NotSoLittleMermaid

Oh, and I am NOT getting the lapband, I am getting the Gastric Plication Sleeve.

My doctor is doing it at the same time. Dr. Watkins, What is your opinion on the viability of the stomach after the plication surgery. I was informed that eventually the stomach would adhere to itself and really could not be taken down after a month or two. I ask this as a Barretts esophagus patient that would need the use of my stomach should my Barretts progress to esophageal cancer. Excellent question. The stomach will always be viable after plication. Since it is just folded in on itself and there is no cutting or stapling, there really is no issue with its viability. Reversing it would involve cutting the stitches and the subsequent bit of scar tissue around the stitches and you would be left with your normal stomach. We know this can be taken down even after many years because we've been doing this for many years when we take down plicated stomach after Nissen fundoplication (a stomach plication operation for severe reflux - heartburn) or after Lap Band surgery (the stomach is plicated over the band). Barretts esophagus, for anyone who hasn't heard about it, is when the esophageal lining changes due to chronic reflux (heartburn, GERD). The esopagus (swallowing tube) is made to handle neutral pH Fluid such as spit and mucous and food. It really doesn't want to see gastric acid or bile. In the case of bad heartburn, the lower esophagus gets exposed to so much acid and bile that it gets irritated and chronically inflammed and has to change its cells to protect itself. These cells look more like stomach lining cells than esophageal lining cells and this is what they call Barrett's esophagus. Dr. Barrett is the physician who discovered this interesting protective mechanism by morphology in the wonderfully designed human body. The problem with Barrett's is that it can form pre-cancerous cells over time and these can progress to cancer. This is why it is a good idea to have an endoscopy (stomach scope, EGD - esophagogastroduodenoscopy) if you suffer from severe heartburn to rule out Barrett's. If biopsies show Barrett's with low grade dysplasia (pre-cancerous change) you need to have more frequent endoscopy to monitor for progression. If you have high grade dysplasia or frank cancer cells this is when esophageal resection (cut the affected area out) is recommended. Moderate grade dysplasia is either more closely watched with frequent endoscopy or treated surgically. The good news is that if the heartburn is treated surgically, in some cases the Barrett's will resolve (go away, cured). I have seen this many times in my own practice. Treatment typically involves addressing the associated hiatal hernia. Hiatal hernia is when the hiatus - the opening in the diaphragm (breathing muscle) - is too large and there is no "valve" to prevent acid and bile from backing up into the esophagus. With that operation, the esophagus is mobilized to ensure that an intra-abdominal portion of the esophagus is below the diaphgram. This is what we call an intact anti-reflux mechanism. After doing laparoscopic weight loss surgery for 8+ years, I have learned that essentially 100% of patients have a hiatal hernia or at best a weak hiatus that needs repair. This is easy to do because it simply involves mobilizing the esophagus to achieve an intra-abdominal portion and stitching the hiatus until it is the appropriate size. This is very important to do in any stomach-reduction surgery because if you give a patient a smaller stomach without an intact anti-reflux mechanism, this creates more severe heartburn and frustrated patients and less successful weight loss. I feel very strongly about creating an intact anti-reflux mechanism with each weight loss operation and I know this is important from personal experience. Many surgeons don't do this - they don't believe in it - to the detriment of their patients. All of this to say, by fixing your hiatus, you may very well achieve resolution of your Barrett's esophagus. Even if the worse should happen and it progresses, you could still have an esophageal resection with gastric reconnection to re-establish continuity with no problem even after plication. Brad Watkins MD LapBandTalk Click to visit the largest Lap-Band community online!

I never have either! You look too skinny to need surgery! Great pic!

