January 28, 2009

First Fill and Lapband vs. Gastric Bypass

I had my first fill on Monday. I am so excited to be on the next phase of the band. Since this was my first fill the doctor requested that I have my fill done under fluro. I wasn't exactly sure what to expect and I was a little nervous going into the appointment but more excited than anything else. I laid on the hospital table and the doctor clean the area with some antiseptic cleaner. He then had his assistant turn on the fluro to locate exactly where to insert the needle to find my port. It took him a few attempts until he found just the right spot. All I felt was a tiny prick and a few seconds later I was done. I sipped a little water to make sure I had no problems swallowing, which I didn't. That was it. I'm now on day 3 after my fill and I'm not really feeling anything different. I need to follow a full liquid diet for the rest of today and then soft foods tomorrow. I'm hoping that when I get back to normal foods I will notice a difference.

I also wanted to talk about the difference between the Lap Band and the Gastric Bypass today. I've had quite a few people ask me the difference or automatically assume that the lap band is the Gastric Bypass. The Lap Band is still pretty new to most people that they aren't really sure what it is and what it isn't.

The Gastric Bypass:

The Gastric Bypass can be done either through full incision surgery or through laparoscopic surgery. The surgeon makes a small pouch from your stomach and cuts away the rest of the stomach. They then cut away about 6 feet of your intestines and then attach your stomach to the now shorter intestines. The remaining stomach and intestines stay in your body.
Here is a bulleted list of the Gastric Bypass:
  • Time Tested
  • Complex Operation, multiple areas of abdomen involved
  • Cutting and stapling of stomach and bowel are required
  • Rapid weight loss over 3-6 months, settling at final weight 10-16 months after surgery
  • Portion of digestive tract is bypassed, reducing absorption of essential nutrients, requiring long term supplements
  • Dumping syndrome (intolerance to sugars and some carbs)
  • Not reversible
  • No significant hardware in body
  • Mortality rate: 0.5%3
  • Total complications: 23%
  • Major complications: 2%
  • Most common include:
    Standard risks associated with major surgery
    Nausea and vomiting
    Separation of stapled areas (major revisional surgery)
    Leaks from staple lines (major revisional surgery)
    Nutritional deficiencies
  • Higher perioperative mortality rate than LAP-BAND® Adjustable Gastric Banding System

The Lap-Band:

The Lap band is performed by laparoscopic surgery. My surgeon made 5 small incisions. They create a small pouch at the top of your stomach with the band. Attached to the band is a tube that leads to a port. The port is adhered close the outside so the doctor can access it later on. You'll need to have fills or adjustments to make the band tight enough to give you restrictions. It's the fills/adjustments that make the band work correctly. Without the follow up care, your band will not work as designed.

  • New Technology
  • Simpler operation, gives lower risk around surgery (less chance of death or prolonged hospitalization)
  • Lower short-term mortality rate than gastric bypass2
  • Slow and steady weight loss (1-2 pounds per week), settling at final weight around 2 years after surgery
  • No stomach stapling or cutting, or intestinal rerouting
  • Possible deficiencies due to decreased intake, long-term supplements also recommended
  • No dumping syndrome
  • Reversible
  • Long Term plastic material in body
  • The Band must be adjusted for best success
  • Mortality rate: 0.05%3
  • Total complications: 9%5
  • Major complications: 0.2%5
  • Most common include:
    Standard risks associated with major surgery
    Nausea and vomiting
    LAP-BAND® System slippage
    Stoma obstruction

When you decide to go the route of gastric surgery, you need to decide which operation is better for you. I have thought long and hard about this before deciding to go with the Lap Band. I know a few people who had the Gastric Bypass. Some personally and some celebrities. I have watched them lose their weight and most have kept it off. Although there are a few who didn't keep it off and started gaining their weight back. I have also read the stats on deaths and complications. For the past 6 years or so I have asked myself if my weight problem was worth the chance of complications, mainly death. Each time i asked myself that question, I always answered myself with a "Hell No". When the lap band came along, I started doing some reading online about this new procedure. After reading that the risk levels were far less than the Gastric Bypass, I knew that this might be my answer. I thought long and hard about the commitment this new procedure requires; Long term eating healthy, continued care after placement of the band, eating smaller portions and having weight loss fall off slower than the bypass. After al ot of thought, I made the decision to go with the lap band. I am very happy with my decision and know that I made the right one for me.

I have heard stories about people who didn't succeed with the lap band. After listening to their stories, I soon came to realize that it wasn't the lap band that failed them, but themselves. They didn't listen to what their doctor told them. You have to follow up with your doctor, you have to continue getting fills until you reach the point where the band is working correctly. You have to eat correctly. You can always find things to eat that won't bother your band but aren't good for you - like chocolate, ice cream, high calorie drinks. If you don't listen to your body, eat healthy, exercise and follow your doctor's directions - you may not succeed. I know that there are times when you can follow your doctor's orders and do everything you're suppose to and things can still go wrong. Most of the time though, you'll find that it was bad choices made by the individual, rather than the surgery itself.

The Lap Band and Gastric Bypass are not for everyone. Each person needs to weigh their options and then make the best decision for them. What might work for me, might not work for you. Plus, what worked for you, might not work for me. We must all respect each person's decision.

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