New procedure Gastric Sleeve Plication as a Revision for LAP Band

[Banding Together 0]

In reading about revision surgery for the Lap Band, I found a link to the results of a clinical study in the Bariatric Times, (reference this link: My Tiny URL - Create Tiny URL's Short URL Service) on gastric sleeve plicaiton.

Results of the report are based on post-operative outcomes for 66 patients (44 female) who had the gastric sleeve plication procedure between January '07 and Mach '10. Mean patient age was 34, with a mean BMI of 35. Follow-up visits for the assessment of safety and weight loss were scheduled for 1 week and 1, 3, 6, 12, 18, and 24 months in the postoperative period.

The study describes gastric sleeve plication (also referred to as gastric imbricaiton or laparoscopic greater curvature plication) as a restrictive technique that eliminates the complications associated with adjustable gastric banding and vertical sleeve gastrectomy -- it does this by creating restriction without the use of implants and without gastric resection (cutting) and staples.

The authors of the Bariatric Times study present gastric sleeve plication as an alternative procedure that can be as restrictive as sleeve gastrectomy with no staple line or prostheses, and as an ideal revision surgery for LAP Band based on the reduction in known complications.

The stomach is reduced by dissecting the greater omentum and short gastric vessels, as in vertical sleeve gastrectomy; the greater curvature is then� invaginated: using multiple rows of nonabsorbable suture over bougie to ensure a patent lumen.

No major complications were reported among the 66 patients. Weight loss outcomes are comparable to gastric bypass.

There isn't a lot of info out there but I did find a press release by Crospon, a medical device company, announcing the EndoFlip, a device that visually guides surgical sizing of the sleeve duirng the gastric sleve plication procedure. They call it "the perfect marriage between a new proceudre and a new technology".

There are a few US surgeons doing it - Dr. Daniel Cottam is one. The Mexico surgical hub for the procedure seems to be Hospital Angeles, in Tijuana, Mexico where Dr. Juan Antonio Lopez Corvala has performed ~50-100 gastric sleeve plications and is conducting training sessions for US surgeons beginning June 5th.

Has anyone heard of the plication? What do you know about it? Has anyone here had the procedure? Please share!

[RaeZur 0]

At my First Weight Loss Seminar (5/12/10), my surgeon spoke very highly of this procedure. He said it was a happy medium between the two methods that exist. He also said that by next year he thinks about 90% of insurance companies should be paying for this surgery. This is due to the success rate and small rate of complications. I am excited about it, but really want the lap-band..maybe this will be a replacement once I get the weight off with the lap-band.

The only part that disturbs me about the procedure is that they do remove a portion of your stomach, so it is irreversible. Other than that, it seems very promising.

Good Luck to you whatever your choice may be!

Edited May 21, 2010 by RaeZur

[Sunshine79 0]

Yeah I just found out about the sleeve a couple weeks ago. Unfortunately my insurance company does not yet cover it(just bypass and band) and since I'd already been approved for the band and given a surgery date, I just went with it and was banded last Thursday.

To be honest, had they covered the sleeve, I would have gone with that. Especially when I read about getting stuck and PBs and sliming and erosion and slippage. There are just fewer complications with VSG and there are almost no food restrictions, you just can't eat much. Maybe I jumped the gun and should have waited until it was approved, I don't know. But the good thing is that if I do have complications in the future, I can always revise to the sleeve and it will probably be covered by then.

[RaeZur 0]

Sunshine,

I am just beginning the lap-band approval process...I did not know as most people don't about all the complications that can occur with the lap band. The one thing that is attractive to me about the lap band is that it can be removed. I am honestly at the point where if I don't do this now, I may continue to put it off, and let' face it we aren't getting any younger...I just turned 33 and am close to the heaviest that I have ever been. Somethings gotta give, I think that I can be successful with the band, and although I am a bit nervous about the unknown that lies ahead with the band, I am confident that I will be successful and ultimately happy (unless of course I have some ungodly complication(s).

I wish the sleeve was covered though, I would heavily consider it over the band.

Good luck with your banding and congrats!

[Sunshine79 0]

Thanks! I will say that so far I've been pretty happy with the band. I've only had it for a week and I've lost 13 lbs. My recovery was a breeze and now that I've moved past the liquid phase, I'm less hungry all the time and it doesn't take much to fill me up (even without restriction). I still have a long way to go but I definitely don't regret my decision to have WLS, just a little regret over the method I chose.

[RaeZur 0]

Congrats on your weight loss! That is so great to hear. I am also glad that you are feeling restriction. I read so many forum posts about people not feeling restriction, it scares me a bit!

