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??

I looked into it, but opted not to do the plication. I'm a little over two weeks post-op with only a one pound loss and now wishing I had gone ahead with the plication. I'm also quite hungry between meals and with no restriction I'm having to force myself to stop eating -- Bandster Hell!

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

How was your recovery?

100% in about 14 days but I had a very large hiatal hernia as well.

How soon did you go back to work?

Back to work in 5-7, could have been 3 to 4 though.

Do you follow a low carb diet?

Yes for the most part just balance beteen Protein and carbs. Zone diet is close to my ratios. I have Protein shake every morning with high protein whey. 20 grams per 7 oz drink. Sometimes I just eat whatever and whenever though. always try to keep it to healthy items though for the most part.

There are things I dont like to eat anymore though because its a pain like steak.

Have you had to have any fills in your band?

every month I get adjusted but now its every 2 months they might not fill much at all though they just adjust so its folwing at the right speed when I drink the barium drink. Always on floroscope too.

How is your hunger level?

fine not too bad at all. 1000 to 1400 calories a day usually.

How much can you eat before you feel "full"

about 1 to 1.5 cups, most of the time 1 cup. 1000 to 1400 calories a day usually.

I looked into it, but opted not to do the plication. I'm a little over two weeks post-op with only a one pound loss and now wishing I had gone ahead with the plication. I'm also quite hungry between meals and with no restriction I'm having to force myself to stop eating -- Bandster Hell!

Not to rain on your parade but I think the addition of plication is huge. If I had just gotten the band I dont think Id be as successful as I am so far. My cousin got gastric bypass and we have lost the same amount of weight in the same amount of time for the most part. And quite honestly its pretty easy for me. For the past 2 months I have worked out on average 1 to 2 times per week(burning aprox 300 cals) and I am still losing 6 to 7 pounds per month. It's pretty crazy. Dont get me wrong though my friend has just the band and she has lost 80 pounds in a year I think but she does seem to work alot harder then I do at it. She works out alot more.

Having said that I still think youll do fine because I can feel the band working too.

Hi Jacksbanster,

I was banded back in 2004 and weight loss was great. I went from 322 pounds to 140 pounds. In 2010 my band seem to stop working and i started to gain weight (plus I stopped following the bandster rules) but that is because again I didn't feel I had the control the band gave me originally. Anyway, after gaining 60 pounds I was fed up and decided to investigate if others where experiencing the same thing with the band and if there were other options out there for me to look into. So I did a lot of reading and research and found out about the plication surgery. So I met with my Lap Band doctor and he told me more about this new investigational surgery called Plication. Fast forward, I had the surgery Dec 8th 2011. The surgery was a success, recovery was a breeze, the liquid diet was hard, but I got through it. My first post op visit I had lost 8 pounds. Then I got walking pneumonia and had to go on prednisone - this made me ravenously hungry and of course I regained all the weight I had lost back. I was so disappointed and frustrated that I wanted to die. But my doctor told me that prednisone is know for weight gain and I'll get back on track soon. So fast forward, my next appointment with him I had only lost 4 pounds which did not make me happy because before I had lost 8 and now I was starting all over and at a slower pace. It is now Feb 16th 2012 and I've not gotten on the scale because I don't feel like I've lost any weight. All my clothing fits the same and I just don't see any change and I've not weighed myself since my last fill. I've had two fills since my plication surgery and I'm still hungry (more than) I thought I would be with the band and the plication. This is a different experience than when I had the lap band surgery, the lap band surgery had the weight come off very quickly. I didn't even have to think about dieting I just wasn't hungry. With this surgery (albeit it is a revision of the previous band, new band with more capacity, and the plication) I'm not as pleased as I had expected. With all that said I think my expectations need to be adjusted. I wonder if people who have had the band and have had some type of complication with it (slippage, erosion, etc) it the pouch that is above the stomach is premanently stretched out of shape. I don't have the answer I just know that the experience is not the same. I'm having to really monitor what I eat and exercise everyday. So I eat around 900 to 1000 calories a day, and I exercise on the stairmaster for an hour/ or I go for a jog. I know that I need to incorporate some weight training but I'll just have to get to it when I can.

As for your questions above:

How was your recovery?

Recovery was great. The first couple of days there was a little pain but after that it was a breeze.

How soon did you go back to work?

Surgery was on a Thursday I went back to work on the following Wednesday.

Do you follow a low carb diet?

I followed the liquid diet they put me on for about 4 weeks. Since then I've tried everything - right now I'm basically eatting lean cuisines or smart ones. But I think I'm going to try a one week Medi fast - we will see. Right now I'm so hungry between meals I doubt if I can pull that one off.

Have you had to have any fills in your band?

Yes I've had 2 fills since my surgery and they don't seem to have made that much of a difference. The doctors, are being cautious because they don't want me to get too tight and have another band slippage.. I understand that but in the meantime I wish I had more restriction.

How is your hunger level?

Higher than I thought it would be. But if I try to stay on an eat every 4 to 5 hour schedule I do okay.

How much can you eat before you feel "full"

If I allowed myself I could eat a lot. The think is I count every calorie that goes into my mouth. I use www.fatsecret.com they have an incredible food database - almost everything you can put into your mouth in in their database, So that helps.

I hope that my story has helped you and I will keep you informed on my progress - I hope that you will do the same.

Regards,

Willowsdoweep

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

How was your recovery?

