Starr

Your story sounds awful and besides feeling terrible for you, I am now freaking about my upcoming surgery in February. A few questions:

How would the surgeon have prevented this from happening to you? Did the bariatric surgeon you consulted discuss what WLS would have been better besides the plication. If you had to do it over would you do something else?

You should go for the regular Vertical Sleeve Gastrectomy. I wasted time and chance focusing on the Plication. I don't believe that it will be safe long-term. I was too scared to cut my stomach and silly me, now I am empty handed. I am glad, so glad that I did not have the plication.

All the Best to you,

Leila

Hello Everyone,

I want to start off by saying I had the plication surgery with Dr. Corvala in Tijuana in July 2010. From July to mid December 2010 I had no problems. I had a quick recovery and had managed to lose 60 or so pounds. Then, in mid December, a serious complication occurred. I'm pasting below an email I sent to my patient experience manager, Courtney Talmadge, in response to an email from her asking what happened and how I was doing.

"On December 21 I went to my local emergency room (Capital Region Medical Center in Jefferson City, MO) with abdominal pain, pain in my left shoulder when I breathed in, and dry heaving. They did an xray and ct scan and found what they referred to as free air in my abdominal cavity. They also found that the contrast Fluid I drank for the procedure was leaking from my stomach into my abdominal cavity. At that time the attending physician told me I was being transported to the University Hospital in Columbia.

I was transported by ambulance to the University of Missouri Hospital. I was met there by a surgical team from the bariatrics department. I explained the procedure I had received from Dr. Corvala. The surgeons told me that I needed surgery immediately to repair a perforation in my stomach that was allowing air and fluids to pass into my abdominal cavity.

After I woke up from the surgery I was told that the perforation occurred because part of my stomach was not receiving adequate blood flow and perforated as a result. The surgeons explained that, in order to attempt to prevent future occurrence, the surgeons had loosened plication stitching. The surgeons put a tissue patch over the hole to prevent leakage and to allow the hole to heal. They told me and my family that the portion of the stomach where the hole had formed was white in color from being cut off from adequate blood flow for so long and that they had almost decided to resect that part of the stomach rather than repair it. They told me and my family that, in their opinion, it's very possible this will happen to me again in the future because of the damage to my stomach and other areas that hadn't been receiving proper blood flow.

I was in the hospital from 12/21-12/26, spending my Christmas there. It took 4 days to rehydrate my body, because the hole that had formed in my stomach had let all the fluids I drank into my abdominal cavity. I had a tube coming out of my left side abdomen to drain the fluids for the duration of my stay. I had a tube coming up from my stomach and out of my nose to drain any fluids from my stomach for the first 3 days I was there. It was a horrific and traumatic experience for me and my family.

At my follow-up appointment on January 7th I spoke with one of the bariatric surgeons at the University of Missouri Hospital in Columbia, MO about what happened. He explained to me that, due to a technical error that occurred during my plication surgery, the plication stitching had not allowed portions of my stomach to get adequate blood flow. This caused a part of the stomach to start dying and a hole formed. Also on Jan 7 I had another xray with contrast to see if there was any further leakage. The results of this test show no further leakage but that my stomach is very swollen at this time.

I am continuing to be monitored through Missouri Bariatric Services, a University of Missouri Hospital Clinic.

I believe this to be a dire complication. I was told when I came to the ER that, due to the severity of my condition I was about 24 hours from sepsis and death. It is very important that Dr. Corvala, his team, and potential patients know about this possibility. This was not mentioned to me as a possible complication of the plication surgery. In fact, I had asked about the possibility that that folding and stitching could harm the stomach and had also asked about cutting off blood flow to the folded portion of the stomach. I was told plication procedure was done in such a way as to retain the health of the stomach and that blood continues to flow regularly to the folded part of the stomach. I was also told that the plication procedure was much safer because there was no risk of leaks because no portion of the stomach is cut away and there is no staple line. Potential patients thinking of getting the plication procedure should know the possibilities."

It should be noted that I asked my surgeons here in Missouri if there was anything I did that could have caused this complication. They have informed me that this complication was not at all my fault, but due to an error committed by the surgeon (Dr. Corvala) during my plication surgery. If you decide you're interested in the plication procedure and go through Dr. Corvala I would suggest you ask him about my case.

To be perfectly honest, I'm happy with the results of my surgery. My restriction is great, my weight loss has been what I expected. However, as noted above, I almost lost my life. I wanted to share my story because when the surgery was described to me it was being advertised as a safer alternative to other surgeries and that the risk for complication was very low. As noted above, I even asked Dr. Corvala about blood flow to the stomach with the plication surgery and was told that the blood flow would be retained and the stomach tissue would remain healthy. For me, this was not the case. Please feel free to ask questions.

-Alexa Thompson

Hey Lexy. You sent me a personal message on OH the other day. I did not respond but I want you to know that I am thinking about you - a lot!

