Both the Lap Band and Gastric Sleeve surgery is done laparoscopically while the patient is under general anesthesia. Laparoscopic surgery simply means that the procedure is conducted through small incisions into the abdomen rather than a larger open incision. To begin surgery, a few small incisions are made in the abdominal wall for the insertion of long, thin surgical instruments including a narrow camera. This camera allows the surgeons to view the operative site on video monitors. Following laparoscopic surgery, most people feel much less pain than after more invasive methods of open surgery.

Compare Gastric Sleeve vs Lap Band Side by Side

 

Lap Band Procedure

“An adjustable and removable plastic band placed around the upper stomach dividing it into a tiny pouch above the band with the remaining stomach below.”

The band is placed around the upper part of the stomach forming a small pouch using the preferred Pars Flaccida technique to ensure the band remains in place without slippage. To complete the procedure, Dr. Kuri uses sutures to close the incisions that absorb under the skin with time naturally.

Lap-Band® surgery does not involve partial removal or the stomach nor bypass of intestines, and it is reversible if needed. The Lap-Band® simply limits the amount of food you can eat by providing an early sensation of fullness and maintaining satiety (satisfaction). It does not affect your ability to absorb the nutrition your body needs. With the Lap-Band’s unique feature of being adjustable we can change the amount of restriction you have at any time with a simple office procedure.

IMPORTANT SAFETY STATISTICS:

Mortality rate: 0.05%

Total complications: 9%

Major complications: 0.2%

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Gastric Sleeve Procedure

During sleeve gastrectomy, the surgeon will remove the larger, rounded part of the stomach from the body. (This is the only gastric surgery in which part of the stomach is taken out of the body.) The remaining stomach looks like a sleeve (or hose or tube) and holds about 50 t0 150ml. or about the size of a banana.
By removing up to 85% of the stomach including the portion that produces Ghrelin an appetite hormone, it works by reducing the size of the stomach as well as suppressing appetite. This procedure is also performed laparoscopically. . It is well tolerated and does not require adjustments like the Lap-Band and may be an additional option for patients who may have limited access for getting adjustments for a Lap-Band or are unable to tolerate needles.

The Gastric Sleeve (Vertical Sleeve Gastrectomy) is a “Happy Medium”
One of the reasons that the Lap-Band became so popular since its FDA approval in 2001 is because it was shown to have a lower risk of complications than the Gastric Bypass (RNY) which was the “gold standard” at that time. Although the Gastric Bypass resulted in more rapid weight loss, many opted to go with the Lap-Band simply due to the decreased risk of complications. Shortly after the Gastric Sleeve procedure was introduced, however, it was revealed that it may often help patients lose weight even faster than with the Lap-Band, while having fewer complications than the bypass. This is a combination of benefits that makes it a good choice for many bariatric patients seeking a middle-ground surgical option.


IMPORTANT SAFETY STATISTICS:


Mortality rate:
0.39%

Total complications: 22%

Major complications:
1.9%

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How long does the procedure take? (Lap Band)

The procedure is routine and only takes approximately 25 minutes.
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How long does the procedure take? (Gastric Sleeve)

The gastric sleeve procedure takes approximately 1 hour.
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How would you describe the procedure? (Lap Band)

The lap band is placed around the upper part of the stomach to form a ring. It is locked and secured with minimal stitching.
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How would you describe the procedure? (Gastric Sleeve)

During sleeve gastrectomy, the surgeon will remove the larger, rounded part of the stomach from the body. (This is the only gastric surgery in which part of the stomach is taken out of the body.) The remaining stomach looks like a sleeve (or hose or tube) and holds about 15 percent as much food as the original stomach.
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Is the procedure reversible? (Lap Band)

Yes! One of the unique features of the Lap Band is that it is reversible and adjustable – it can be removed completely, or adjusted for the desired rate of weight loss.
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Is the procedure reversible? (Gastric Sleeve)

No, the gastric sleeve is permanent and not reversible.
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How long do I have to be in the hospital? (Lap Band)

Patients are discharged the day after surgery and can return to work with no heavy lifting after just a few days.
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How long do I have to be in the hospital? (Gastric Sleeve)

2 nights in the hospital, 3 nights in a hotel.
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How quickly can I return to normal activities? (Lap Band)

Patients recover faster and are able to resume normal activities sooner than other methods of weight loss surgery.
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How quickly can I return to normal activities? (Gastric Sleeve)

