I just read an article that I have never seen before. The article basically states that after 4 years of plication all the sutures disappear and our stomach returns to a somewhat normal state.

Here is the article. Anyone else ever heard this from their docs? It also discusses the average volume plicators can take in at different points in time post surgery. Very interesting and somewhat shocking, at least for me. I have not heard most of this before.

Chow,

A lot of that information is new to me as well. I will discuss this with my doctor when I see him in October. The increase in stomach volume doesn't surprise me as I think this is pretty common for most WLS. Even if the stomach increases to 250 ccs that only equals about 1 cup. An average unaltered stomach holds about 7-8 CUPS of food!! And Im sure I ate that much before surgery!!

I'll post any info. that I get from my doctor.

Jenn,

Thanks so much-I would really appreciate that! I was just checking right before I saw your post and saw that the average stomach holds 1000 cc's. As you said, that is still a lot compared to the 250cc's that the article mentioned the stomach capacity expanding to. As long as I don't go back to normal, or near normal, stomach capacity I think that I can be ok. As I mentioned, when I saw my stomach for the first time this week on barium swallow study, I realized my stomach was never as tight as I thought it was, and yet I still lost weight. So hopefully even if our capacity expands over time the restriction that still exists, coupled with better learned habits on food and exercise, will be enough. I was expecting an increase in capacity over time, but not that the stitches and plication would leave after 4 or so years. Thank you again for offering to get info from your doc!

I just read an article that I have never seen before. The article basically states that after 4 years of plication all the sutures disappear and our stomach returns to a somewhat normal state.

Here is the article. Anyone else ever heard this from their docs? It also discusses the average volume plicators can take in at different points in time post surgery. Very interesting and somewhat shocking, at least for me. I have not heard most of this before.

I've never heard of this either, but I think, even if the sutures do desolve, the plicated areas remain adhered to eachother due to scar tissue. I don't think it goes back to the "normal" size presurgery.

That is insane,At least you have for years to learn how to eat less,and maybe the body will get used to that.

I just read an article that I have never seen before. The article basically states that after 4 years of plication all the sutures disappear and our stomach returns to a somewhat normal state.

Here is the article. Anyone else ever heard this from their docs? It also discusses the average volume plicators can take in at different points in time post surgery. Very interesting and somewhat shocking, at least for me. I have not heard most of this before.

I am a registered nurse and I read the article. The quote is that "Although sutures disappear after 4 years but based on endoscopic data folds are remained at place." per the article. So the stomach fold still stays the same although the sutures are gone. Still some restriction especially is you can only hold the equivalent to a can of pop.

Different surgeons use different sutures. This article is from Iran. You will need to talk to your own surgeon to see what they used but I still believe the anatomy of the stomach maintains some restriction. I will speak with my doctor about this too. Can wait to see what you all find out.

I am a registered nurse and I read the article. The quote is that "Although sutures disappear after 4 years but based on endoscopic data folds are remained at place." per the article. So the stomach fold still stays the same although the sutures are gone. Still some restriction especially is you can only hold the equivalent to a can of pop.

Different surgeons use different sutures. This article is from Iran. You will need to talk to your own surgeon to see what they used but I still believe the anatomy of the stomach maintains some restriction. I will speak with my doctor about this too. Can wait to see what you all find out.

I believe this doc is regarded as the 'father of plication'. I remember seeing things about him while I was first researching my surgery, but obviously I didn't see this article. I guess what really confused me is the next part where it states: "This means that patients after 4 years find normal weight and normal stomach without any finding of their operation (sutures) in their stomach."

On obesityhelp most of the DSers report that their stomachs pretty much hold what they did pre-surgery once they're a couple of years out. For the Duodenal Switch 75% of the stomach is usually removed (for VSG alone it's 85%). Verticalsleevetalk is only a couple of years old, so I wonder if we'll start to see reports of this on there.

When you think about it most people looking for WLS have managed to defeat simple restriction. I remember as a kid not being able to drink a whole can of coke or eat a whole apple (the first half would be brown by the time I made it round to the other side and that was just doing a single line across the middle). Alas that feels like a lifetime ago!

I have read everything I can on the plication surgery, including the journals and information from other countries. I believe it was south america that has been doing the surgery for the longest period of time (8 years). Everything said that the patients kept the weight off! There was nothing about the sutures dissolve that I read! I have not had the surgery yet (Oct 4th), but my surgeon said that the sutures would stay forever, but not to think that it was reversible down the road because the stomach and scar tissue would somewhat grow together. I guess it would all depend on what kind of sutures the Dr uses.

I sure hope that article is WRONG!!!

Becky

I just read an article that I have never seen before. The article basically states that after 4 years of plication all the sutures disappear and our stomach returns to a somewhat normal state.

