Two Studies on Lap Band with Gastric Plication

[bazookadoe 0]

I was able to find two studies on combining a lap band with gastric plication. You can see them in full below but to summarize, people who had both procedure lost more, saw fewer complications and underwent adjustments both later and less often.

Something like this isn't a snap decision for me and I was dissappointed with how much information was available. It took a long, long time but after finally finding medical studies on this option, I feel a lot better. Hope they help you, too. With 143 studies in all, the link is an information goldmine with something for everyone. I'm too tired to post this in other places and fear wearing out my welcome to boot, so feel free to post the link on other forums should the Lord so lead you.

Dori

http://www.nsikas.gr.../abstractLA.pdf

EVENT: The IFSO XV Congress, July 2010 (International Federation for the Surgery of Obesity and Metabolic Disorders)

Gastric Plication To Improve The Results Of Laparoscopic Gastric Banding

Background: Laparoscopic gastric banding (LAGB) is a well established procedure to treat morbid obesity and to improve its comorbidity, Gastric banding entered into widespread use in the mid 1990s. Hallberg and Forsell, as well as Kuzmak worked on separate continents to develop the clinical application of adjustable gastric bands in the early 1980s. Several technique were applied to decrease the complication of the gastric band and to improve the weight loss. In our comparative study we observed the results of two different techniques of LAGB for at least one year.

Methods: we randomized 100 patients who attended our clinic from Oct. 2008-March 2009 for laparoscopic gastric banding to have one of two approaches. Gr.A:The conventional way of LAGB without gastric Plication Gr.B:LAGB with anterior gastric Plication. We observed pattern of weight loss, complication rate and need of adjustments in both groups.

Results: we operated 50 patients in each group and followed up for one year. BMI was 42 and 43 kg/m2 respectively. Age and gender similar in both groups. Excess weight loss was 45% in Gr. A and 62% in B(p<0.005). Slippage rate was in 2 cases(4%) in A and Zero in B (p<0.05). Average number of adjustment 4 times in A and twice B. First adjustment after 4 weeks in A and 7 weeks in B. No band erosion.

Conclusion: The early results of LAGB with gastric Plication seem to be significantly superior to the conventional one to improve weight loss and decrease complication rate.

New Bariatric Concept: Laparascopic Adjustable Banded Gastirc Plication.

Background: Laparoscopic adjustable gastric banding has been widely accepted to treat morbid obesity. However, the stagnant of weight loss from poor compliance of patients made weight loss slower and inconsistent. Here, we describe a novel technique for Laparoscopic Adjustable Banded Gastric Plication( LABGP) to augment and improve postoperative weight loss.

Methods: After approval of ethics committee, LABGP was implicated to morbidly obese patients after getting patient‟s consent. Laparoscopic surgery with 5-ports technique was performed. Swedish band was placed with pars flaccida method and then total vertical gastric Plication from fundus to lower antrum, 3 cm from pylorus was performed with Ethibone suture and Endohernia staples. Preoperative data , intra and postoperative complications and length of hospital stay were recorded.Upper gastrointestinal series and GI QOL questionnaire were done 3 months later postoperatively. And all patients were regularly followed up.Excess weight loss was analyzed.

Results: Between May 2009 and February 2010, 20 morbid obese cases with a mean BMI of 40.47kg/m2(range 35-48) underwent LAGBP. Mean operation time was 81.9 min and patients were discharged after 1.25 days in average. No surgical complication happened. Mean %EWL at the 1st, 3rd, 6th and 9th month was 21.3%, 1.67%, 45.41% and 69.77% respectively. Till now, band adjustment frequency was only 0.8 times/patient in this period.

Conclusion: Laparoscopic Adjustable Banded Gastric Plication, a combination of restrictive and reductive procedure, is safe, feasible and reproducible. It can offer excellent weight loss under a more physiological concept. Long-term follow up for this procedure would be mandatory.

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[elcee 3,341]

You might want to pop over to the plication support site. There are not a lot of people on there as it is still a relatively new surgery. What I found worrying was that out of such a small group there were a number that were already having/had serious issues.

[bromo 17]

That site does not seem to have many that are banded with the plication. I think these are two different surgeries. Plication alone is closer to the sleeve than banded plication, which seems to be more associated with the banding. I think I will stay here and post after my Lap Band surgery with Plication next week.

[Corrigan 75]

I wonder if there isn't some confusion about Plication, banded Plication, and the procedure where a portion of the stomach is folded over the band to

prevent slippage, sometimes called "Modified Plication". I'm having the latter done Monday and I'll let you know how it goes.

[bazookadoe 0]

Havind seen more than one name used, I've had trouble figuring out the proper term myself. To remove any mystery, I got a lap band plus my stomach folded in and stitched from the outside. I wish one medical authority or another would rule on the official name of this procedure. It would make life a little easier for those of us who went this route.

[healthy and happy 64]

I had the sleeve plication with a banding done on Aug 11. I am very happy with it so far. I have had no sickness, I do feel full and satisfied when eating the amount of food that we are advised to eat. I have lost a total of 42 pounds (that includes the weight I lost in the pre surgery prep also), JUst this week I lost 6 pounds and I am not one of the larger patients. I now weigh 211 pounds. I know it is still early in the game for me but things are looking hopeful and I believe that my doctor has helped me make the right choice.

