Re: DS or Lap band?

July 22, 2001

HI SUSAN

Sounds like you have a fine surgeon. The most important point for me

in my decision to have the ds was..........AMOUNT OF WEIGHT KEPT OFF

OVER THE LONG RUN " . My research indicated no procedure or diet nor

drug works better than the bpd/ds!!!!

I am 25 days postop, lap revised to open with only a 3 and 1/2 inch

incision, but 8 hour surgery. Went back to work after two and a half

weeks. Feel great, and am amazed how good everything is. Just saw Dr.

Herron for three week check up and down almost 38 lbs.

Wish you the best in you journey and remember..... How quick or easy,

is not what is paramount. What takes the most weight off, keeps it

off the longest, and has the best quality of life....is.

regards

dan berman

> I am cross posting this to the DS and bandster lists in the hopes

that

> somebody can give me some insight.

>

> I finally saw my surgeon for a consult just last week. We talked

a long

> long time about the DS. We discussed the RNY very briefly and both

> dismissed it. She brought up the lap band. She made it very clear

that I

> can have the DS if I want it. She also wanted me to consider the

lap band,

> and after thinking it over, I am going to go with that. Her stated

reasons

> were that I am not that large (288) and am about 140 lbs

overweight, that DS

> would lose about 85% of my excess weight and the band about 65% but

that in

> practical terms that means 120 lbs versus about 100 lbs (my math,

not hers,

> which is a heck of a lot better). I could have the DS. It is a

major

> operation, there can be complications, like leaks, which can be very

> dangerous. I would be under general for 3-4 hours during surgery,

spend 3-4

> days in the hospital and have it lap and have an excellent chance

at a good

> surgery without problems. I could do the lap band, be off the

table in 1

> hour, out of the hopsital the next day, also do it lap. Procedure

wise the

> difference is considerable and if the band does not have the

desired effect

> I can get a DS in the future.

>

> I know there are considerable differences in terms of what you eat

> afterward. A good friend who had a DS tells me that the DS is

better suited

> to how I like to eat. I am concerned about cormorbs (sleep apnea,

> hypertension etc) more than losing extra weight for looks and this

is a time

> when I could handle the band and those restrictions easier than I

could

> handle a major abdominal surgery.

>

> Anybody have any advice? I'd appreciate any thoughts.

July 22, 2001

I am not sure if this is the same procedure I read about, but I

believe I read that a lot of people had to go back and have them

removed. The bands were slipping and causing problems. Also that the

weight is more likely to come back. It is almost unheard of for a DS

person to gain their weight back. That is one of the main reasons I

have chosen the DS. I haven't had the surgery yet, my date is in

August.

Good luck with your decision,

Maggie

> I am cross posting this to the DS and bandster lists in the hopes

that

> somebody can give me some insight.

>

> I finally saw my surgeon for a consult just last week. We talked

a long

> long time about the DS. We discussed the RNY very briefly and both

> dismissed it. She brought up the lap band. She made it very clear

that I

> can have the DS if I want it. She also wanted me to consider the

lap band,

> and after thinking it over, I am going to go with that. Her stated

reasons

> were that I am not that large (288) and am about 140 lbs overweight,

that DS

> would lose about 85% of my excess weight and the band about 65% but

that in

> practical terms that means 120 lbs versus about 100 lbs (my math,

not hers,

> which is a heck of a lot better). I could have the DS. It is a

major

> operation, there can be complications, like leaks, which can be very

> dangerous. I would be under general for 3-4 hours during surgery,

spend 3-4

> days in the hospital and have it lap and have an excellent chance at

a good

> surgery without problems. I could do the lap band, be off the table

in 1

> hour, out of the hopsital the next day, also do it lap. Procedure

wise the

> difference is considerable and if the band does not have the desired

effect

> I can get a DS in the future.

>

> I know there are considerable differences in terms of what you eat

> afterward. A good friend who had a DS tells me that the DS is

better suited

> to how I like to eat. I am concerned about cormorbs (sleep apnea,

> hypertension etc) more than losing extra weight for looks and this

is a time

> when I could handle the band and those restrictions easier than I

could

> handle a major abdominal surgery.