Although I had a hernia repair my recovery was pretty easy, I was off of pain meds in about 3 or 4 days and I was sleeping on my stomach in less than a week. I also didn't really have any gas pains after surgery.

How soon did you go back to work?

I went back to work 2 weeks after surgery because that is how much time I was given from Short Term disability, I could have been back to work much sooner than that, probably by about day 5 or 6.

Do you follow a low carb diet?

I don't really follow a low carb diet but according to the PA at my doctor's office, I should try to stay under 50g a day. Overall I try to focus on getting Protein and staying at around 800-1000 calories a day

Have you had to have any fills in your band?

I haven't had a fill yet, I had my 1 month follow-up appointment last week and that is traditionally when you are supposed to get your first fill. I didn't want to get a fill and didn't feel like I needed it because I'm not eating that much in a sitting and I don't feel hungry between meals. Even though I had gained a pound since my post surgery follow-up the PA agreed with me. I believe that the weight gain was mostly due to not eating enough protein and too many carbs or my body just adjusting to the surgery and lower calories. Since that appointment I have lost about 6 lbs in a week,

How is your hunger level?

I rarely get hungry at all even if I go hours between meals. Early on, about week 2 and 3, I felt what I thought was hunger (rumbling stomach and all) but it might have been acid which caused similar sensations. Since then, I really can't think of a time that I felt so hungry I couldn't wait to eat. I think the bigger struggle is not eating just because something is there, though even when I give in I'm not eating near as much as I could before surgery

How much can you eat before you feel "full"

This is a little tricky because by the time I feel "full" I'm at or near the uncomfortably stuffed feeling and probably should have had a few bites less, it's a learning process and I'm getting better at not getting to that point. I don't really measure my food right now but I would say that I'm good at 3-4 chicken wings when before I could eat 10, about 1/2 a sandwich, or two eggs and a slice of cheese.

How was your recovery?

I had a "huge" hiatal hernia as well, but was walking around driving, etc, in about 3 days. My surgery was on a Monday and I was back at work the following week. The only problem was with the referred pain from the abdomen full of gas and anesthesia, which is worse than with band alone, simply because you are out a good deal longer, etc. My serious nausea only lasted a day or two.

How soon did you go back to work?

Working from home on day three and back to the office 1 week.

Do you follow a low carb diet?

I am a full fledged low-carber... and swear by the science... incidentally, I am a scientist :-)

Have you had to have any fills in your band?

my first fill tomorrow morning! 2/17 first fill... surgery 1/23... it seems a little quick...

How is your hunger level?

I don't count calories (calories supplied by carbs vs Protein vs fat are used differently, so total calories in and total calories used/out isn't actually physiologically true, but I'd estimate 1000-1200/day). I won't lie - I am hungry, but even with a BMI on the lower end of WLS eligible, I was a BIG eater before... I'm learning to deal with it. I did not previously drink much water/beverage throughout the day, but since I've adopted the habit with sugar free drinks like Crystal Light, I find I'm not really hungry between planned meals as much.

How much can you eat before you feel "full"

a typical meal for me right now on soft foods is an egg, mixed with a tiny bit of cream, whipped together, add a little feta (garlic/herb), and fry like an omelette. That's pretty satisfying. For lunch today I had two slices of deli turkey meat with a little mustard and a string cheese. My biggest problem is wanting to drink right after eating, which I have experienced is a BIG TIME NO NO!

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

Everything for me has been great.

I think my experience was surgeon-specific... and having expectations that someone who weighs much more than I do should have to start off the journey. At my one week follow-up, I had lost only 4.5lbs, and you'd think I'd been chugging maple syrup during those 7 days. I do not care to be compared to other patients, nor do I like being made out to be a liar of sorts... or told I shouldn't have bothered with the surgery if I didn't plan on changing. Heck - I went in there thinking "woo hoo! 4.5lbs and I only need to lose 50-60 total" and came out all kinds of upset and pee-o'ed. I worked through all of that though and am now down exactly 10lbs since surgery with my 3 week follow up tomorrow. Bring on the criticism doc... I can handle it, get my fill, and walk right back out. :-)

I think my experience was surgeon-specific... and having expectations that someone who weighs much more than I do should have to start off the journey. At my one week follow-up, I had lost only 4.5lbs, and you'd think I'd been chugging maple syrup during those 7 days. I do not care to be compared to other patients, nor do I like being made out to be a liar of sorts... or told I shouldn't have bothered with the surgery if I didn't plan on changing. Heck - I went in there thinking "woo hoo! 4.5lbs and I only need to lose 50-60 total" and came out all kinds of upset and pee-o'ed. I worked through all of that though and am now down exactly 10lbs since surgery with my 3 week follow up tomorrow. Bring on the criticism doc... I can handle it, get my fill, and walk right back out. :-)

Your doctor sounds like an idiot. Id consider changing. Any person that has any experience in this knows that the body could be holding on in efficiency mode and not losing like it should be at certain times in your weight loss and to say 4.5 in a week is bad is ridiculous. Its actually too much. Get ready to plataeu here and there because thats just how the weight loss works. Its like stairs. Down 2 platuea at 0 down 3 platuea at 0 down 4 etc. The body needs a chance to catch up to the losses.

Also if you only need to lose 50 to 60 its going to come off much slower then someone that needs to lose 150. 2 lbs a week would be amazing. 1-1.5 pound is plenty.