After the surgery, patients usually incur intense pain, swelling, and discomfort which lasts a few weeks. Most patients can resume normal daily activities after one week.
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Are there any major health risks I should be concerned about? (Lap Band)

Although the major risks are significantly less than other forms of bariatric surgery, possible risks do exist and include: band slippage, stretching of the pouch and erosion into the stomach. If any complications become serious, the band can simply be removed or replaced.
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Are there any major health risks I should be concerned about? (Gastric Sleeve)

Yes, as with any major surgery, there is a risk of blood clots, other complications or death:
• Complications can occur with the stapling, such as leaks or bleeding
• You may need malabsorptive surgery – intestinal bypass or duodenal switch – in addition to your sleeve gastrectomy in order to lose all the weight you need and want to lose
• The smaller portion of the stomach may stretch, causing weight gain
• Gastric surgery puts you at higher than normal risk. of developing gallstones and gallbladder disease
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What are the most common risks associated with each procedure? (Lap Band)

• Standard risks associated with major surgery
• Nausea and vomiting
• Band slippage (minor revisional surgery)
• Band erosion (minor revisional surgery)
• Access port problems (minor revisional surgery)
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What are the most common risks associated with each procedure? (Gastric Sleeve)

• 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
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What is the average cost of the procedure? (Lap Band)

Costs: $5,500.00 – $25,000.00 (Avg. $16,125.00)
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What is the average cost of the procedure? (Gastric Sleeve)

Costs: $7,500.00-$20,000.00 (average cost: $12,600.00)
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What are the major advantages of each procedure? (Lap Band)

• Promotes weight loss by restricting amount of food that can be eaten at any one time
• No stomach stapling or cutting, or intestinal re-routing
• Digestion system is not changed, and digestion goes on as normal
• Adjustable
• Reversible
• Low malnutrition risk
• Done laparoscopically (keyhole surgery)
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What are the major advantages of each procedure? (Gastric Sleeve)

Gastric Sleeve Has Hormonal Advantages
In addition to limiting the capacity of the stomach, the Gastric Sleeve also limits the amount of Ghrelin that is released. Ghrelin is a hormone released by the stomach that tells the brain that it is time to eat. In obese patients, however, it appears to be produced in greater abundance, and production appears to actually increase as an individual loses weight. When 80 percent of the stomach is removed with a sleeve gastrectomy, many of the hormone emitters that release Ghrelin are also removed. The result is a significant reduction in the persistent cravings that can sabotage long-term weight loss and maintenance.
It Involves No Foreign Objects – While the Lap-Band is a safe and effective weight loss tool, many patients may have trouble adjusting to the idea of a permanent foreign object in their body or the periodic adjustments that are often required with banding. The Gastric Sleeve, on the other hand, simply creates a stomach that is smaller without putting any permanent fixtures other than surgical staples and simple sutures (stitches) in place. The Gastric Sleeve also avoids altering the path of digestion, as is the case with the gastric bypass

• Promotes weight loss by restricting amount of food that can be eaten at any one time
• Sleeve gastrectomy may be safer than gastric bypass for patients who have a number of health risks
• It lowers the risk of ulcers compared to gastric bypass
• Unlike gastric bypass, which changes stomach openings, sleeve gastrectomy leaves the openings intact — it does not involve any bypass of the intestinal tract and patients do not therefore suffer the complications of intestinal bypass such as intestinal obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency
• Digestion system is not changed, and digestion goes on as normal
• The surgery cuts away the part of the stomach that produces grehlin, a stomach hormone that stimulates hunger
• Weight loss in the first 2 years is an average of 40-60% of excess weight
• Done laparoscopically (keyhole surgery)

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What are the major disadvantages of each procedure? (Lap Band)

• Slower initial weight loss
• Regular follow-up critical for optimal results
• Requires an implanted medical device
• In some cases, effectiveness can be reduced due to band slippage
• In some cases, the access port may leak and require minor revisional surgery
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What are the major disadvantages of each procedure? (Gastric Sleeve)

• Doctor will remove 2/3-3/4 of your stomach during surgery
• It is a permanent, non-reversible procedure
• Cutting and stapling are used
• Only restricts some solid food, and not liquid
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Either option you ultimately choose, you may be sure my team and I are all committed to your success and we’re here to support you before, during and after surgery.

Dr.Kuri