Hi VSG family!!!

I thought that I would post a thread for all members that had or is considering the TGVP procedure. I thought it would be a great idea for us to share our thoughts and experiences. I know of only one person so far. If you all know of any others please tell them to respond. Thanks VSG family!! :scared0:

We have now done plication on four patients that previously had gastric bands. They mostly like the fact that the fullness is abdominal and not high in the chest and that you don't need band adjustments and there is no port. They like that they will never require an urgent unfill from getting too tight.

We also know that the plication, like any other procedure, is best to think of as a tool for weight loss and works best in conjuction with making good food choices and adding some type of calorie burning to the mix.

Regarding emotional eating, this is a complex subject and even skinny people have emotional eating and there are literally hundreds of books written on this subject, but the best book on emotional eating I have seen so far is Dr. Gould's book, "Shrink Yourself". Dr. Gould is a psychiatrist who has worked with weight loss patients for nearly 30 years in California. I learned a lot by reading his book. Basically, he helps us identify possible things in our past that might be creating "phantom hunger". It is a pretty intense book and not everyone likes it but I haven't found anything that does a better job of really understanding the kind of emotional eating that interferes with successful weight loss. It is also easier to read than many books on this subject.

Brad Watkins MD

Dr Watkins,

My Dr told me that I have gall stones and that if there not bothering me then I should worry about them. I was just wondering if I get the surgery

Will they become bothersome??

Lisa~

Dr Watkins,

I am in a delima, I have been planning on getting the Plication surgery but have been reading that it is for lower BMI patients that have around 50 or so pounds to loose. I have about 85lbs to loose and im not sure if I should get the VSG or Plication. I would love to have the safer surgery but I also want to loose all my weight, can I have a professional opinion please.

Thank you very much

Lisa~

To say that one should choose different operations for different BMI ranges is an often propagated myth by surgeons. The truth is that all weight loss operations are tools for weight loss and regardless of the operation, patients that take full advantage of the tool do great but some patients don't lose that much weight with any operation. Interestingly, if you look at band vs bypass, the bypass looks better the first year, but 5-10 years later the band looks better because bypass weight loss is somewhat "false" in the beginning because it is a disease weight loss with muscle wasting (NOT the way to lose weight in a healthy manner even though it makes the scale look better, temporarily). The problem with bypass is that patients regain weight later requiring revisions. We do a lot of band-over-bypass surgery to create an adjustable bypass so patients can lose weight again.

The plication success rate should be no different from other weight loss operations. I anticipate most patients will do very well with the tool but some patients will lose very little weight just like we see with other weight loss operations. I've got a couple of GPS patients (Gastric Plication Surgery is what we call it) who have already lost over 40 pounds in a couple of months - amazing. Obviously, it is early in the game but it is so simple I do not anticipate any massive surprises with the operation. In Europe, plication patients' average weight loss looks better than the band.

A common theme of patients not losing weight as fast is eating too much ice cream and/or too many "concentrated sweets" (cake, Cookies, etc). The good news is that when the appetite is turned down after surgery, patients find it much easier to avoid these foods because they are not hungry. I've had a lot of patients -before surgery- tell me, "Well, Doctor, if I could make good food choices I wouldn't need surgery," but then they are pleasantly surprised after surgery at how much easier it is with the appetite turned down and getting full on small meals.

Also, sometimes complex emotional eating issues are thrown in there which sometimes requires experts in that area if it is interfering with weight loss but it is rare that patients need that level of help after surgery in my experience.

At any rate, we have done band surgery on patients through all BMI ranges and they all lose weight very well when they use the tool effectively. I feel no different about the GPS (plication). I like the plication because there is no malabsorption, no cutting, no rearranging, no foreign body, no port, etc. Plication has a lot going for it.

Brad Watkins MD

Dr Watkins,

My Dr told me that I have gall stones and that if there not bothering me then I should worry about them. I was just wondering if I get the surgery

Will they become bothersome??

Lisa~

Generally, if you have known gallstones, I recommend removing the gallbladder at the time of weight loss surgery simply because I've seen too many patients with nasty problems from gallstones. If I had gallstones or someone in my family had gallstones I would tell them to get the gallbladder out as soon as practical. Gallbladder surgery pales in comparison to the grief gallstones can cause. Patients with gallbladder attacks seem to develop the massive profanity syndrome.