I am really hoping that I can be approved, congrats again to you!:thumbup:

[Sunshine79 0]

Well it might just be because of the post-surgical swelling, I can't say for sure. But it seems like I can feel the tightness of the band and it feels tighter the more I eat. Last night I made myself some boxed mashed potatoes for dinner and ate less than a cup and surprisingly was not hungry again all night. That would have never happened before surgery. I would have been starving about an hour later. So it's doing something. I don't know how long it will last but I'll take what I can get before my first fill in 4 weeks. Anyway, thanks for your well wishes and I wish you the best in making your decision and starting your weight loss journey.

[emjay 8]

Here is the information I received from my surgeon's newsletter who is currently beginning to do the procedure.

"In addition to our Cosmetically Superior Gastric Band technique, Dr. Watkins is one of the first

surgeons in the United States to offer Gastric Plication Surgery (GPS procedure). Our first GPS

procedure is complete and several more are already scheduled. The new procedure has also been called

gastric imbrication, gastric plication and vertical sleeve plication among others. We call the operation

GPS for Gastric Plication Surgery as we have integrated our cosmetic techniques and our routine

strengthening of the hiatus (opening in diaphragm breathing muscle associated with hiatal hernias and

acid reflux). CWLC is one of four clinics in the United States currently offering gastric plication

surgery.

The operation imitates a Sleeve Gastrectomy operation, but without any cutting or removal of the

stomach. The procedure was first done in India and Greece. In the U.S., the procedure is currently done

in Cleveland, Tampa and Salt Lake City and Dr. Watkins has brought it to Cincinnati. The data so far

shows excellent weight loss results similar to the sleeve gastrectomy which is not surprising since GPS

emulates the sleeve. They both reduce the stomach to a narrow tube. The operation reduces the amount

of food required to make you feel full by folding the stomach in on itself with stitching. The resulting

stomach tube is small and patients describe feeling very full on small amounts of food. The surgery will

be less expensive than other options because there is no expensive medical device or staples required.

The operation is ideal for patients that need a lower cost option and for patients that do not desire a port

or adjustments. It is an ideal option to consider for band patients that have not lost much weight with

the band. GPS patients do not require adjustments and have fewer food restrictions. For example, GPS

patients can eat bread and can drink with meals and they have more abdominal fullness as opposed to the

very high chest sensation of fullness with the band.

It is important to note that, like the band and other weight loss operations, GPS is to be

considered a powerful tool for weight loss. There is no operation that guarantees success since these

operations do require patient effort. In addition to a “salvage” operation for band patients that haven’t

lost that much weight, GPS can also be an ideal primary operation for weight loss. The only downside to

the GPS procedure is that long-term results are not known. Outside the U.S., gastric plication is showing

stable weight loss two years after the procedure and the results appear very similar to the sleeve

procedure which shows excellent long-term weight loss."

Just thought I'd pass along the info.

[Beccatatqueen 11]

I am actually having this procedure done on July 14th. My understanding by my doctor is that this is the new thing although not used a lot in US. It has pro's and con's like the lap band. You do lose weight a little faster but not as much as gastric bypass. The pros are you don't have a device put in, the chance of food getting stuck and little faster weight loss and it's cheaper. You still could have dilation of the stomach and if you overeat you could still vomit. The other down fall is the long term statistics but the way I see it, in the beginning they didn't have long term statics on lap band either.

[emjay 8]

Becca---please keep us informed of your progress. It sounds like an interesting type of WLS and one that if the band ever fails me and needs to come out, one that I might consider long term. Thanks!

[Alex Brecher 10,516]

We've started a new forum for the Total Gastric Vertical Plication Sleeve Surgery at Total Gastric Vertical Plication Sleeve Surgery - Vertical Sleeve Gastrectomy Surgery (VSG) Forum . We plan on launching a community dedicated to this surgery shortly.

[BeautyisherGODgivenname 0]

While I am very comfortable with my doctor, I am most comfortable with the Sleeve. The port/band issues seems a little over whelming. I am commited tothe change but I am concerned with the life long relationship. I am fortunate enough to have VLS covered by my insurance and I think I will tell the dr I have changed my mind

[AlienBandit 10]

here is a great website comparing all the surgeries Compare LAP-BAND® to Other Weight Loss Options | LAP-BAND®

[shdigu01 0]

The only part that disturbs me about the procedure is that they do remove a portion of your stomach, so it is irreversible

==========================

This is not true. They don't remove any stomach at all and it is reversible

[PrincessErin 64]

I'm so confused about the whole thing. I wanted the band until I started reading here!! There are some very inspiring exceptions, but MOST posts are about how AWFUL the band is and how they're ALWAYS hungry and the band does NOT WORK!!

Does it work or not?? Should I just go on a strict diet and hope for the best?!

I'm very confused right now as to how the band is helpful, which really sucks because I feel like it's the only surgery I'm comfortable having.

I'm truly confused about how it works and WHY so many people are feeling unsuccessful with it.