How does Lap Band compare to Gastric Bypass (Roux-en-Y)? Listen as Dr Terry Simpson explains why the Lap Band system is superior in terms of safety, speed of recovery, and post surgery complications than Gastric Bypass.
If you are considering Roux-en-Y, make sure you see this video first.
Advancements in Surgery Make the Lap Band 10 Times Safer than Rouen-Y Gastric Bypass
Dr. Terry Simpson: I began doing weight loss surgery in 1991when I first moved to Phoenix. The first surgery I did was Rouen-Y Gastric Bypass, and I was one of the first surgeon’s in Phoenix to do it. In 1993 the Rouen-Y Gastric Bypass had its 100th anniversary. The two changes that had been made to that surgery were the advent of surgical staples brought from the Soviet Union in the 1960s and the change of the surgery from an open surgery to a laparoscopic procedure.
Also in 1993 another invention came, and medicine advances, and the invention that came from Europe was the laparoscopic adjustable band. The laparoscopic adjustable gastric band became the only weight loss surgery we did starting a couple of years ago. An let me tell you why: The main reason is because of patient safety. The surgeons were very concerned that our patients have effective and safe operations. We know there is a certain amount of morbidity and mortality with any operation that’s done, but we as surgeons want to minimize that because we want you to be safe.
Lap Band Proven Safer than Rouen-en-Y Gastric Bypass
Dr. Terry Simpson: I want to tell you why the laparoscopic band is safer. We can look at a couple of statistics, one of which is mortality, or death. Death after any surgery is one of the complications that we know can occur. When you look at death rates from the Roux-en-Y Gastric Bypass often times they will tell you it’s 1 in 200-250 that can occur, but it is actually probably more.
Roux-en-Y: Higher Rate Than What We Think
Dr. Terry Simpson: There was a study done looking at 16,500 Rouen-Y Gastric Bypasses that was published in the New England Journal of Medicine. It showed that if you followed these patients for a year, there were over 740 deaths. That’s a lot more than the 80 or 100 that you would predict if you were to extrapolate out the death rate of 1 in 100-200. That’s pretty high.
Lap Band: Much Lower Death Rate
Dr. Terry Simpson: One of the things we discovered when we started doing the Lap Band was that the patients did better immediately afterwards. We’ve never had a death from them. We found from our data as well as data from around the world, it is at least 10 times safer than the Rouen-Y Gastric Bypass. That in itself was reason enough for us to change from doing Rouen-Y Gastric Bypass to the laparoscopic, but there were a few other things as well.
Fast Recovery
Dr. Terry Simpson: We discovered that our patients got up much faster, the operation lasts less than an hour, patients are up walking around and recovering in 45 minutes, and most of them go home that same day. There are some exceptions to that, in fact, I like to joke with my patients that the ones we see staying overnight are the mothers with kids and a husband that isn’t used to taking care of them. Other than that, the primary group that we see is patients who leave the hospital that day.
They are usually driving within 72 hours and back to work in a week. There is a range, there are people who take time off of work, and people who have a little more pain, but most of our patients go home with Tylenol. That translates to a lot safer surgery.
Malabsorption a Problem with Rouen-Y Gastric Bypass
Dr. Terry Simpson: Remember, with a Lap Band we don’t cut or rearrange intestines. There is no malabsorption. A recent study showed that at one year after a Rouen-Y Gastric Bypass, 46% of patients have what we call protein calorie malnutrition.
You’ve all seen the patients who have had Rouen-Y Gastric Bypass; some of them are celebrities on TV. Carnie Wilson had it, Al Roker had it. Some of you have known someone who had it and you see this tremendous shrinkage in their bodies very, very quickly and they have a lot of plastic surgery.
Plastic surgery is an individual thing and everybody will have their own rate at which they want to have plastic surgery done, that’s something we can’t tell you that you will or won’t have. I can tell you that we’re sending out a lot less people for plastic surgery now than when we did the stomach stapling. We think the reason is this; when you have old fashioned stomach stapling, Rouen-Y Gastric Bypass, you lose muscle mass and you lose protein. If you have protein calorie malnutrition you shrink very rapidly. With the Lap Band, we don’t see that. We see a nice, gentle, sustained weight loss.
Weight Loss Comparison Between Lap Band and Roux-en-Y
Dr Terrry Simpson: There is a graphic that shows Gastric Bypass compared to the Lap Band over time. Besides safety, you want an operation that will work. Does the Lap Band work? The first few months it’s much slower than Rouen-Y Gastric Bypass. Starting at 18 months Rouen-Y Gastric Bypass patient plateaus out, meaning they stop losing weight. Then you see them starting to regain weight at about 20-24 months. What you see with the Lap Band is continual weight loss, the ability to lose weight. We think one of the reasons is because a Lap Band is adjustable and we can adjust it to your needs.
Because of safety, because of efficacy, we chose to become a practice that just specializes in the Lap Band. You aren’t going to get information from our practice about another surgery; you are going to hear about the Band. We are going to teach you about the Band. We did this because it is the safest weight loss surgery available.