That said, many surgeons make the case for not doing gallbladder surgery unless the stones are bothering you. The problem is that they can bother you in a very unpleasant way and they generally don't check with your schedule first and this generally happens in the middle of the night on a holiday weekend. It's like a ticking bomb...

Also, I've seen many examples where gallstones weren't symptomatic until patients started losing weight and they end up having urgent gallbladder surgery on an inflammed organ instead of the smooth, elective, outpatient variety that is so much easier from which to recover.

You could go 30 years and not be troubled with gallstones or you could have a massive attack prior to finishing reading this wordy post. Both are possible and the gallbladder decides the timing.

Brad Watkins MD

Generally, if you have known gallstones, I recommend removing the gallbladder at the time of weight loss surgery simply because I've seen too many patients with nasty problems from gallstones. If I had gallstones or someone in my family had gallstones I would tell them to get the gallbladder out as soon as practical. Gallbladder surgery pales in comparison to the grief gallstones can cause. Patients with gallbladder attacks seem to develop the massive profanity syndrome.

That said, many surgeons make the case for not doing gallbladder surgery unless the stones are bothering you. The problem is that they can bother you in a very unpleasant way and they generally don't check with your schedule first and this generally happens in the middle of the night on a holiday weekend. It's like a ticking bomb...

Also, I've seen many examples where gallstones weren't symptomatic until patients started losing weight and they end up having urgent gallbladder surgery on an inflammed organ instead of the smooth, elective, outpatient variety that is so much easier from which to recover.

You could go 30 years and not be troubled with gallstones or you could have a massive attack prior to finishing reading this wordy post. Both are possible and the gallbladder decides the timing.

Brad Watkins MD

Thank you so much for the answers that I have been looking for..

On the gall bladder issue. If I am going to have surgery at the end of november, do you think it would be ok to get surgery now to get the gallbladder out??

Thanks again,

Lisa~

Thank you so much for the answers that I have been looking for..

On the gall bladder issue. If I am going to have surgery at the end of november, do you think it would be ok to get surgery now to get the gallbladder out??

Thanks again,

Lisa~

Yes, you could have gallbladder surgery now and be ready for another surgery in November or you could have them done at the same time.

We have done simultaneous gallbladder surgery with the band and I wouldn't hesitate to do this with a plication as well.

Brad Watkins MD

Thank you, for answering me. I also have been reading that our stomach that is stitched up is like soft melon and that eventually the stomach will start coming out of the stitches, they say it's like cutting through it.

Do you have any insite on this??

Thanks again,

Lisa~

Dr Watkins,

If the bougie that they are using is size 32 and they are using 2-0 silk stitches, is that the correct stuff for the plication???

Also does the surgery make the gall stones inflamed??

To say that one should choose different operations for different BMI ranges is an often propagated myth by surgeons. The truth is that all weight loss operations are tools for weight loss and regardless of the operation, patients that take full advantage of the tool do great but some patients don't lose that much weight with any operation. Interestingly, if you look at band vs bypass, the bypass looks better the first year, but 5-10 years later the band looks better because bypass weight loss is somewhat "false" in the beginning because it is a disease weight loss with muscle wasting (NOT the way to lose weight in a healthy manner even though it makes the scale look better, temporarily). The problem with bypass is that patients regain weight later requiring revisions. We do a lot of band-over-bypass surgery to create an adjustable bypass so patients can lose weight again.

The plication success rate should be no different from other weight loss operations. I anticipate most patients will do very well with the tool but some patients will lose very little weight just like we see with other weight loss operations. I've got a couple of GPS patients (Gastric Plication Surgery is what we call it) who have already lost over 40 pounds in a couple of months - amazing. Obviously, it is early in the game but it is so simple I do not anticipate any massive surprises with the operation. In Europe, plication patients' average weight loss looks better than the band.

A common theme of patients not losing weight as fast is eating too much ice cream and/or too many "concentrated sweets" (cake, Cookies, etc). The good news is that when the appetite is turned down after surgery, patients find it much easier to avoid these foods because they are not hungry. I've had a lot of patients -before surgery- tell me, "Well, Doctor, if I could make good food choices I wouldn't need surgery," but then they are pleasantly surprised after surgery at how much easier it is with the appetite turned down and getting full on small meals.

Also, sometimes complex emotional eating issues are thrown in there which sometimes requires experts in that area if it is interfering with weight loss but it is rare that patients need that level of help after surgery in my experience.