You need to call the dr right away if you haven't done so yet. Depression and mood swings are common but need to be treated or medicated. I am concerned about you. Will keep you in prayers

Hi Dave, I have the same thing as you! My husband and I would eat a meal, and within an hour, my stomach with be literraly in pain like I hadn't eaten anything! For most of my life I can eat a nice big plate of food. I've never stuffed so bad I vomited, but I can eat alot. So before deciding on surgery, I decided to try and listen HARD for clues. Some people say to stop eating when "are NOT empty" vs. eating till your full. I found out that this would happen to me on very small amounts of food, I could be - done. However, I would be hungry VERY quickly. If I want to, I can easy ignore and push on throught eating. My frustration was over the top when my hubby and I eat a meal, and within the hour my stomach hurts like it went right though me and I am starving again! So that is one reason why I decided my body was working against me (my whole family is big, my sisters diet and exercise hard daily and they are not thin by any means. WHAT I ALSO FOUND OUT EXPLAINED A LOT.. YOUR HUNGER PAINS MAY BE ACID REFLUX. In talking to a couple Drs, I found out that most likely I have that! MOST OVERWEIGHT PEOPLE DO! I thought acid reflux and heart burn are the same thing, but actually I've had heart burn high up in my chest - it does feel different. I just didn't know that for most people I think acid reflux is in the normal stomach area. Can you imagine I never knew I had this and I am 34 years old? Bottom line, many Dr.s can fix it while they are doing the surgery.. it is REALLY important that they do.. read below from Dr. Watkins.. Originally Posted by eac Dr. Watkins, What is your opinion on the viability of the stomach after the plication surgery. I was informed that eventually the stomach would adhere to itself and really could not be taken down after a month or two. I ask this as a Barretts esophagus patient that would need the use of my stomach should my Barretts progress to esophageal cancer. Excellent question. The stomach will always be viable after plication. Since it is just folded in on itself and there is no cutting or stapling, there really is no issue with its viability. Reversing it would involve cutting the stitches and the subsequent bit of scar tissue around the stitches and you would be left with your normal stomach. We know this can be taken down even after many years because we've been doing this for many years when we take down plicated stomach after Nissen fundoplication (a stomach plication operation for severe reflux - heartburn) or after Lap Band surgery (the stomach is plicated over the band). Barretts esophagus, for anyone who hasn't heard about it, is when the esophageal lining changes due to chronic reflux (heartburn, GERD). The esopagus (swallowing tube) is made to handle neutral pH Fluid such as spit and mucous and food. It really doesn't want to see gastric acid or bile. In the case of bad heartburn, the lower esophagus gets exposed to so much acid and bile that it gets irritated and chronically inflammed and has to change its cells to protect itself. These cells look more like stomach lining cells than esophageal lining cells and this is what they call Barrett's esophagus. Dr. Barrett is the physician who discovered this interesting protective mechanism by morphology in the wonderfully designed human body. The problem with Barrett's is that it can form pre-cancerous cells over time and these can progress to cancer. This is why it is a good idea to have an endoscopy (stomach scope, EGD - esophagogastroduodenoscopy) if you suffer from severe heartburn to rule out Barrett's. If biopsies show Barrett's with low grade dysplasia (pre-cancerous change) you need to have more frequent endoscopy to monitor for progression. If you have high grade dysplasia or frank cancer cells this is when esophageal resection (cut the affected area out) is recommended. Moderate grade dysplasia is either more closely watched with frequent endoscopy or treated surgically. The good news is that if the heartburn is treated surgically, in some cases the Barrett's will resolve (go away, cured). I have seen this many times in my own practice. Treatment typically involves addressing the associated hiatal hernia. Hiatal hernia is when the hiatus - the opening in the diaphragm (breathing muscle) - is too large and there is no "valve" to prevent acid and bile from backing up into the esophagus. With that operation, the esophagus is mobilized to ensure that an intra-abdominal portion of the esophagus is below the diaphgram. This is what we call an intact anti-reflux mechanism. After doing laparoscopic weight loss surgery for 8+ years, I have learned that essentially 100% of patients have a hiatal hernia or at best a weak hiatus that needs repair. This is easy to do because it simply involves mobilizing the esophagus to achieve an intra-abdominal portion and stitching the hiatus until it is the appropriate size. This is very important to do in any stomach-reduction surgery because if you give a patient a smaller stomach without an intact anti-reflux mechanism, this creates more severe heartburn and frustrated patients and less successful weight loss. I feel very strongly about creating an intact anti-reflux mechanism with each weight loss operation and I know this is important from personal experience. Many surgeons don't do this - they don't believe in it - to the detriment of their patients. All of this to say, by fixing your hiatus, you may very well achieve resolution of your Barrett's esophagus. Even if the worse should happen and it progresses, you could still have an esophageal resection with gastric reconnection to re-establish continuity with no problem even after plication. Brad Watkins MD

