I went to the surgeon who originally placed my lap band today to talk about the surgery I need to have to remove it due to erosion and subsequent revision surgery. I had my head completely reconciled with having vertical sleeve revision and then he threw in a new option.

For the past year, he has been doing banded plication surgery. In my particular situation, due to the erosion, we would do the surgery to remove my band first, give my stomach time to heal, and then I would have a second surgery to revise to the banded plication.

For those of you who are not familiar with this procedure, it involves folding the stomach in on itself and stitching it to achieve a sleeve like effect. This is a similar procedure to the old stomach stapling procedure but much more effective due to technique and the usage of sutures as opposed to staples. Then, he will place another band at the top of the sleeve thereby essential having two weight loss surgeries at one time.

My understanding is that the plication is better for achieving immediate weight loss, the band is better for long term weight loss. Combining them is essentially the best of both worlds with a few added benefits.

First, because you have restriction from the plication, you don't have to fill the band as fast or as much in order to achieve satisfactory restriction.

Second, because of the more slender shape of the stomach, incidences of slippage are greatly reduced.

Third, there is no need to dissect 90% of your stomach.

Fourth, if you do have a problem with the band, it can be removed and you will still have restriction from the plication.

As always, there can be complications. Sutures can come undone. There can be necrosis of the upper part of the stomach right below the band. My understanding is that so far, the complication rate is extremely minimal and weight loss results have been comparable to the sleeve.

I have to admit that the thought of not having to cut my stomach is appealing to me. At the same time, the thought of putting in another band after my first one eroded is a little unnerving. My surgeon is not pressuring me to do either one. He wants me to do what I'm comfortable with but he is very excited about the results he has seen with this surgery.

I am 52 and this is more than likely my last chance at getting to be where I want to be. This is still considered to be investigational and is not covered by insurance but I believe the majority of the costs will be covered by research study funds.

I have complete confidence in my surgeon. He secondary specialties are liver transplants and pediatric surgery and he is always at the cutting edge (pardon the pun) of the latest and greatest bariatric surgeries. I just want to do the right thing for me.

My instinct is to let him get in there and take out my band, take a look around and see what kind of damage my band did to my insides. Then, make a more educated decision about which surgery would be right for me. As an aside, he completely refuses to do gastric bypass.

What would you do??

How do you know your band has had erosion?

I'd say I would do whatever it takes!

How do you know your band has had erosion?

Hi Bert,

I had absolutely no outward symptoms other than the fact that I could a lot more than I should have been able to eat despite having an almost full band. It has been almost exactly four years since I had my band so my doctor thought it might be a good idea to do an upper GI and make sure everything was working as it should. Imagine my surprise when I watched the contrast Fluid I drank go down my esophagus and not only go through the stoma but also around the outside of my band! The only way that could happen is if the band was now inside of my stomach. We made a subsequent appointment for me to have an upper endoscopy which confirmed the erosion. The only restriction I have right now is because I have a tissue covered band of plastic running through the middle of my stomach. Needless to say I have some reservations about getting another one even in conjunction with the plication.

That is something I think about, the erosion, and causes. I know we are limited but for it to wear out like that. I think if it happened to me, I would not put a new one in for awhile. my weight loss has been swift and before I had lapband done, (6 days ago). The surgery you mention must really be new if insurances aren;t covering, but I always have assumed if its for health reasons and your doctor would vouch for you, they would cover.

I wish you well on your decision , keep us updated!

Bert

I have the banded plication and it was covered by my insurance. I believe that if you had plication alone it wouldn't be covered by insurance. So far I have been banded for a lttle less than a month and I am happy with it. Currently there isn't any fluid in my band, but I have pretty good restriction from the plication. I usually don't have hunger between meals and so far I haven't experienced bandsters hell. The main reason that I went with the banded plication was that was because it has been shown to help prevent complications like erosion and slippage. I have my first fill appointment coming up and I'm not sure if I need a fill but we'll see what the doctor has to say.

I was banded with plication in August. My surgery too was covered by insurance. I have been extremely happy with the results. The weight loss has been very consistent and I am not hungry. I do believe that the success has been due to the plication. I have only had one fill since my surgery. I feel fantastic, I havent had a single issue (knock on wood). I havent thrown up one time and have only had one stuck experience and it lasted maybe 60 seconds. I would do it again in a heartbeat. I have a friend who had the sleeve surgery and was sick constantly. He had so many issues that he finally had to go back for a revision surgery and they did the full bypass on him. But I am not knocking the sleeve surgery either. I think different people have success with all the different options, so if you follow all your docs instructions and do what you are supposed to do I think you can be a success at all of them. I will say though that with the plication as opposed to the sleeve, I dont think you are faced with the malabsorption problems. I like the fact that I only have to take a multivitamin a day and dont have to take all that other stuff. I get the nutritional value out of the foods that I eat. Good luck with your decision.

I had this procedure in aug 2011. So far its been really great. Lost almost 60 pounds now in under 6 months. You really get full easily on a cup of food.

I have the banded plication and it was covered by my insurance. I believe that if you had plication alone it wouldn't be covered by insurance. So far I have been banded for a lttle less than a month and I am happy with it. Currently there isn't any Fluid in my band, but I have pretty good restriction from the plication. I usually don't have hunger between meals and so far I haven't experienced bandsters hell. The main reason that I went with the banded plication was that was because it has been shown to help prevent complications like erosion and slippage. I have my first fill appointment coming up and I'm not sure if I need a fill but we'll see what the doctor has to say.

Thank you for your response. Your statement about the reason you went with the banded plication is my understanding as well. According to the surgeons who are performing this procedure, the combination of the plication with the lap band reduces the instances of slippage or erosion because you do not have to fill the band as much and as rapidly in order to achieve restriction. From my research, one of the reasons erosion happens is from filling the band too quickly in order to achieve restriction which puts pressure on the stomach wall resulting in an abcess which is technically what an erosion is.

I'm still doing my research and won't be making any rash decisions. I appreciate everyone's input as long as it is fact based or first person experience.

For those of you who have had this procedure was it the first time you had bariatric surgery or was it a revision from a prior bariatric surgery?

It was a first time procedure for me

I had the band and plication on Jan 23, 2012, and it was my first procedure... not a revision or new LWS. So far, though, I've been really disappointed.

I had the band and plication on Jan 23, 2012, and it was my first procedure... not a revision or new LWS. So far, though, I've been really disappointed.

Its only been one month for you? How come you are disappointed?

Everything for me has been great.

For those of you who have had this procedure was it the first time you had bariatric surgery or was it a revision from a prior bariatric surgery?

first time for me.

I had the band and plication on Jan 23, 2012, and it was my first procedure... not a revision or new LWS. So far, though, I've been really disappointed.

Hi Leigh,

Can you please explain in greater detail how you have been disappointed?

Thanks

For those of you who are having success with the banded plication........

How was your recovery?

How soon did you go back to work?

Do you follow a low carb diet?

Have you had to have any fills in your band?

How is your hunger level?

How much can you eat before you feel "full"