>

> Anybody have any advice? I'd appreciate any thoughts.

July 22, 2001

My understanding is that 25 percent of the patients in the LAP-BAND

trials had the band removed. That's a pretty high failure rate and one

that makes me wonder why the FDA even approved it.

L.

> I am cross posting this to the DS and bandster lists in the hopes that

> somebody can give me some insight.

>

> I finally saw my surgeon for a consult just last week. We talked a long

> long time about the DS. We discussed the RNY very briefly and both

> dismissed it. She brought up the lap band. She made it very clear that I

> can have the DS if I want it. She also wanted me to consider the lap band,

> and after thinking it over, I am going to go with that. Her stated reasons

> were that I am not that large (288) and am about 140 lbs overweight, that DS

> would lose about 85% of my excess weight and the band about 65% but that in

> practical terms that means 120 lbs versus about 100 lbs (my math, not hers,

> which is a heck of a lot better). I could have the DS. It is a major

> operation, there can be complications, like leaks, which can be very

> dangerous. I would be under general for 3-4 hours during surgery, spend 3-4

> days in the hospital and have it lap and have an excellent chance at a good

> surgery without problems. I could do the lap band, be off the table in 1

> hour, out of the hopsital the next day, also do it lap. Procedure wise the

> difference is considerable and if the band does not have the desired effect

> I can get a DS in the future.

>

> I know there are considerable differences in terms of what you eat

> afterward. A good friend who had a DS tells me that the DS is better suited

> to how I like to eat. I am concerned about cormorbs (sleep apnea,

> hypertension etc) more than losing extra weight for looks and this is a time

> when I could handle the band and those restrictions easier than I could

> handle a major abdominal surgery.

>

> Anybody have any advice? I'd appreciate any thoughts.

July 22, 2001

> I am cross posting this to the DS and bandster lists in the hopes that

> somebody can give me some insight.

, I think when you're considering two procedures that are so very

different, it behooves you to really do some serious self-examination,

in order to determine which method will best fit for your needs.

The DS surgery does have the best reported percentage of excess weight

loss maintained over the long term. At the same time, this procedure

those include a malabsorptive component that requires lifelong diligence

with regard to vitamin supplementation and aftercare. The DS surgery is

comprised of a moderately restrictive component as well as a moderately

malabsorptive component. The restriction is not nearly as extreme as you

will have with the Lap-Band. Those of us choose the DS procedure

generally do so because we feel that the postoperative quality of life

is the best. We can truly live and eat very normally. I haven't lived

the Lap-Band, so I can only give you my perception of the procedure and

the reasons that I dismissed it for myself:

1.) I didn't want an extreme level of food restrictions. (Lap-Band

enthusiasts may poo-poo this concern by saying that the band is

adjustable to your level of comfort -- but honestly, what if your level

of comfort with the band doesn't give you the weight loss you hope for?

Then, you might be stuck feeling like you're on a diet forever. I would

hate to be left having to choose between the lesser of two evils:

unpleasant diet restrictions, or unsatisfactory weight loss. It's just

not a place that I wanted to be after making the tough decision to go

forward with WLS.)

2.) I simply wasn't comfortable with the idea of having a foreign

material placed around and squeezing my stomach tissue. (I had read of

too many ugly complications from band erosion, stomach erosion, etc. for

my comfort.)

3.) The clinical data was not very compelling. The best percentage of

long-term excess weight loss than I could turn up was something like

60%EWL, and a more often poorer than that.

As I said, it's a very individual thing. The fact that the band was less

invasive was attractive to me, but in the final analysis, I opted for

the procedure that I felt would give me the BEST result. My age and diet

history and self-analysis had a lot to do with it. I was 38 when I had

this done, and I didn't want to find myself 5 years down the road

looking back at a failed WLS and more years of my life wasted in failure

mode. I knew that I was not a volume eater, so I was not convinced that

a purely restrictive procedure would work for me. I have never been a

" whole bag of cookies " person. I just had a body that held on to every

morsel and turned it to fat! My never-been-fat sisters grew up with the

same diet as me, yet they stayed thin. I took me a while to accept that

I wasn't doing anything so wrong and bad! My bad diet choices were no

worse than anyone else's bad choices in the world. I wasn't perfect, but

my body wanted more than perfection. I would have had to be a paragon of

diet virtue day in and day out in order to get or keep any weight off. I

just didn't want to live that way. I was convinced that my metabolism

was broken, and that the malabsorption was the fix that I needed. I

didn't want an option that would make dieting easier; I wanted an option

that would set me free with regard to food! Thank god, the DS procedure

has been it for me. Now I'm getting verklempt. :-) But it's true.

