I was banded April 26 and they also did a plication where they folded the stomach in on itself and put stiches there without permenantly cutting away some of the stomach. It is a farily new procedure. It's alot like the sleeve without all the same risks and they do not use staples they use stitches and there is no cutting. It's not a complete gastric plication only a modified verison to almost guarentee no slippage and just like the lap band is reversible. There is not alot of info on the internet on this yet, but my doctor feels it will be the preferred method going forward. He studied it at Duke and his center has the excellence rating.

So I now have a smaller stomach and a band in place. My doctor didn't recommend just the plication. Anyway, I already lost 35 pounds since the pre op diet. I'm on the mushie stage and I'm thrilled at the weight loss, but I wonder if it is too fast, or will I come down to earth once the solid foods start. I see my doctor June 8 where the decision will be made if I need my first fill. Is this on par with others? I did read that the plication with the band will be a bit quicker on the front end like those who have the sleeve.

Common. You're losing a combination of water weight, fat, muscle, etc. The scale can drop big time when your glycogen is depleted.

I agree, part of it is lots of wate weight. I wouldn't worry, your loss is bound to slow down. I think you are doing just fine.

I was banded April 26 and they also did a placation where they folded the stomach in on itself and put stitches there without permanently cutting away some of the stomach. It is a fairly new procedure. It's a lot like the sleeve without all the same risks and they do not use staples they use stitches and there is no cutting. It's not a complete gastric placation only a modified version to almost guarantee no slippage and just like the lap band is reversible. There is not a lot of info on the internet on this yet, but my doctor feels it will be the preferred method going forward. He studied it at Duke and his center has the excellence rating.

So I now have a smaller stomach and a band in place. My doctor didn't recommend just the placation. Anyway, I already lost 35 pounds since the pre-op diet. I'm on the mushy stage and I'm thrilled at the weight loss, but I wonder if it is too fast, or will I come down to earth once the solid foods start. I see my doctor June 8 where the decision will be made if I need my first fill. Is this on par with others? I did read that the placation with the band will be a bit quicker on the front end like those who have the sleeve.

Hi Curt! I hope you're doing well. I was wondering if you could please update us on your progress... I am scheduled to do the placation/band combo surgery next month, and I have very limited resources to go to about this unique option. I feel confident based on my research that it'll work effectively, but I just want to hear firsthand from someone who's gone through this already. Thanks in advance!

I agree with the others, you are doing just great. it's common to loose a bunch of weight at the beggining, I think you will see it slow down. Your next post will probably be your weight loss stalled lol. Seriously, I hope that doesn't happen, but it might after such a large amount of weight loss. Your body will need to adjust. Keep up the good work!

Wow, that's 35 lbs in less than a month after surgery?! How much weight did you have to lose? I didn't drop a single lb. In the month after surgery. Hope that changes now that I have a fill.

I was banded April 26 and they also did a plication where they folded the stomach in on itself and put stiches there without permenantly cutting away some of the stomach. It is a farily new procedure. It's alot like the sleeve without all the same risks and they do not use staples they use stitches and there is no cutting. It's not a complete gastric plication only a modified verison to almost guarentee no slippage and just like the lap band is reversible. There is not alot of info on the internet on this yet, but my doctor feels it will be the preferred method going forward. He studied it at Duke and his center has the excellence rating.

So I now have a smaller stomach and a band in place. My doctor didn't recommend just the plication. Anyway, I already lost 35 pounds since the pre op diet. I'm on the mushie stage and I'm thrilled at the weight loss, but I wonder if it is too fast, or will I come down to earth once the solid foods start. I see my doctor June 8 where the decision will be made if I need my first fill. Is this on par with others? I did read that the plication with the band will be a bit quicker on the front end like those who have the sleeve.

I had the same thing. I am about 3 months post op and have lost 40 lbs (28 since surgery). I am happy I did it. I wouldn't worry. He may just hold off on giving you a fill. I lost about 13lbs in my first 10 days and the weight lost has slowed down. I am losing about 2-3lbs a week. I like losing slow because it gives the skin a chance to tighten up and I have been exercising. I wouldn't worry--sounds like you are doing fantastic.

My surgeon was from a center of excellence too and she got her training at John Hopkins.

I am having LapBand with plication surgery tomorrow at Duke.

I undergo surgery at Duke on Tuesday, June 28. My original plan was the lap band only, but I was then told about banding with plication. After hours of research, I was finally able to find two studies on banded gastric plication. (I'm still not sure of the official term for banding and plication combined, or even if there is one.)

To summarize, people who choose both procedures lose more weight and see fewer complications than people who choose banding alone. Adjustments, meanwhile, are fewer and start later. The writing style found in medical reports can be hard to chew on, but you'll definitely want to read them in full and they are found below along with the link, which includes 143 studies in all. I know, a lot!

