Pleatman's Conversion Surgery

[DeLarla 22]

I read on another threat that a surgeon is offering to convert his bandsters to a new version of bypass. He also mentioned it in the "Ortiz" thread. Does anyone know what he's talking about? Is it a newer less evasive bypass?

I'm at a standstill with my weight. To lose more I'd have to eat less but I'm so hungry the way I'm eating now. I just don't know if I can stand restricting calories much longer.

I realize a bypass isn't even an option since I'm no longer "morbidly" obese so I don't know why I'm asking, but I'm really curious why a surgeon would want to convert from band to bypass.

Anyone?

[puddin 7]

Because the band didn't work for them or it had to be removed. That's why. At least, that's what I've gathered from Pleatman's posts. Hell, I'd probably convert if this band weren't working so darn well.

[PamRN 0]

I suppose if you were obese enough to get a band, the band failed, and you hadn't completed the weight loss portion of the band program, you should qualify for a continuation of your journery as a prevention to relapse of obesity. As for bypass...I was gonna do it before I found the band. I'm glad I found the band, because I was scared s#itless about having my intestines cut, BUT I'd still consider it if my band failed me, and I found myself gaining weight. I hated obese me, I was disgusted by my fatself, and I'll do whatever it takes to keep me from ever getting there again. That certainly includes bypass. Could Dr Pleatman be talking about the switch that Geezer Sue is having? (I think it was the Duodenal switch).

[the best me 6]

Dr Pleatman mentioned the Gastric Sleeve, which is apparently some type of, uh, sleeve, the fits over the stomach, making it smaller, or at least unable to expand as much. From what I have gathered, it does NOT require any re-routing or stapling or cutting of the digestive system.

Worth investigating? Vera mentioned she would convert to that if she needed another option. I'm curious to find out more, too.

[JanetC 2]

Just a quick search brought up:

http://cpmcnet.columbia.edu/dept/cs/divisions/obesity/surgical_sleeve.html

[the best me 6]

Yer cool Janet! So I was wrong about the cutting...60% of the stomach is removed laporoscopically. It's a pre-cursor to the switch (DS) or gastric bypass, but can be done alone. I dunno. I imagined a mesh-type sleeve around the stomach but, I guess not.

[princess_n_thep 2]

What I don't understand about the "sleeve" is that it is designed to be a 1st phase before the RNY. So for severely morbidly obese, they have this surgery first, then follow up with a normal bypass operation when they are within better levels for surgery. Why would this be a conversion option? I don't understand why Dr. Pleatman would say this is recommended for someone banded in a conversion. If someone had the band for 2 years, then chances are they are not severely morbidly obese anymore. So why would this be the preferred surgery when it is meant to be the first of two surgeries? I hope he comes and posts about this, I would like to know exactly what it is as I have definitely contemplated the "conversion" option. But, I think I would be a candidate for straight RNY rather than the sleeve.

"Sleeve gastrectomy is a new procedure that induces weight loss by restricting food intake. With this procedure, the surgeon removes approximately 60 percent of the stomach laparoscopically so that the stomach takes the shape of a tube or "sleeve." This procedure is usually performed on superobese or high risk patients with the intention of performing another surgery at a later time. The second procedure can either be a gastric bypass or duodenal switch.

This combined approach has tremendously decreased the risk of weight loss surgery for specific groups of patients, even when the risk of the two surgeries is added. Most patients can expect to lose 30 to 50% of their excess body weight over a 6 - 12 month period with the sleeve gastrectomy alone. The timing of the second procedure will vary according to the degree of weight loss, typically 6 - 18 months." http://www.columbiasurgery.org/divisions/obesity/surgical_sleeve.html

[DeLarla 22]

Hmmm, interesting. Thanks everyone. Though I'm not a typical conversion person since I don't even have a band. Jenna, two surgeries? No thanks.

[princess_n_thep 2]

Hmmmmmmmmmmmm, this sounds interesting. It is a newly introduced form of surgery they are performing now in study trials. The band WITH RNY bypass. Geez, could you imagine the list of things that can go wrong? Side effects of the band AND RNY? How would I know if I was going to PB or dump? Or maybe both? Oh the confusion!! Just give me one or the other please.

