Some data and information on gastric plication

mednar · June 18, 2011

In reading about the experiences of others who have posted on these forums, I wanted to share part of the data I researched in deciding to have my plication surgery. It's a big decision to have this surgery, and it took me nearly three months to make my decision to proceed.

I had considered the Lap-Band and VSG two years ago, but I excluded both because the drawbacks to both were not acceptable to me. I became interested again in weight loss surgery after learning that a local bariatric physician was going to participate in a clinical trial here in the US to collect data about plication effectiveness. After reviewing the data about the study and reading the article about the study completed in Brazil, and having a long, frank discussion with my bariatric physician, I made the decision to go ahead with the surgery.

I knew going into the procedure that there have not been studies done with significant numbers of patients (in the US or elsewhere), that long term data wasn't available, and that there was no guarantees because this is still considered an experimental procedure.

The data from the Brazilian study appeared promising to me, and I felt comfortable with my physician.

Brazilian study information:

http://www.ncbi.nlm....2?dopt=Abstract

It's not much information, but hopefully it might be of use to someone.

TijuanaPlication · June 18, 2011

Have you had your surgery yet? If not when is it?

mednar · June 18, 2011

I had my surgery on June 6. Will be two weeks this Monday.

DonnaC · June 20, 2011

are you happy with the surgery? Have you been feeling okay? I am so confused right now. I am supposed to do Plicsation on July 1st but have some reservations and am looking at Sleeve...even thought I don't want to have "things' cut out.

chowchows · June 21, 2011

are you happy with the surgery? Have you been feeling okay? I am so confused right now. I am supposed to do Plicsation on July 1st but have some reservations and am looking at Sleeve...even thought I don't want to have "things' cut out.

Donna,

You might want to start a new topic so that people see it more. That being said, I will answer you. I am mostly happy with my plication, and would do it again. I too went back and forth on the sleeve vs. plication. I had several personal reasons for choosing plication. One of which, crazy as it may seem, is that you get to keep the part of your stomach that they use to make an "esophagus" if you get esophogeal cancer. I had a friend's husband go through this, and I suffered from bulimia for several years and have bad reflux, so this is just a reason I thought the plication was better. I also liked the idea of losing a bit slower (although not as slow as it sometimes goes, lol) so as to give my skin time to rebound as much as possible. That being said, I was perusing the sleeve boards last night, and I am very inline with the amount of weight loss several sleevers that are 6 weeks out have. :blink: That kind of surprised me, because I thought I was losing slowly. I have lost almost 24 lbs in just over 6 weeks. I have no problems eating anything that is on the "ok" list at 6 weeks. I have been having pain in my stomach the last couple of days, not sure what that is about as I have had no pain for a month, and then this suddenly showed up. I think it is reflux though, or gas, but if it continues I am going to get it checked out. I have never been sick once, even in the hospital. My recovery was pretty easy. My cravings (and boy did I have a sweet tooth and a junk-food tooth pre-surgery) have subsided 95%. I feel restriction, but am still able to enjoy (on a small scale) my favorite foods. On the bad side, I have had two really long stalls which concerned me and depressed me. That being said, I lose really fast post stall, but the stalls really get me down. I have really had to work to not question (and you will see in my posts that I have questioned) having the surgery during those times. Overall though, I would do it again and am about 75% happy with the plication. Feel free to ask any particular questions and I will try to answer.

Take care,

CC

TijuanaPlication · June 21, 2011

Hi Donna, I'm 7 months out. I only ever lost 17.5lbs (I started at 189). I never lost the hunger and to be honest this hasn't felt any easier than a diet. Sarah over on the VST was the same as me, see her last post on that forum here http://www.verticalsleevetalk.com/topic/11938-not-enough-restriction/page__p__103315#entry103315

The esophageal cancer that chowchows raised was a big thing on my mind, plus being scared of getting a leak. Leak risk with a virgin VSG is 1% and that quadruples if you're revising from a band due to scar tissue/erosion. A few people have band over plication, which if your band isn't causing you discomfort may be an option for you. Genepha on VST has that. Last I heard she hadn't had any fills.

