from regular gastric bypass surgery. There has been some confusion regarding laparoscopic procedures with respect to what is and what is not covered. Effective Dec. 2, 2004, the laparoscopic bariatric surgical procedures are no longer excluded from TRICARE coverage and are now a covered benefit. However, laparoscopic banding is still not covered.

Exclusions:

TRICARE will not allow cost sharing for nonsurgical treatment of obesity, morbid obesity, dietary control or weight reduction. Excluded procedures include:
Biliopancreatic bypass (jejunoileal bypass, Scopinaro procedure, CPT2 procedure codes 43645, 43845, 43847 or 43633)
Gastric bubble or balloon
Gastric wrapping/gastric banding (CPT2 procedure code 43843)
Unlisted CPT2 procedure codes 43659 (laparoscopy procedure, stomach); 43999 (open procedure, stomach); and 49329 (laparoscopy procedure, abdomen, peritoneum and omentum).

AirForceWife · 02-12-2007, 11:23 AM

LisaM,

I am doing my surgery through the Walter Reed bariatric program, but having the surgery at Dewitt (it's much closer) and they have been doing Lap-Band for about a year. Everything is covered. Thanks for the insight though, I had no idea it used to be so hard for military to do this.

AirForce Wife.

lealphachienne · 02-12-2007, 11:57 AM

I think the Lap band is great for those who are on the border of qualifying for RNY......we have several people on this forum that had Lap Band...then a few years later converted to RNY.....there are risks to it all. Do your reseach and make the best infomed decidion for yourself.

My BMI was 41 when I had RNY.

Casinocat74 · 02-12-2007, 02:46 PM

Hello and welcome!!! I am a LAP band failure scheduled for bypass next week. I only lost 15 pounds after my LAP band surgery in December of 2005. I am one of about 150 patients at my surgeons office that is having this revision. I feel like I wasted an entire year when I could have just done the bypass and not worry about it. Honestly the decision is really up to you. If you are not comfortable having the bypass, then I say do the band. Weigh your options, read and read and read, that's what I did. Good luck to you, and remember that there is no rush.

Debz · 02-12-2007, 04:23 PM

Hi and welcome. I had a VBG in 1988. It was successful for approximatly 7 years. My staple line has broken, and I have regained all of my weight, plus some. I am now pre-op and have chosen RNY because, having lived with a simply restrictive procedure, I don't feel they really work. You can always find a way around it.

One of the things that makes RNY more attractive to me is dumping syndrome. With the band, you can eat as much sugary stuff as you'd like. My surgeon told me that if you're the kind of eater that just likes huge portions, the lap band may be an option. If, however, you like sweet fatty things, you'd be better off with RNY. The whole idea of having the band with the possibilty of having to revise later turns me off. Just my thoughts...good luck with your decision.