[nomedia=http://www.youtube.com/watch?v=ZzAmRuez-Cc]YouTube - Dr Cottam perfroms a Gastric Imbrication using EndoFLIP® technology[/nomedia]

Great question and great feedback. Thanks everyone!

mine is like a normal sleeve done laproscopically but folding stomach over and sewing vs. cutting and discarding stomach with v s g

It is called Plication or vertical sleeve plication. There is a ton of info about it on this website. I am having this surgery in a month..

Yea! I am getting syched for surgery on Oct 13! Yes, I am the same, eating like it is going to be my last meal! I emailed my doctor about it, and he didn't seem overly concerned, but that may be due my lower BMI. I think it is quite common do it That is probably why they want most of us to go an a pre-op diet! My starts on Oct 6, liquids! I am more nervous about the pre-op diet then eating afterward...But I am determined to be good that week:thumbup:!

Great and informative post! Makes me feel even better about my decision. :001_tongue:

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

Thank you so much. Yes he is very caring and attentive.

A BIG HUG & CONGRATULATIONS, JANE! Keep up the great work everyone!

I am excited Joanie! Dr. Watkins and their staff has been really great and caring.

Amen Ladies!

Here are my thoughts on surgery.. I just posted this in response to someone who is struggling after surgery..maybe you'll find it helpful? ------------------------ Yes, we are all pulling for you! You are going to be so happy in relatively short amount of time.. and you'll be set to be thinner and healther for life! I have no doubt that I am going to through depression (probably even in Pre-Op) just because I feel deprived when I can't have what I want. However, my thoughts are going to try to be I just have to get through a about 3-4 weeks, then it will get better and eventually, I'll have what I want:slimmer body, more energy, etc. I can only imagine that is very hard to get your head around the smaller portions. However, I try to remember that everyone always has to stop eating at some point: 2 Cookies or 8 cookies, or a whole box. I am not a whole box person, but eat a little too much of everything (of course, otherwise I wouldn't be here). Everyone has to decide if they can do a life of salads and 1-2hr workout a day (I can't, my sisters do, and still aren't thin.) or do whatever to have the discpline to loose and keep the weight off. I am choosing surgery because I am so tired of having so many clothes in different sizes, and being envious of skinny people and not wanting to travel or go on trips with people because I am fat. I have to burn 192,500 calories to equal the 55 pounds I want to loose. Assuming I could "walk it off"-it would take about 1925 trips to the gym. And that is assuming I don't eat an extra cookie or calories to add on that 100 calories burned at the gym. Some may question my math here, but whether you burn 100-400 calories, in this day and age, with all the good, fatting food, it is hard to stay a low calorie diet, and hard to create the deficit long term..at least for me. Maybe back in the day, when food was scarce, my appetite, low metabolism would be ideal, but this day and age--I feel at a disadvantage. Sure a pill would be nice, but the body always finds a way around it, due to natural instincts. There are always side effects too. To me, this sound like the best way to help. Small portions so you don't starve and moderation with foods you like. Don't get me wrong, it isn't a free ride. There is still work and it won't be easy. But I've got to believe it will get easier! I am looking forward to the day when I go to the gym to be "healthy" and not doing it to be punished and burn calories as the main focus. Just think what a powerful tool you have! You'll be able to have the best of both worlds once healed! You all can remind me my little speech here in a few weeks, because I'll probably be saying "what I have done!" too! But at this point, I am excited and looking forward to a new, thinner life and a more level playing field. Also, I just got in "Shrink Yourself" by Roger Gould regarding emotional eatting, because I know it will be weird to eat such a small amount. I am not one of those persons who eats out of saddness, etc, but food is always on mind and I know that learning to focus on other things in life would be helpful. I also feel like it is 'unfair' when I can't eat what I want. I am alway thinking about the next meal, so I hope that I can find an easier way focus on other things. My Dr. recommended this book. So..to wrap up..just try to get past the next few weeks, knowing you'll have a better life, thinner and happier.. maybe focus on the others who have been successful and soon you'll be one of them!

