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There was a time when lap band was the shiny new object in bariatric surgery, a purported solution to obesity that seemed practical, sensible, and convenient. After its approval by the U.S. Food and Drug Administration in 2001, the lap band’s popularity surged. But recent statistics show that this weight loss option has lost its luster, amid controversy and questions about its long-term effectiveness.
As a world-class bariatric surgeon, Dr. Guillermo Alvarez has never recommended lap band to patients. At the Endobariatric medical facility he founded, located in Mexico across the border from Texas, he specializes in gastric sleeve procedures. The popularity of this procedure has risen dramatically in recent years because it yields provable, real-life results for obese clients.
The American Society for Metabolic and Bariatric Surgery tracked the comparative popularity of bariatric surgical options from 2011 to 2015. During that time, the percentage of bariatric surgeries that were gastric sleeve procedures rose from 17.8 percent of the total to 53.8 percent. Meanwhile, the percentage of lap band surgeries dropped from 35.4 to 5.7 percent. In this same period, gastric bypass declined from 36.7 to 23.1 percent.
Studies have followed patients who have had each type of bariatric surgery and found gastric sleeve to be more successful for a wider variety of patients. On average, gastric sleeve patients lose weight more quickly. Moreover, at the two-year mark, they have lost about 18% more weight than gastric lap band patients.
Overall, dietary limitations are stricter for gastric lap band patients. Many patients prefer gastric sleeve since it does not involve maintaining a foreign object inside their body. With gastric lap band, patients must attend monthly appointments for the first year following surgery so that a doctor can adjust the band. On the other hand, gastric sleeve patients only must undergo a single procedure.
Gastric lap band involves an intestinal bypass. Gastric sleeve does not, and therefore avoids the potential complications associated with intestinal bypass. Potential risks for gastric lap band surgery include blood clots, hiatal hernia, nausea, GERD (gastroesophageal reflux disease), bowel perforations, indigestion and gallstones. Sometimes, a second surgery is necessary to address these complications or repair the band; in fact, the rate for reoperation is particularly high.
Gastric sleeve has the lowest complication rate of any bariatric surgery procedure, with Dr. Alvarez’s record being well below the industry average. Furthermore, it is suitable for patients who are not considered good candidates for other types of bariatric procedures: patients with heart conditions, hernias and mild obesity are usually cleared for gastric sleeve because it does not affect how the stomach functions.
Mexico currently ranks as one of the safest destinations in the world for medical tourism patients. Because the Endohospital sits just eight blocks away from the United States border (Eagle Pass, Texas), it is accessible to patients who wish to drive, as well as those who wish to fly. The immediate community is famously safe, and many patients choose to take the shuttle we provide to visit the local shops and restaurants.
Dr. Alvarez designed the Endohospital entirely around the idea of providing safe, efficient gastric sleeve surgery to his patients. The facility has hospital rooms, labs, a radiology center and a cafeteria so that it can quickly respond to a patient’s needs as they arise. Our staff members are bilingual in English and Spanish and are happy to respond to all requests. Security guards surveil the premises at all hours of the day.
Endobariatric is one of a few facilities worldwide to have earned the “Center of Excellence award from the Surgical Review Corporation for bariatric and metabolic surgery. Recognized for our “excellence in safety, efficacy & efficiency,” we strive to continue living up to that pledge for all of our patients — past, present and future.
Below, Dr. Alvarez answers questions about lap band’s costs and risks, and compares the procedure with gastric sleeve:
At first glance, the thinking behind the lap band does seem logical: If a silicone band is surgically attached to the upper portion of the stomach, sectioning off a small “pouch” that will store and digest food, patients should feel full more quickly, and therefore want to eat less.
In reality, the result is quite different. Unlike other options, including gastric sleeve, gastric bypass, and gastric balloon, the patient will still feel hungry with the lap band but will find it uncomfortable to satiate this hunger. That sometimes leads to the adoption of unusual diet patterns, such as eating large quantities of soft foods to avoid unpleasant sensations lap band patients often feel with foods of normal texture, and then vomiting what has been consumed to relieve discomfort. Clearly, this is not an ideal lifestyle choice.
Patients who choose lap band lose less of their excess weight over time and regain weight faster compared with gastric sleeve, the preferred procedure that reduces the size of the stomach while also removing the fundus, where the hunger-inducing hormone ghrelin is produced.
While gastric sleeve naturally suppresses the urge to overeat, lap band seeks to restrict calories by negative reinforcement: Eating becomes uncomfortable, especially with certain foods, and may lead to difficulty swallowing and bouts of vomiting, indigestion, acid reflux and nausea. This makes eating unpleasant, but because a strong appetite remains, patients often find creative (and unusual) ways to consume the calories the body still craves (e.g., bowls of mashed potatoes or numerous milkshakes). Nausea and vomiting are rare with gastric sleeve, and there are no hunger pangs throughout the day.
Lap band placement may take less time in the operating room, but a 2017 study published in the Journal of the American Medical Association showed that lap band patients frequently need follow-up surgery. Researchers reviewed data from 25,000 lap band patients over a 16-year period and found that 20 percent needed additional surgery, compared with 3 to 9 percent for gastric sleeve and gastric bypass.
Second surgeries frequently involve the need to remove the lap band because of leaking, slippage of the band, esophageal dilation, hernia, blood clots, perforated bowel, or other problems with bowel function. More than half of lap bands are removed within 10 years of the initial surgery. Sometimes the second surgery is an emergency procedure when slippage of the band causes extreme pain.
If you would like to learn more about the gastric sleeve surgery, we invite you to request a free consultation with experienced Texas and Mexico bariatric surgeon Dr. Guillermo Alvarez by calling 1-800-381-8115 (toll-free) or filling out our online contact form today. Dr. Alvarez is extremely accessible to patients on both sides of the border and offers convenient transportation options from San Antonio and other Texas cities.
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