LAP-BAND with gastric plication

well the way my doctor explained it to me was it is alot like the sleeve without all the same risks and they do not use staples they use stitches and there is no cutting at all  and its not a complete gastric plication only a modified verison to almost guarentee no slippage and just like the lap band is reversible it is not permanent like the sleeve my doctor has done several now i have done as much research as i can find on this but yes it is new so they dont have alot of statistics on it but i feel for myself i am going to have it done along with the band but as with all weight loss surgery u must do tons of research and determine which one will be best for you

Here are my concerns.  How is gastric plication different than the stomach stapling?? 


Also I would want to know how they expect the band to stay in place.  I would really be concerned about the band slipping!! Is there a increased rate of band slippage with the plication. 

Lots of concerns.

Please do your research on this.


Tamara

 Thank you all for all the input. It is certainly a mixed bag of opinions on the procedure. My doctor explained too that it is modified sleeve -like procedure. The statistic he told me was about a 1% chance of band slippage. I look forward to talking to other people who have elected to have this done. 

I had band over plication surgery in January. I could not do the sleeve because my insurance would not cover it. So my surgeon highly recomended the band and plication since my insurance would cover the band. He said the results of this surgery closely resemble that of the sleeve. I was the 3rd patient to have this done at that hospital. My surgeon has studied and done plication for several years. The combo of the band with plication is what was newer for them.. I have lost over 50 lbs since surgery and have had no complications so far. I am feeling great and doing things I haven't done in years such as walking. I am happy with my decision. No regrets t all.

here's the link to the video:

https://weightloss.clevelandclinic.org/WhatisBariSurg1.aspx

After you watch it check out their video about the realize band.

Here is some info about the surgery:

https://weightloss.clevelandclinic.org/gastricplication.aspx

Here is the results of a study done about plication:

https://weightloss.clevelandclinic.org/images/file/Articles/ Laparoscopic%20Gastric%20Plication_inpress.pdf

Although this info only talks about plication it really halped me with my decision. I knew that the lap band had been done for several years so that part didn't concern me as much.

 Thank you for those links airhead! Very informative and helpful site for me to share with friends and family to explain what I am having done. 

How much pain would you say you experienced the first week post-op?

A majority of the pain was for the first three days post-op. It wasn't unbearable but I was sore. I don't think it would have been nearly as bad if Mother Nature hadn't visited the night before surgery. That time of the month is always extremely painful for me without having surgery. After the first few days it was more discomfort & nausea rather than pain. I think I would have felt better had I been at home. But, since I live 3 1/2 hours away from the hospital where the surgery was performed, I stayed in a hotel on campus for a couple of days until my post of appointment per my surgeon's request. they had me up and walking the evening of my surgery. Walking isn't something I do often but I was able to do it. It definitely helps to walk to alleviate the gas pains. Sorry I didn't answer you sooner. We had a hail storm yesterday and it knocked out our power until this morning. :( 

Hi Lisa,

I'm glad to find someone else local that is looking at the same procedure I am.  I also think it's important to find as much information as possible to make my decision, but living in the RTP area I guess I also expect for "new" or "young" procedures to be common since we have several major university hospitals....so I guess I'm trying to say that if my surgeon has only performed the surgery five times, I would not discount it immediately (as another poster felt).  It's really a personal thing I suppose about what you are comfortable with.  I don't think either direction is "wrong".

That being said, are you using Dr. Yoo at Duke Raleigh?  I just had my consult with him two weeks ago and after discussing all the options he brought up the plication as well.  It would be nice to find some more "first hand" folks...and even more research.

The biggest confusion I have is that when I find plication online, it seems to refer to folding the stomach and stitching it....and I had the impression the stomach wasn't actually folded over...but I may be remembering incorrectly already.  The other thing that I can't cohoborate online is that when my surgeon was telling me about a study comparing the plication to the sleeve...he mentioned how the stiches were meant to dissolve after about two years.  This was making the plication a success at first, but not offering enough support for long term weight loss, so plication was being viewed as a failure.  Pairing it with gastric banding gives the patient the sleeve-like weight loss upfront, while offering the long-term help of the band in an attempt to help the patient maintain weight loss....or at least that's how it is as I understand it!

I'm eager to learn more, and will certainly share anything else I find out.

Cheers!
Heather

Heather,

I am having my lap band with plication done at Duke next week.  I have worked in the medical field for 37 years (part of the time working in clinical trials) so I know the amount of regulation any new research or procedure goes through.

The plication is similar to the very old stomach stapling. The outer curve of the stomach is imbricated (the middle is tucked in) and sutured to hold it there. The normal risks are associated with bleeding due to severing the blood supply to the outer stomach curve (it still has other blood supplies). I asked if there were higher risks of ulcers at the suture sites or problems with food getting stuck in the folds and was told no to both of those.

The plication is being done as a separate surgery. It is also being done as a combination surgery with the lap band. With the band, they are already doing a form of Plication when they surgeon pulls/folds part of the greater curve of the stomach up over the band and sutures to keep the band in place. In the band with Plication combination procedure, they go another step and fold the remainder of the outer curve of the stomach in, and suture. The end result is similar to a vertical gastric sleeve (without removing part of the stomach). The weight loss results are coming back to be higher than lapband alone (40-50% excess weight at 1-2 lbs per week), and more along the results of vertical sleeves (76% and a more rapid weight loss) (a higher % lost at a faster rate) than the band alone. It has the benefits of the vertical gastric sleeve without removing part of the stomach muscle.

Unlike the other surgeries, it is (somewhat) reversible in that the band can be removed and the sutures can be removed so that the stomach regains it's original size/shape.

Every surgery has risks, but so does being overweight. In my case, the benefits outweigh the risks so I'm having it done next week.

janet

Hi Janet!

Thanks for your further information!  It's nice to meet others that are also doing the plication I am.  Everyone assumes I am always referring to the plication in which the band is secured to the stomach to lessen slippage.

I hope your surgery and recovery goes well.  I'm scheduled for July 11th, at Raleigh Duke with Dr. Yoo.  Please keep us updated!

Heather