At any rate, we have done band surgery on patients through all BMI ranges and they all lose weight very well when they use the tool effectively. I feel no different about the GPS (plication). I like the plication because there is no malabsorption, no cutting, no rearranging, no foreign body, no port, etc. Plication has a lot going for it.

Brad Watkins MD

Dr Watkins,

I was wanting to ask you if the Dr uses a 32 bougie and 2-0 silk property of redusing fibrosis stitches, is this the correct things to use?

Also does the surgery inflame the gall stones??

Thanks,Lisa

Dr. Watkins: I, like MS Lisa, have about 50 pounds to lose & have been looking into VSG. I have been approved by LIMARP (Dr. Pompa) in Mexico, but now that I have seen this thread, I'm very interested in more information. I would be self-pay, I am Canadian and do not qualify for any WLS as I'm not considered morbidly obese. Is there a website or email address where I can get more information on the cost of the procedure? I have no major co-morbidities, just GERD.

Hi Lisa you can also click on link below. Also I would read every thread that has Plication in it.

AmyN

Plication Surgery Date:10.13.2010

Surgeon: Dr. Brad Watkins

http://www.cincyweightloss.com/gastric-band-surgery/gps-procedure.html

Edited September 8, 201016 yr by AmyN
My usual autosignature was not included for some reason w/link

Dr. Watkins: I, like MS Lisa, have about 50 pounds to lose & have been looking into VSG. I have been approved by LIMARP (Dr. Pompa) in Mexico, but now that I have seen this thread, I'm very interested in more information. I would be self-pay, I am Canadian and do not qualify for any WLS as I'm not considered morbidly obese. Is there a website or email address where I can get more information on the cost of the procedure? I have no major co-morbidities, just GERD.

Hopin4slv, I didn't have surgery with Dr. Watkins, mine was with Dr. Corvala in Tijuana Mexico. Here is their website: http://www.angeleshealth.com/procedures/weight-loss/default.aspx I received wonderful care and loved the hospital and Doctors. My experience I've documented on my blog...I love the results I've gotten and the way my life is now...I eat everything I want, just smaller portions of everything....check it out...for me it just made sense. Fat Woman on a Mission Also, here is Dr. Watkins's website: Cincinnati Weight Loss Center :: Home. He has been very informative on this forum.

Welcome Ellen. Here's a big WOOHOO! on your 20 pound weight loss. Joanie

Congrats!!! :cursing: Was your Dr. "Jose" Rodriguez?

I'm considering the VSP too and I'm trying to decide between Dr. Jose Rodriguez, Dr. Corvala, or Dr. Ortiz???

Looking for experienced Dr. in Mexico to perform the TGVP

Trying to decide between Dr.'s Jose Rodriguez, Dr. Corvala, and Dr. Ortiz??

Welcome any and all info!!!

Dr Watkins,

I was wanting to ask you if the Dr uses a 32 bougie and 2-0 silk property of redusing fibrosis stitches, is this the correct things to use?

Also does the surgery inflame the gall stones??

Thanks,Lisa

Silk sutures would be a good choice. I prefer 2-O Ethibond suture which is a third generation silk suture. A 32 bougie would be a standard size bougie that is a good choice in my opinion. The surgery would not inflame gallstones. Gallstones are more common in women especially with weight gain and weight loss. That is why gallstones are common in weight loss patients.

Brad Watkins MD

Dr. Watkins: I, like MS Lisa, have about 50 pounds to lose & have been looking into VSG. I have been approved by LIMARP (Dr. Pompa) in Mexico, but now that I have seen this thread, I'm very interested in more information. I would be self-pay, I am Canadian and do not qualify for any WLS as I'm not considered morbidly obese. Is there a website or email address where I can get more information on the cost of the procedure? I have no major co-morbidities, just GERD.

Our website is www.CincyWeightLoss.com. You could call our office for details. Acid reflux will resolve after plication surgery if the associated hiatal hernia is taken care of at the time of surgery. I routinely repair the hiatus at the time of surgery and I think this is important. Feel free to e-mail me with any questions you may have. My private e-mail is Brad.Watkins@CincyWeightLoss.com.

Brad Watkins MD

Hi, I had the Super Sleeve Plication done a few month ago by Dr. Jose Rodriguez. I am so happy with his entire surgical team and the Beliteweight team that held my hand through the whole process. I would highly recommend them.

Jo