To be quite honest, I'm still a little pissed by all this. My first appointment at Duke was a month ago, but I didn't learn about plication and the option to have it until my second appointment on Wednesday, just six days before surgery. Whaaaaaaaaat??? My last appointment was this morning so I asked to meet with my surgeon; none of them were in. I did, however, get to meet with a nurse practitioner who admitted someone

had "dropped the ball." I was supposed to have been told about this during the first appointment but instead look like a deer in the headlights when Dr. Portenier asked me if I was going this route or sticking with a band alone. It felt more like "Would you like fries with that?" Now I look like a b***h for expressing my concern and asking for information but ya gotta do what's right for you. Hopefully these studies will help others feel fully informed.

http://www.nsikas.gr.../abstractLA.pdf

EVENT: The IFSO XV Congress, July 2010 (International Federation for the Surgery of Obesity and Metabolic Disorders)

Gastric Plication To Improve The Results Of Laparoscopic Gastric Banding

Background: Laparoscopic gastric banding (LAGB) is a well established procedure to treat morbid obesity and to improve its comorbidity, Gastric banding entered into widespread use in the mid 1990s. Hallberg and Forsell, as well as Kuzmak worked on separate continents to develop the clinical application of adjustable gastric bands in the early 1980s. Several technique were applied to decrease the complication of the gastric band and to improve the weight loss. In our comparative study we observed the results of two different techniques of LAGB for at least one year.

Methods: we randomized 100 patients who attended our clinic from Oct. 2008-March 2009 for laparoscopic gastric banding to have one of two approaches. Gr.A:The conventional way of LAGB without gastric plication

Gr.B:LAGB with anterior gastric plication. We observed pattern of weight loss, complication rate and need of adjustments in both groups.

Results: we operated 50 patients in each group and followed up for one year. BMI was 42 and 43 kg/m2 respectively. Age and gender similar in both groups. Excess weight loss was 45% in Gr. A and 62% in B(p<0.005). Slippage rate was in 2 cases(4%) in A and Zero in B (p<0.05). Average number of adjustment 4 times in A and twice B. First adjustment after 4 weeks in A and 7 weeks in B. No band erosion.

Conclusion: The early results of LAGB with gastric plication seem to be significantly superior to the conventional one to improve weight loss and decrease complication rate.

New Bariatric Concept: Laparascopic Adjustable Banded Gastirc Plication.

Background: Laparoscopic adjustable gastric banding has been widely accepted to treat morbid obesity. However, the stagnant of weight loss from poor compliance of patients made weight loss slower and inconsistent. Here, we describe a novel technique for Laparoscopic Adjustable Banded Gastric Plication( LABGP) to augment and improve postoperative weight loss.

Methods: After approval of ethics committee, LABGP was implicated to morbidly obese patients after getting patient‟s consent. Laparoscopic surgery with 5-ports technique was performed. Swedish band was placed with pars flaccida method and then total vertical gastric plication from fundus to lower antrum, 3 cm from pylorus was performed with Ethibone suture and Endohernia staples. Preoperative data , intra and postoperative complications and length of hospital stay were recorded.Upper gastrointestinal series and GI QOL questionnaire were done 3 months later postoperatively. And all patients were regularly followed up.Excess weight loss was analyzed.

Results: Between May 2009 and February 2010, 20 morbid obese cases with a mean BMI of 40.47kg/m2(range 35-48) underwent LAGBP. Mean operation time was 81.9 min and patients were discharged after 1.25 days in average. No surgical complication happened. Mean %EWL at the 1st, 3rd, 6th and 9th month was 21.3%, 1.67%, 45.41% and 69.77% respectively. Till now, band adjustment frequency was only 0.8 times/patient in this period.

I was told on my first visit w Dr. Yoo. My guess is it may not be all Duke surgeons that are doing, or perhaps 'embracing' the procedure (just like they said if you want sleeve you have to see a certain doc in the clinic). At first appt Dr. Yoo asked what procedure you would like - I told him I was undecided between lap band and roux n y - told him my concerns about roux n y such as potential for dumping syndrome & permanent changes to anatomy but wasn't sure if I really wanted to go through the lap band if I would only lose 40% of the weight - was afraid of some 'after the fact' regret. He told me about the lapband with plication and I asked him questions. My guess is some providers have adopted the procedure moreso than others in the clinic. No information on this option was included in my generic 'orientation' program (where they describe surgical options) but he brought up at my first clinic visit 1:1. Good luck next week on your lapband with or without plication.

I undergo surgery at Duke on Tuesday, June 28. My original plan was the lap band only, but I was then told about banding with plication. After hours of research, I was finally able to find two studies on banded gastric plication. (I'm still not sure of the official term for banding and plication combined, or even if there is one.)

To summarize, people who choose both procedures lose more weight and see fewer complications than people who choose banding alone. Adjustments, meanwhile, are fewer and start later. The writing style found in medical reports can be hard to chew on, but you'll definitely want to read them in full and they are found below along with the link, which includes 143 studies in all. I know, a lot!