I was scheduled to have my plication in NYC with my long-time surgeon on December 20th. As my IV was being hooked up in the OR, I let my surgeon know that I only wanted my Lap Band removed. I battled back and forth with this particular surgery. I had profound concerns about the condition of stomach tissue long term due to scarring and possible circulation issues. Prior to going into the OR, my doc drafted some sort of document for me to sign. We had many, many, many talks over the months - OMG, so many. He said something about not knowing what kind of condition the stomach would be in long-term then said something about "grapes" and I thought . . . you're gonna have to amputate my stomach??? I don't know why I said that, but all the long I had been thinking about those stomach vessells being constricted, the stomach being contricted - and all that scar tissue. Sorry to tell you exactly what I was thinking but it is why I backed out.

Gosh, I am so sorry that you've had this experience and I pray that everything will remain good and stable for you and that you are able to lose all of your excess weight and be healthy for the rest of your life.

(((HUGS)))

Leila

Thank you so much for the response Dr. Watkins. It is greatly appreciated not only by me but by others who visit here with interest in the Plication. I feel very lucky that you are here. Best,

Starr

It is critically important to strengthen the hiatus when making the stomach smaller (band, sleeve, plication, etc). In essence, hiatal hernia is present in nearly 100% of overweight people. Overweight creates chronically elevated intra-abdominal pressure which dilates the hiatus.

In doing band surgeries by the thousands over the last 8 years we have learned that you have to stitch the hiatus (basically a hiatal hernia repair) in all patients, otherwise they will have terrible reflux (heartburn) after the procedure. Plication is the same way. I always repair the hiatus with plications or bands. I have talked to patients plicated by other surgeons where this was not addressed and they have terrible reflux. I have a lot of transfer patients (patients who had surgery by other surgeons) where they have a band but no hiatal hernia repair was done and they have such terrible reflux that I have had to perform a hiatal hernia repair so they could lose weight with their bands - be able to tighten it enough for weight loss.

Many surgeons say this is unecessary but my experience tells me this is not correct. Anytime you make the stomach smaller, the hiatal hernia must be addressed. What I have learned is that you have to look for the hiatal hernia. In many cases it is not obvious untill you dissect out the hiatus. Reflux after plication is preventable by good hiatal hernia repair. Even with hiatal hernia repair, if you eat too fast or eat too much after plication you can still have heartburn, but the kind of severe heartburn that occurs even after eating a small meal and chewing carefully - that is preventable with perfect hiatal hernia repair.

I also have learned how important it is to use the proper suture material and the proper way to stitch the hiatus closed. Incorrect suture or improper technique are associated with hiatal hernia recurrence which you also don't want.

Brad Watkins MD

Are one of the side effects with the plication reflux? Did you get it? How do you control?

Best,

Starr

Well, I don't have a lot of time under my "belt" , I just had band removed and plication done on Dec 1. I hope that what I've experienced so far will continue. I'm still on soft/mushie foods, but the full feeling is way more "normal". With the band, I didn't actually feel full, I just felt more clogged. Now I can eat about 3/4 of an egg, or about 2 T of mashed potato and I feel "full" very content. I found the recovery to be a little different from when I was banded. I had less pain, less nausea, but I get some odd stomach cramps now, I'm assuming thats because I am still healing in there. I have found that my stomach hates to be empty. If I throw a little something in there every 2-3 hours, and keep drinking Water, I'm fine, but if I get busy, or forget, or overnight, I get the cramps, it just feels like bad hunger, but yet, just stomach hunger, not appetite, if that makes sense. It will even wake me up at times. As far as time off of work, I was under for a lot longer with this surgery, not sure if that has anything to do with it, but it took me several days to feel like myself again. I just was foggy, and felt drugged up, even tho i hadn't taken anything since the day after surgery. I went back to work in less than a week, but really wasn't feeling up to it until 1 week post op. Now at 10 days post op, I can say I am 90% back to myself, I do tend to get tired a little more often, and I have those stomach cramps when I don't eat , well after the babble, lets see if i answered any of your questions

How is restriction with the plication compared to restriction with the Lap Band? Its soooo much better, its early, but so far, I love this feeling of restriction! I have never felt stuck, or plugged, or like i need to hurl

Do you feel your stomach? Yeah, it all feels normal, just can't eat hardly anything

How long did you need off from work? 1 week

Are liquids hard? Nope, I just can't gulp yet, that makes me too full, but liquids worked find from the beginning

Do regret this surgery? hell no, if it continues to be like this, I will be THRILLED!

Good luck, keep posting, we need some action on this board!

Karen

OMG Karen, it makes me so excited to read about your experience so far. I am hoping that my experience mirrors yours.

Thank you so very much! Lets please keep in touch.

Best,

Starr

I've not had the band but there's a person here on youtube talking about her band to plication

If you really need to get back, a week off might be OK - it depends how physical your job is and if you have much of a drive to get there.