Thanks Diva! Can't wait to hear about your surgery and success journey!

Yes, we are all pulling for you! You are going to be so happy in relatively short amount of time.. and you'll be set to be thinner and healther for life! I have no doubt that I am going to through depression (probably even in Pre-Op) just because I feel deprived when I can't have what I want. However, my thoughts are going to try to be I just have to get through a about 3-4 weeks, then it will get better and eventually, I'll have what I want:slimmer body, more energy, etc. I can only imagine that is very hard to get your head around the smaller portions. However, I try to remember that everyone always has to stop eating at some point: 2 cookies or 8 cookies, or a whole box. I am not a whole box person, but eat a little too much of everything (of course, otherwise I wouldn't be here). Everyone has to decide if they can do a life of salads and 1-2hr workout a day (I can't, my sisters do, and still aren't thin.) or do whatever to have the discpline to loose and keep the weight off. I am choosing surgery because I am so tired of having so many clothes in different sizes, and being envious of skinny people and not wanting to travel or go on trips with people because I am fat. I have to burn 192,500 calories to equal the 55 pounds I want to loose. Assuming I could "walk it off"-it would take about 1925 trips to the gym. And that is assuming I don't eat an extra cookie or calories to add on that 100 calories burned at the gym. Some may question my math here, but whether you burn 100-400 calories, in this day and age, with all the good, fatting food, it is hard to stay a low calorie diet, and hard to create the deficit long term..at least for me. Maybe back in the day, when food was scarce, my appetite, low metabolism would be ideal, but this day and age--I feel at a disadvantage. Sure a pill would be nice, but the body always finds a way around it, due to natural instincts. There are always side effects too. To me, this sound like the best way to help. Small portions so you don't starve and moderation with foods you like. Don't get me wrong, it isn't a free ride. There is still work and it won't be easy. But I've got to believe it will get easier! I am looking forward to the day when I go to the gym to be "healthy" and not doing it to be punished and burn calories as the main focus. Just think what a powerful tool you have! You'll be able to have the best of both worlds once healed! You all can remind me my little speech here in a few weeks, because I'll probably be saying "what I have done!" too! But at this point, I am excited and looking forward to a new, thinner life and a more level playing field. Also, I just got in "Shrink Yourself" by Roger Gould regarding emotional eatting, because I know it will be weird to eat such a small amount. I am not one of those persons who eats out of saddness, etc, but food is always on mind and I know that learning to focus on other things in life would be helpful. I also feel like it is 'unfair' when I can't eat what I want. I am alway thinking about the next meal, so I hope that I can find an easier way focus on other things. My Dr. recommended this book. So..to wrap up..just try to get past the next few weeks, knowing you'll have a better life, thinner and happier.. maybe focus on the others who have been successful and soon you'll be one of them!

Hi Carrie I think there is a thread on this forum that addresses conversions. From everyone I've read, people LOVE the sleeve and life is much better without the band. I wish you the best..I am a SLEEVE girl! Click on link below to learn about Sleeve without partial stomach removal.

Hi Sara, I think there is a band to sleeve thread or band to plication. From what I gathered, you can get it removed and sleeved in the same operation.

Momoftwo, are you feeling any better? Our thoughts and prayers are with you.

You can contact the doctors and ask about acceptable BMI.. http://www.cincyweightloss.com/gastric-band-surgery/gps-procedure.html Weight Loss Surgeons | Salt Lake City, Utah http://www.angeleshealth.com/doctors/juan-lopez-corvala.aspx

Hi I would think normal BMI for this Plication Surgery would be 30-60 bmi, and it would be up to your surgeon.

Usually it is $9,900-$12,000 and BMI 30 or over