Lap-Band vs. Gastric Bypass

Facts from medical studies about the effectiveness and safety of the Lap-Band vs. Gastric Bypass.

There have probably been hundreds of articles comparing the benefits of Gastric Bypass vs. the Lap-Band (or Gastric Band) written over the years. Before you go any further reading this article I will tell you in advance that this will be a Pro Lap-Band article. For some very specific and scientific reasons.

Safety

Let's start with results of independent scientific results. The Journal of the American College of Surgeons published a paper in February of 2006 which made an objective comparison of the Lap-Band vs. The Gastric Bypass. The study was performed by 5 prominent surgeons on 780 patients. Complication rates were as follows: Lap-Band was 9% of the total, Gastric Bypass 23% and Biliopancreatic diversion was 25% overall. These complications were everything from minor risks, need for blood transfusions, re-operation etc.
Lap-Band vs. Gastric Bypass Complication Rate

Now let's look at the serious complications, these complications are classifieds as resulting in residual and lasting disabilities requiring re-operation and organ resection and then complications resulting in death. The stats for these are: The Lap-Band has a 0.2% rate of serious complications, and the Gastric Bypass 2% and the Biliopancreatic diversion was 5%. What does that mean in numbers the average person can understand? Well let's do the math. Over the 780 patients in this study 235 had the Gastric Bypass and 2% had serious complication, which is almost 5 patients (4.7). In this study 1 of the 4.7 patients that had a gastric bypass died.

Lap-Band vs. Gastric Bypass Major Complication Rate
In this study 480 patients had the Lap-Band surgery of the 480 only 1 patient had a serious complication and none died. So what is the easy math? According to this study 1 in 235 that have the gastric bypass will die, and 4 more will have serious complications. In the same study twice as many had the Lap-Band surgery (480 vs. 235) and none died and only one had a serious complication. If we take those numbers and multiple them out to include a theoretical patient base of 1000 patients, then clearly 4 of 1000 Gastric Bypass patients will die and around 20 will have serious complications versus the Lap-Band procedure where none will die and 4 will have serious complications.

Weight Loss

In a study by Dr. Paul E. O'Brien published in 2006 it was determined that the Lap-Band System and the Gastric Bypass resulted in similar weight loss results after three years and as the patient approached the fourth year weight loss was identical to the Gastric Bypass and actually exceeded weight loss past year eight. Since rapid weight loss is not as healthy or as permanent as weight lost over a longer period of time this is probably a good thing.

Lap-Band vs. Gastric Bypass

The Stretch

As you may already know by looking at people who wear heavy earrings or purposely stretch their ears with progressively larger earrings you know that most any body part if put under enough strain will eventually stretch to accommodate the item. We also know this to be true when it comes to breast augmentation. Gastric bypass patients over time will experience a similar phenomenon with their stomach if they just eat a little bit more every day. The internet is covered with stories of people who have "stretched their pouch" to a point where they have achieved a full size stomach again. New procedures like the ROSE (Restorative Obesity Surgery, done Endolumenally) procedure have been created to help address issues related to Gastric Bypass patients who have stretched their stomach out to full size again. Lap-Band patients usually don't have a similar issue because the band sits higher on the stomach and over eating in an attempt to stretch the stomach pouch results in nausea and vomiting which in many cases is enough of a deterrent to keep all but the most self destructive Lap-Band patients from undermining their success.


Conclusion

So we have determined that you are at less risk having the Lap-Band surgery, you are likely to lose a similar amount of weight over 3+ years with the Lap-Band and you are less likely to stretch out your stomach pouch using the Lap-Band. Well then why are there so many folks having the Gastric Bypass? Well there are many reasons and some of them are very valid. Others reasons are not as valid. The first reason is that by in large more insurance companies will cover the gastric bypass vs. the Lap-Band. Why insurance companies don't cover the Lap-Band as often is anyone's guess and the hope is that they will see the light of day and change their reimbursement practices. The Lap-Band is cheaper, safer than and just as effective as the Gastric Bypass so why not cover it? It's also reversible, does not require intestinal rerouting and has a faster recovery time and also has dozens less side effects. More valid reasons in defense of the Bypass is that super obese patients (folks who are 200 plus pounds overweight) whose life may be in danger would benefit from the more rapid weight loss that occurs in the first couple of years with the Bypass.

Everything related to any type of surgery is full or risks and rewards, and ultimately it is your decision as to which surgery is safer, more effective and more economical for your budget. The hope is that this article shed some light on your decision making process.