[ladykim12 1]

Hello all,

My surgeon suggested the placation as well, and I initially agreed. I have sense changed my mind because it is considered investigative and insurance companies are not covering it. (At least my insurance company isn't) With that being said, I don't feel comfortable having the placation done. What are your thoughts?

Kimberly

[Corrigan 75]

I had the band plus plication done six weeks ago with no complications, almost no

pain and to date have lost about 50 lbs. My surgeon explained it in detail and it sounded

good at the time. I haven't seen any downside yet. I have an appointment Tuesday,

for a fill, but with my current lack of hunger, I think I'll pass. I'm not recommending

this to anyone else, you'll have to make up your own mind with the information you

have, but I'm happy with it.

[Shellyac 22]

Hello all,

My surgeon suggested the placation as well, and I initially agreed. I have sense changed my mind because it is considered investigative and insurance companies are not covering it. (At least my insurance company isn't) With that being said, I don't feel comfortable having the placation done. What are your thoughts?

Kimberly

I am planning on having this done in January. While it is a new procedure, my insurance is covering it because at it's core it is a lap band procedure, it's like the doctor is throwing in the plication for free. I would encourage you to consider the procedure if possible. It looks like the banded plication will help to reduce the risk of band slippage and erosion. Also you'll need fill less often and possibly not at all. The other advantage is that you will not be able to eat around the band. With the plication, if you eat slider foods they will go into a reduced stomach and you will have to stop eating. With the regular band you could eat as much of the slider food as you could before the surgery.

If this is something you decide you want, you should see if your doctor will accept the insurance's payment for the band as full payment for the banded plication, and if not ask them what the price difference is and see if it is affordable. I have a feeling that doctors are more concerned about finding patients willing to do the procedure than getting extra money for doing it.

Michelle

[mylynn1377 93]

Banded Plication

Banded Plication is a combination of two procedures: the gastric band and a new investigational procedure called gastric plication, or plication. During plication, the stomach is folded in on itself and stitched in place. This greatly reduces the stomach’s volume . In addition, a gastric band – most commonly the Lap Band – is placed around the upper part of the stomach. The band compliments the effects of the plication by also significantly reducing the amount of food eaten, as well as feelings of hunger.

How it Works

Weight loss with the gastric band is generally slower than with other procedures like the sleeve or gastric bypass. However, since the band is adjustable, patients have ongoing follow-up and “fills” (adjustments). Other than the benefit of a personalized process of finding the optimal tightness of each patient’s band, the adjustable nature of the band means that patients who relapse and begin to gain weight back, can often be helped back on track by further adjusting the band. No other weight loss procedure has this benefit. The banded plication was created with the idea of combining the advantage of the rapid early weight loss seen with plication, and the ability to further sustain weight loss for a longer period of time with the adjustable gastric band.

The Procedure

Banded Plication is a procedure that is performed laparoscopically, meaning it’s minimally invasive. Generally the surgery involves five or six small incisions in the abdomen. Using a tiny video camera and instruments through these small incisions, the surgeon performs the procedure with no cutting, stapling, or removal of the stomach or intestines during the Gastric Plication. Additionally, Plication is potentially reversible. This is different from the Sleeve Gastrectomy, in which part of the stomach is removed, making it irreversible.

After Surgery

After undergoing a banded Plication, patients usually stay in the hospital for 1-2 days. Patients are usually asked to stay on a liquid diet for several weeks after surgery, and then transitioned to solid foods under the guidance of the surgeon and dietician. Your surgeon and support staff will advise you on what type of post-surgery eating and lifestyle habits you should follow, in order to most benefit for your procedure.

Weight Loss Trends

Although there is significant data about the weight loss that occurs with a gastric band, the banded plication is a new and experimental procedure, so there is very little data available yet. Additionally, even plication performed on its own is a new procedure, and considered investigational because of the current lack of data in terms of safety or efficacy. Short-term clinical studies on the plication have reported that patients lose between 40% to 70% of their excess body weight during the year following the surgery. Additionally, many co-morbidities improve or resolve after weight loss surgery. However, clinical trials comparing either plication or banded plication to standard bariatric procedures are not available yet.

Who Qualifies

Since Plication is investigational, it is usually performed only in research studies (ASMBS gastric plication statement). Different surgeons and institutions will have different criteria for patients they would accept into these studies, however these requirements would typically be similar to criteria for other bariatric procedures, such as the NIH criteria for bariatric surgery, and the FDA criteria for the Lap-Band.

Cost

The cost of Banded Plication varies from practice to practice, and is generally expected to be more than the Lap-Band alone, but less than a more complex procedure like the gastric bypass. Because plication is an investigational procedure, and therefore the combined banded plication is investigational, it is not usually covered by insurance.

Potential Complications

All surgeries have risk of complications. Potential complications of Banded Plication include infection, bleeding, injury to other organs, and a leak from the suture line used to fold the stomach. A good surgeon will inform you about the risks associated with the various weight loss surgery procedures. It’s important to make sure you understand both the benefits and risks of any procedure you consider.

http://doctorsofweightloss.com/banded-plication