BANDED GASTRIC BYPASS

This procedure is a combination of the Roux-en-Y gastric bypass and the once common Vertical Banded Gastroplasty. In this operation, the implantation of a plastic band around the stomach pouch (resulting in significant restriction of food intake) in addition to the changes of absorption seen from the gastric bypass, may have been associated with 20% more excess weight loss than one would expect from gastric bypass alone. Therefore, expected weight loss is 60-90% of a patient's excess weight.

Banded Gastric Bypass is being offered as a prospective randomized and double blind trial to patients who are suffering from malignant obesity. Malignant obesity, defined as a body mass index of 50 or greater (approximately 200 pounds or more over ideal body weight) is associated with decreased quality of life, many illnesses and an increased risk of dying that has been estimated at 5-10 times greater than normal weight patients.

This research study involves the implantation of a plastic band around the stomach pouch during a standard gastric bypass procedure. The band is made of polypropylene mesh, commonly used for hernia repair as well as in Vertical Banded Gastroplasty. Patients are assigned at random (like the flip of a coin) to have the standard gastric bypass operation or the experimental procedure with a band around the stomach pouch. Patients are not told which operative group they belong to until two years after surgery. The Nurse Practitioner conducting follow-up evaluations will also be uninformed as to which group patients belong.

At this time, Banded Gastric Bypass is only being offered at our center as part of this study. If results from this study show a benefit, this may be offered outside the study in the future

http://www.columbiasurgery.org/divisions/obesity/surgical_banded.html

[Vera 7]

Gastric Sleeve would be my choice if my band would have to be removed.

Most patients can expect to lose 30 to 50% of their excess body weight over a 6 - 12 month period with the sleeve gastrectomy alone.

I have done research on this for the last month.

I believe the Phobi ring was put on Randy Jackson?(American Idol judge) along with the Rny.

[niche 0]

a friend of mine was in the FDA trial for the fobi pouch. she has the opening to her pouch banded with a non-adjustable ring and a mesh around her pouch as well. it has worked very well for her and she has lost all of her excess weight. the purpose of the ring is that your esophagus doesn't dilate and the pouch never gets bigger.

[Sunta 4]

Does anyone know which of these procedures (excluding the LAP Band) has the best safety record?

[DeLarla 22]

Jenna, all that stuff you wrote sounds like a pretty good motivator to count calories! That's way too complicated for these old bones! I'll just get my lips sewn shut.

[DevilMayKare 1]

Jenna, all that stuff you wrote sounds like a pretty good motivator to count calories! That's way too complicated for these old bones! I'll just get my lips sewn shut.

I had my jaw wired shut for 12 weeks one time. Seriously. Well, they basically put braces on your back molars and wire your mouth shut. The grossest part is not being able to brush your teeth but you can get pretty good with a waterpik. Talking is a bit tough--but you can double as a ventriloquist.

Really--I am NOT making this up! I lost about 50 pounds in those 12 weeks tho.

Pretty unbelievable, uh?

Oh yeah... maybe not as unbelievable as spending $10,000 and having major surgery to wrap a plastic band around one's stomach...

The things we do...

[Kelliebelly 13]

There is actually a few people here in Australia that have had different probs with the band and have converted to a procedure called Tubal Gastrectomy. They have had amazing results with it. I am not sure of the in and out details but I can copy an email she wrote to me about what it is in her words with permission of course :

Well the Tubal Gastrectomy is reducing the size of your stomach, let a set

and forget type of thing. So if I did a drawing for you, you would see,

oesophagus, small tube of stomach and then intesting all about the same

width. However with the TG, its done in a certain way to go with the way the

muscles work and are constructed in the stomach. Its supposed to be so you

may get stretch BUT it should spring back pretty quick, unlike old stomach

stapling. Its not reversible as far as I know.

It can also be done via keyhole surgery!

So, I was thinking if anything happened with my band I may look into this but touch wood I will have my band forever because I LOVE MY BAND!!!

It may be an option though for those who have lost their band and are struggling.

You are doing so well with no band Delarla, I cant imagine how hard it must be for you.

Hugs