Expert: John Pilcher, MD - 6/4/2009

Question
Hi
I have researched the band and the Sleeve surgery extensively. Everything tells me that the Sleeve is by far the superior option on so many fronts. beg one time operation assuming successful no further ops no need for fills or adjustments etc etc . It appears that slippage and erosion is quite common which requires further surgery and possible removal and or replacement. It also appears that many people who have had the band removed because of complications opt for the sleeve as the next step.  Yes I know the Sleeve is more drastic and irreversible but it seems from the results so far to be superior with  few post op complications . If one were trying to think of a procedures for weight loss one I feel would intuitively conclude that the sleeve is preferable to the band option.  Yet I still can't decide  .If you were considering weight loss surgery what would you choose considering the above?

Answer
Dear Alison,
I can tell you quite honestly that educated and experienced people in our field are unable to form an opinion about which is the one "best" bariatric surgical procedure.  I agree with your research which has found a number of appealing features related to the Sleeve, but I don't think it has a long enough track record to designate it as the one correct procedure.  I would also refuse to designate the gastric bypass or the gastric band as the one correct procedure, for different reasons.

In my practice, I have settled on educating patients in a balanced and thorough way about these three procedures, and then letting them choose.  I understand you were hoping to receive the one right answer, but since you are going to live and work with this procedure (not me) the fact is that you must decide.  The good news is that a well motivated patient can have great weight loss and health improvement with any of these.

Best of luck!
Dr JP