To be quite honest, I'm still a little pissed by all this. My first appointment at Duke was a month ago, but I didn't learn about plication and the option to have it until my second appointment on Wednesday, just six days before surgery. Whaaaaaaaaat??? My last appointment was this morning so I asked to meet with my surgeon; none of them were in. I did, however, get to meet with a nurse practitioner who admitted someone

had "dropped the ball." I was supposed to have been told about this during the first appointment but instead look like a deer in the headlights when Dr. Portenier asked me if I was going this route or sticking with a band alone. It felt more like "Would you like fries with that?" Now I look like a b***h for expressing my concern and asking for information but ya gotta do what's right for you. Hopefully these studies will help others feel fully informed.

http://www.nsikas.gr.../abstractLA.pdf

EVENT: The IFSO XV Congress, July 2010 (International Federation for the Surgery of Obesity and Metabolic Disorders)

Gastric Plication To Improve The Results Of Laparoscopic Gastric Banding

Background: Laparoscopic gastric banding (LAGB) is a well established procedure to treat morbid obesity and to improve its comorbidity, Gastric banding entered into widespread use in the mid 1990s. Hallberg and Forsell, as well as Kuzmak worked on separate continents to develop the clinical application of adjustable gastric bands in the early 1980s. Several technique were applied to decrease the complication of the gastric band and to improve the weight loss. In our comparative study we observed the results of two different techniques of LAGB for at least one year.

Methods: we randomized 100 patients who attended our clinic from Oct. 2008-March 2009 for laparoscopic gastric banding to have one of two approaches. Gr.A:The conventional way of LAGB without gastric plication

Gr.B:LAGB with anterior gastric plication. We observed pattern of weight loss, complication rate and need of adjustments in both groups.

Results: we operated 50 patients in each group and followed up for one year. BMI was 42 and 43 kg/m2 respectively. Age and gender similar in both groups. Excess weight loss was 45% in Gr. A and 62% in B(p<0.005). Slippage rate was in 2 cases(4%) in A and Zero in B (p<0.05). Average number of adjustment 4 times in A and twice B. First adjustment after 4 weeks in A and 7 weeks in B. No band erosion.

Conclusion: The early results of LAGB with gastric plication seem to be significantly superior to the conventional one to improve weight loss and decrease complication rate.

Wow I'm surprised they were able to 'randomize' 100 patients to either get a lap band or lap band with plication - that must have been an interesting study and procedure consent form - you may get lapband or you may get lapband w/ plication. Hope they at least advised the patients what procedure had postop (or at preop visit).

The plication sounds like the way to go if the risks of band slippage, etc.... are lower. And less need for fills. That makes it all the more appealing to me. The surgeons briefly mentioned this in the seminar I attended and said they would talk more to us about it at our consult.

Isn't the cost a LOT more also? With no insurance coverage?

The plication sounds like the way to go if the risks of band slippage, etc.... are lower. And less need for fills. That makes it all the more appealing to me. The surgeons briefly mentioned this in the seminar I attended and said they would talk more to us about it at our consult.

Isn't the cost a LOT more also? With no insurance coverage?

I asked about cost but I can't help you there because I'm insured. They said that the insurance code for plication is the same as for banding so it shouldn't be an issue and that they've heard no stories of one being covered but the combination rejected. I'll be calling my insurance company on Monday to make sure, NOT my idea of a good time.

Momo, I'm glad you got more information than I did. It's not Portenier's fault, though, as I see it. As the nurse practitioner stated, I should have been informed during my first visit and my appointment with Poretenier was not 1:1 but a group session. Sorry, but I really resent being made to look like a dumbass when I'm not the one who did anything wrong. I got no info during orientation, either. Any idea on why that is? It's like their withholding information!

I'm very happy that I had the procedure done. Including the pre op diet, I've lost a total of 51 pounds. I'm averaging a bit over 3 lbs per week. My doctor was very pleased at the 6 week post op appt and said I definately needed no fill. They billed my insurance the same as the band so no issues there so far.

Wow! Wish my surgeon and husband knew about this. I think it sounds like what my husband could use. He is very afraid of being under tho', so he won't go for any surgery! He needs to loose about 150lbs, too. My son is due to go for surgery in August.

I guess that I have a whole family that could use (or have had) lapband surgery. My daughter and I had it in 2009. You are doing great, Curt! Good luck in loosing your weight. Come back often to update us. Karen

Bazooka, My memory was jogged when reading your replies. I do remember in the brief mention of the plication, the surgeon did say something about it being so new there was not even a code to use for billing it. So maybe that is a positive in this case. :0)

Oh and I do have insurance' but waiting until Sept since my new ins plan year will start so I will have different plans to pick from. When I wrote "with no ins. covg, I meant no covg for the actual plication, but now we know about the " no cpt code" for it. Thank you for your reply. I wish you much success on your surgery. I look forward to reading success stories.