After about 3 or 4 days liquids were pretty easy - can get down 8oz OK.

I'm only just going on to mushys and I had a couple of mouthfuls of mashed potato and wow was I full.

I'm very happy with this surgery and with my limited experience would recommend it.

Hey thanks for the response. Good to know that liquids are going down pretty easy .

Blessings,

Starr

Well, I certainly did not make up my story - and I've never had reactions to milk like that before.

Also, I do not believe my stomach was thrown in the trash. I think that would be hazardous waste? There is enough room on this board for support of all surgeries listed as support here. I don't think it's necessary to vilify one to pump up another. I have not done so, and would appreciate none others do as well.

Thank you.

Hi Irene, certainly not looking to bash your surgery at all - please not at all. There is too much negativity in the world already. I wish you nothing but success with your gastrectomy. The thing is that there is no where for Plications to go for information - I thought this was a Plication forum and it seems like most the couple of people here are gastrectomies.

ABSOLUTELY TRUE, some VSG do indeed dump. If you go on OH, you can ask on that forum. I've seen it since the early days of the VSG as a stand alone procedure. FYI, ppl who have not had any WLS at all can dump - it is rare, but it can happen.

I panicked when I saw your post about not simply lactose intolerance, but full blown dumping. I want to have a baby real soon and I want to be able to supplement my diet with skim milk and other dairy. I thought hey, if I can't eat too much, surely I'd be able to sneak in 300+ extra calories of dairy.

Please understand that there is not a place for plications and I thought this was the place. On the other site - I adore everyone, but they are not really embracing us plications. They say "fake sleeve" and how we should really specify that we don't have the gastrectomy when we post because we will give a false impression of the "sleeve" because of the faulty results we are having. They don't want pre-ops and newbies to believe they will have plication "issues". They are right to a certain extent. We must clarify our surgery types over here. Although our sleeves look the same from the inside, we are different in the "issues" we may have. A huge reason I am not having the gastrectomy is: I am anemic most my life for none of the typical reasons, I didn't want a higher possibility of dumping - I don't want to be punished, I just want to be somewhat "normal", there is nothing wrong with the removal of 80+% of our stomachs, but for me I just never could come to terms with it. And reflux scared me - I had a single dance with that with the band - again, I don't want to be punished and yes it may happen with the plication. We will see.

No weight loss surgery is perfect - very far from. My plication may fail as any of these surgeries may BUT this is the one I am chosing and this is the one I am going to stick by and do my very best for success - a normal life, a chance to eat right and exercise and keep a normal weight.

(((BIG HUGS)))

Starr

You kno

Hi Dr. Watkins!

I'm reading what sounds like "dumping syndrome". I know that some Gastrectomies can get this and it seems like even though this is the plication forum it is still mixed with gastrectomies. No doubt I will cancel my surgery if this is a possible side effect from the sleeve. I've had one foot outside the door and to hear this is scaring the heck out of me.

Okay, this one particular person just shared that she had the VSG!

Some patients develop new lactose intolerance after malabsorptive procedures (gastric bypass, BPD/DS, etc). Since the plication involves no malabsorption, theoretically you shouldn't develop lactose intolerance any more than if you had it before. In the early weeks after plication, swelling of the stomach tissue in response to surgery can make it harder to eat solid foods, but this swelling goes down typically within 3 weeks.

Real lactose intolerance typically causes crampy abdominal pain after eating dairy followed by bad gas that would impress any fraternity and diarrhea.

Brad Watkins MD

Hi Dr. Watkins!

I'm reading what sounds like "dumping syndrome". I know that some Gastrectomies can get this and it seems like even though this is the plication forum it is still mixed with gastrectomies. No doubt I will cancel my surgery if this is a possible side effect from the plication/imbrication. I've had one foot outside the door and to hear this is scaring the heck out of me.

Hi! I am glad to be here with you other VSP's!!!

Those of you that revised from Band to Plication what was your experience like? What should I expect or need to know?

How is restriction with the plication compared to restriction with the Lap Band?

Do you feel your stomach?

How long did you need off from work?

Are liquids hard?

Do regret this surgery?

And any other comments or information is greatly welcome

Thanks!

Starr

My Plication is 12/20/10

Melanieleigh, maybe you're right and it was a hoax. I sure hope so. I had my surgery, and all is well (no weight loss yet after a week, but it will happen). It's amazing what people think is 'funny' to do as a hoax, and I think you might have figured it out. If she really was sick, or even if she had died, someone would have posted that as a follow-up (you'd think so, anyway). So - I am choosing to agree with you that it was a hoax! Hope you're doing well!

Yep, I think that it is a hoax. And I've been worried about this person and scared for myself. I believe someone is doing this type of thing on OH too. They don't like the idea of the Plication! I mean there was a person posting that the plication made her hunger constant AND immediately post-op, she was eating Bagels and pizza WTH!!!