Here is the article. Anyone else ever heard this from their docs? It also discusses the average volume plicators can take in at different points in time post surgery. Very interesting and somewhat shocking, at least for me. I have not heard most of this before.

The biggest concern I had going into this procedure was the idea that at some point down the road the stitches would disappear or pop out over time. I had my three month follow up early in Sept. I didn't realize it that I wasn't meeting with Dr. Ponce at that point, but I did have this conversation again with the nutritionist who did my three month follow up conversation. She was able to look in the medical file and tell me that he had used Prolene brand non-absorbable sutures for my procedure (I'm about 80 percent sure I'm remembering that brand name correctly. I did a search for the name and they actually exist. I'm not sure how that name would be in my head otherwise).

As far as them popping, she seemed to indicate that even if an individual stitch popped at some point, they weren't connected to the others. She also mentioned the idea of the stomach scar tissue helping to hold its shape in that event.

There's another post on this board somewhere that mentions the idea of the type of stitching procedure being important. I've wondered as I've read the posts from others if the interplay of that variable, along with Dr. experience, the size of the tube they use to wrap your stomach around, diet, exervise etc. is somehow responsible for some of the slow weight loss that some have experienced.

As this is a relatively new procedure, I wonder if there's a standardized way to do it? If not, I wonder if that lack of a standardized way to do it might be at the root of the problem. Based on the lack of information I found, it doesn't seem like there is.

I've done a lot of talking there that isn't based on a lot of factual information, and I'm not a medical professional. It's just what was going through my head before 6 am today.

Yes, you mean interrupted stitches. If one goes it won't affect the others.

I quoted Dr Watkins post from verticalsleevetalk here http://www.verticals...291-gps-update/ (the part on stitched is at the start of his 2nd paragraph).

I'd love to know what my doc used but I tried calling Angeles Health and they weren't answering and I called during the working day local time!!

There's another post on this board somewhere that mentions the idea of the type of stitching procedure being important. I've wondered as I've read the posts from others if the interplay of that variable, along with Dr. experience, the size of the tube they use to wrap your stomach around, diet, exervise etc. is somehow responsible for some of the slow weight loss that some have experienced.

As this is a relatively new procedure, I wonder if there's a standardized way to do it? If not, I wonder if that lack of a standardized way to do it might be at the root of the problem. Based on the lack of information I found, it doesn't seem like there is.

I've done a lot of talking there that isn't based on a lot of factual information, and I'm not a medical professional. It's just what was going through my head before 6 am today.

Yes, you mean interrupted stitches. If one goes it won't affect the others.

I quoted Dr Watkins post from verticalsleevetalk here http://www.verticals...291-gps-update/ (the part on stitched is at the start of his 2nd paragraph).

I'd love to know what my doc used but I tried calling Angeles Health and they weren't answering and I called during the working day local time!!

Hrm. I had not read that information in the link before or seen that post. I'm going to call and check for sure now. I'm hoping I'm wrong about the type of stitch material or that Dr. Ponce can explain why he chooses to use that material. Not that there's anything to be done about it now, but it would just be nice to know.

Yes, you mean interrupted stitches. If one goes it won't affect the others.

I quoted Dr Watkins post from verticalsleevetalk here http://www.verticals...291-gps-update/ (the part on stitched is at the start of his 2nd paragraph).

I'd love to know what my doc used but I tried calling Angeles Health and they weren't answering and I called during the working day local time!!

Thanks for all your info, TP!

Just remember that while 250 cc's is only 8 ounces of food, the act of chewing can reduce 8 ounces down to 2 or 3 ounces. So effectively, if we're not careful a person can eat a lot of food. Imagine a cup of say, macaroni and cheese - chewing reduces what goes into your stomach to 2-3 ounces (if we're chewing our food to mush like we've been told) - you could eat 1000 calories of mac & cheese pretty quickly.

Remember Plication is simply a tool - we must all watch what we eat, chew slowly and enjoy each bite, eat quality high Protein foods first - they are slower to digest and keep us full longer. And stay well hydrated - this is to key to preventing long stalls and keeping the weight coming off.

Good points grandma!

Just FYI, I contacted my doc's coordinator and asked several questions directly from Watkin's post about 'best practices' and here is what I was told:

Does thedoc used interrupted (individual stitches with a knot tied at each location):

or a running stitch (knot tied at each end of a long stitch taking many "bites" along the way much like sewing) on the plication?

we use one line first with singles stiches.

We do a second line with ininterruped stich to reiforce the fist line!

Also, do you know what brand of stitch material he uses?

Ethicon dermabon 2-0 first line! Prolene 2-0 by ethicon 2nd line.

So it sounds like he followed best practices. I did also ask how far apart the stitches were and didn't get an answer on that one...I may try again.