Banding Together

In reading about revision surgery for the Lap Band, I found a link to the results of a clinical study in the Bariatric Times, (reference this link: My Tiny URL - Create Tiny URL's Short URL Service) on gastric sleeve plicaiton. Results of the report are based on post-operative outcomes for 66 patients (44 female) who had the gastric sleeve plication procedure between January '07 and Mach '10. Mean patient age was 34, with a mean BMI of 35. Follow-up visits for the assessment of safety and weight loss were scheduled for 1 week and 1, 3, 6, 12, 18, and 24 months in the postoperative period. The study describes gastric sleeve plication (also referred to as gastric imbricaiton or laparoscopic greater curvature plication) as a restrictive technique that eliminates the complications associated with adjustable gastric banding and vertical sleeve gastrectomy -- it does this by creating restriction without the use of implants and without gastric resection (cutting) and staples. The authors of the Bariatric Times study present gastric sleeve plication as an alternative procedure that can be as restrictive as sleeve gastrectomy with no staple line or prostheses, and as an ideal revision surgery for LAP Band based on the reduction in known complications. The stomach is reduced by dissecting the greater omentum and short gastric vessels, as in vertical sleeve gastrectomy; the greater curvature is then� invaginated: using multiple rows of nonabsorbable suture over bougie to ensure a patent lumen. No major complications were reported among the 66 patients. Weight loss outcomes are comparable to gastric bypass. There isn't a lot of info out there but I did find a press release by Crospon, a medical device company, announcing the EndoFlip, a device that visually guides surgical sizing of the sleeve duirng the gastric sleve plication procedure. They call it "the perfect marriage between a new proceudre and a new technology". There are a few US surgeons doing it - Dr. Daniel Cottam is one. The Mexico surgical hub for the procedure seems to be Hospital Angeles, in Tijuana, Mexico where Dr. Juan Antonio Lopez Corvala has performed ~50-100 gastric sleeve plications and is conducting training sessions for US surgeons beginning June 5th. Has anyone heard of the plication? What do you know about it? Has anyone here had the procedure? Please share!

Dr. Ortiz is a good surgeon but he is not the pioneer surgeon for plication - where are you getting that information? Has it been suppoted by the IFSO?Dr. Lopez Corvala who is on staff at Hospital Angeles has performed more than 250 plications beginning in December 2009 and based on that experience is considered by far to be the most experienced surgeon in the world regarding plication. Not sure where the 300 comes from but I assure you - it's not correct, there is a typo there. Lopez Corvala invited by the Cleveland Clinic's head of bariatrics to present a special session on his plication findings at the recent IFSO meeting. After Dr. Lopez Corvala, the most experienced surgeon for plication is in Brazil.

I hope you are able to have your band soon! If you end up having to pursue lumbar fusion, please look into LDS - lumbar dynamic stabilization as an alternative. It is a system developed by a US medical device company. though not available in the US it is in Europe and Mexico, price is about $13,000. No fusion, not even general anesthesia, most people go home the same day - you lose no mobility (no fusion) and you can expect a much much better chance at actually getting fixed (fusion has only 70% success rate though it is unholy expensive). Good luck!

The reversibility of gastric plication is still a question mark. Within 2 or 3 months it is, but after that, there is simply not enough experience w/ patients to know. Dr. Lopez Corvala at Hospital Angeles led a session at the last IFSO meeting reporting his results from 200+ patients - hasn't had a reversing situation yet. When asked he says there will be scar tissue as with band, but it's just not clear how long-term scar tissue development affects reversibility of stitches.