You need to sit down and honestly assess yourself. What type of eater

are you. What do you need to succeed? What can you be happy living with

forever and ever? For me, the idea of taking supplements and monitoring

my blood lifelong was MUCH LESS scary than the idea of failing again.

Maybe for you, you want to give the less invasive option a try and hope

for the best, but be prepared to take a more " drastic " step if it

doesn't pan out like you hope. Only you can make that decision. Best

wishes to you -- please feel free to ask if you have any other questions

on the DS.

Hugs,

M.

---

in Valrico, FL, age 38

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

_________________________________________________________

July 22, 2001

,

The lap band was only recently approved though it has been used in

Europe for many years. The lap band is purely restrictive, and most

restrictive procedures have problems with late weight gain. The VBG

is infamous for late regain and even the RNY has some late regain.

The BPD/DS has almost no late regain.

Of cousre you can have the band removed and change to the BPD/DS down

the road, but consider that revision surgery is much more difficult

because of the adhesions. You chances of developing a leak if you do

the BPD/DS as your first major surgery are almost nil. Dr. Anthone

reports 1 leak on a " virgin " stomach out of over 600 procedures. The

leak rate is several percent in revision surgery.

Each procedure has its complications. The quick recovery time of the

band is certianly attractive. I choose the BPD/DS because I only

want to do this once. My wife had the Fobi pouch, and she has had

some weight regain (not bad). My father-in-law also had the Fobi

pouch and regained about 1/2 of his lost weight. He then converted

had the procedure converted to a distal one, and he has all the " fun "

of BPD/DS and RNY + Fobi!

I guess the band is probably the easiest to revise. In that sense it

I would prefer it over the RNY, since revision of that procedure to

BPD/DS is very difficult.

Good luck,

Hull

> I am cross posting this to the DS and bandster lists in the hopes

that

> somebody can give me some insight.

>

> I finally saw my surgeon for a consult just last week. We talked

a long

> long time about the DS. We discussed the RNY very briefly and both

> dismissed it. She brought up the lap band. She made it very clear

that I

> can have the DS if I want it. She also wanted me to consider the

lap band,

> and after thinking it over, I am going to go with that. Her stated

reasons

> were that I am not that large (288) and am about 140 lbs

overweight, that DS

> would lose about 85% of my excess weight and the band about 65% but

that in

> practical terms that means 120 lbs versus about 100 lbs (my math,

not hers,

> which is a heck of a lot better). I could have the DS. It is a

major

> operation, there can be complications, like leaks, which can be very

> dangerous. I would be under general for 3-4 hours during surgery,

spend 3-4

> days in the hospital and have it lap and have an excellent chance

at a good

> surgery without problems. I could do the lap band, be off the

table in 1

> hour, out of the hopsital the next day, also do it lap. Procedure

wise the

> difference is considerable and if the band does not have the

desired effect

> I can get a DS in the future.

>

> I know there are considerable differences in terms of what you eat

> afterward. A good friend who had a DS tells me that the DS is

better suited

> to how I like to eat. I am concerned about cormorbs (sleep apnea,

> hypertension etc) more than losing extra weight for looks and this

is a time

> when I could handle the band and those restrictions easier than I

could

> handle a major abdominal surgery.

>

> Anybody have any advice? I'd appreciate any thoughts.

July 23, 2001

I have to agree with , I am surprised and disappointed in any

surgeon that would move from the DS to a Lap Band. If your weight does not

indicate a DS then the most reasonable medium would most likely be a

Roux-en-Y gastric bypass.

For more information

www.obesitysurgerybook.com

G. Woodward, MPH, LCEP

Live Light, Program Director