Re the cancer thing, we have the same problem that RNYers have, ie a blind stomach that can't be scoped, which is important if you get something like stomach cancer as they won't be able to look at the folded in part with an endoscope. I believe that the part of the stomach they remove in VSG is the part that's prone to cancer, so you have to weigh your risks on this one.

Depending on how heavy you are, the good thing about the VSG is that you can revise to getting the full Duodenal Switch if you don't lose enough (I guess that might still be an option with the GPS but I wouldn't count on it).

The following stats may interest you:

"overall weight loss was considered satisfactory in 78.6% of the patients who underwent gastric plication and in 97.5% of those who underwent sleeve.

http://www.skrekas.net/surg_hemstatistics.htm"

are you happy with the surgery? Have you been feeling okay? I am so confused right now. I am supposed to do Plicsation on July 1st but have some reservations and am looking at Sleeve...even thought I don't want to have "things' cut out.

TijuanaPlication · June 21, 2011

BTW as you're a revision Donna, you may lose more slowly. Hip on VST is a band to sleeve revision and he was losing slowly. This post here gives some clarification as to why revisions lose more slowly http://www.obesityhelp.com/forums/ds/4375541/Unproven-hypothesis-about-why-2-part-DSs-are-less-effective/

The summary of the post is that it's because you've already had some weight loss and your metabolism has compensated by slowing down.

Donna, please don't feel I'm trying to rain on your parade, I just want you to have as much info as possible before you proceed. I wish you all the best with everything and keep us posted!

mednar · June 21, 2011

Hi Donna. Several of the other board members here have had their plications longer than I at this point, so they may have more experience to share. I only had my plicatino done June 6, so I'm just 15 days out from surgery. The only complications have been nausea for the first couple of days after surgery and having to adjust my sleeping position because I can't lie on my side/stomach now.

I definitely feel restriction when I eat and need to eat slowly. I have to be careful and eat slowly. I've had a time or two where my brain was not caught up with my stomach in realizing that I was full. I'd eat an extra bite or two and feel like I might lose my lunch, but that's something I'm trying to get used to.

I'm finding that I get hungry every couple of hours which is different from before, but eat in small quantities when I am. I lost about 12 pounds prior to surgery on the liquid diet and have lost about 8 pounds in the two weeks since surgery. I started at 290.5 and was at 269.6 yesterday on the scale. I've been walking most days at least 20 minutes.

I was really worried about giving up soda (was a diet Coke addict), but it's been over two weeks and really haven't missed them. I do struggle to get in enough Water each day. I was actually better about drinking Water before!

So far, I don't regret having it done, but it's early on for me.

chowchows · June 21, 2011

A few people have band over plication, which if your band isn't causing you discomfort may be an option for you. Genepha on VST has that. Last I heard she hadn't had any fills.

I think Genepha is Jenn on this board, I may be wrong though. She is doing exceptionally well with hers, and I believe you are correct in saying that she hasn't had a fill.

chowchows · June 21, 2011

Re the cancer thing, we have the same problem that RNYers have, ie a blind stomach that can't be scoped, which is important if you get something like stomach cancer as they won't be able to look at the folded in part with an endoscope. I believe that the part of the stomach they remove in VSG is the part that's prone to cancer, so you have to weigh your risks on this one.

Depending on how heavy you are, the good thing about the VSG is that you can revise to getting the full Duodenal Switch if you don't lose enough (I guess that might still be an option with the GPS but I wouldn't count on it).

The scope part is interesting...I did not know that. I thought the only real revision plicators could have was the DS. I read that in several places. Can a plicator successfully revise to a sleeve? I figured all the scar tissue would prevent that, but maybe not.

Edited to add: they are just discussing the revision to sleeve on VST, so I guess it can be done.

chowchows · June 23, 2011

I don't know about this info on this brazilian study,I went to their site and they are not promoting any plication at all .This is the direct web page, gastroobesocenter.com.br .All in Portuguese, I'm portuguese and there is nothing about plication there, I think I'm going to call them.I think the info that we are getting is bogus.

Would love to know what you found out. Thanks!