Lap Band or Plication

[annanyc 33]

Hi,

I recently decided to get lap band after more than a decade of fighting my weight. I have no problem losing it. I've gotten down to 130-140 on no fewer than 4 separate occasions in the past 10 years. But I also shoot right back up to 190-210 mere months later. It's exhausting. And while I wish I could be one of those women who lived life to the fullest, regardless of the scale, I'm just not. My weight has too often limited the way I live- the opportunities I take, the relationships I pursue, etc. This summer I didn't even go to my cousin's wedding, because I didn't want everyone to notice I was fatter than the last time they saw me. Terrible! If I could, what I'd really want to do is lose all the weight again and *then* get the lap band, because that's when I need a little extra help. And don't most dieters gain the weight back? A timely use of lap band at the low point, well, not a doctor and haven't seen any studies, but I bet this would work wonders.

Anyway, my BMI is currently only 30, has only been as high as 33, and I don't have any comorbidities. As such, insurance paying for the lap band was never an option. After much research, I decided to get the procedure done in Mexico, where they will perform the surgery on BMIs above 28. However, the center there seems to be pushing for gastric plication. The price is comparable (especially factoring in the after care for the lap band and none for gp). Both are supposed to be reversible (though one website seemed to suggest that though gp, doesn't cut into the stomach, the folding and sutures scar it so significantly that further revisions are problematic). From what I can tell, gastric plication seems more restrictive and often leads to more weight loss. But there isn't a lot of other data about it in relation to incidence of complications or long-term results. Is anyone aware of any studies? Or does anyone have anecdotal information of why one might be better than the other? Or why they selected one over the other?

[2muchfun 8,927]

The only plication I've seen or heard of is on the forum and it's banded with plication. See Carolinagirl.

[GuyMontag 1,264]

They can do plication without banding but I think they do commonly put the two together now for better results. I know my doc's office has started doing the plication with good results but it's still fairly new.

[annanyc 33]

Yeah, if you google it's called "stomach saving gastric plication". They don't use staples, and it's supposed to be about as effective as a gastric sleeve plus reversible and without required adjustment follow-up like the band. They fold your stomach up over itself and stitch it so it remains contorted in place. You don't bypass anything, you can still absorb all nutrients...

It doesn't sound bad, really, except it does sound more "dramatic" to me, and the fact that there aren't a lot of long-term results out there is also a little unsettling. I'm probably still going to go for the band. But the center seems to be such a fan of gp, I wanted to make sure I wasn't missing out on a much better option for no good reason.

[Toddy 758]

As of last November 2012, plication was still in the research stage and Doctors in the US that were performing plication were only allowed to do it in conjunction with the band. Who knows what the laws are in Mexico.

I had plication after my band slipped and to be perfectly honest, I have needed just as many fills after plication as I needed without plication.

If I was going to do anything other than the band with plication, I would just go ahead and opt for the sleeve.

[lisacaron 5,075]

The plication of the stomach is similar to the gastric sleeve surgery only it is done without staples and it is done without removal of any portion of the stomach. The stomach is instead folded in on itself and then stitched in place.

The purpose is to make the stomach smaller so that food that is passed through the band and into the stomach is there for a shorter period of time before moving onward to the intestine, and so that the stomach portion is filled up with that much less and hunger is there for reduced.

It also helps to stimulate certain hormones in the digestive system similar to that of the gastric sleeve again without the removal of the stomach or the staple line.

This is in the investigation phase right not and has not become the standard for operations as yet. They are still collecting data on patients.

I hope this helps.

I have been banded with stomach plication, and while I still need fills in my band the increased digestion I have with the plication is why I chose to add it to my surgery.

[n2win 123]

Very informative! This was not even discussed as an option during my consultation; which is now understandable being in a pilot stage. I first learned about it on this forum. I find it extremely interesting and cannot waiting

[n2win 123]

Oops hit send... I cannot wait to hear any new data from those who have had it. I hope it is another successful addition to wls.

[annanyc 33]

I believe at the OCC they're offering plication as a sole procedure, without the band. I've decided to go the band route. But I do think it's an interesting option, just maybe a little too extreme for what I'm looking for. I also welcome lap band's continued adjustability depending on how much help I'm needing and where my weight loss is.

Plication does sound like a really promising option to the normal sleeve surgery though. Supposedly, complications so far have been dramatically reduced. If subsequent data backs this up, I bet it will become an additional option.

Thanks for all the comments/help!

[healthydnp 96]

Hi' date='

I recently decided to get lap band after more than a decade of fighting my weight. I have no problem losing it. I've gotten down to 130-140 on no fewer than 4 separate occasions in the past 10 years. But I also shoot right back up to 190-210 mere months later. It's exhausting. And while I wish I could be one of those women who lived life to the fullest, regardless of the scale, I'm just not. My weight has too often limited the way I live- the opportunities I take, the relationships I pursue, etc. This summer I didn't even go to my cousin's wedding, because I didn't want everyone to notice I was fatter than the last time they saw me. Terrible! If I could, what I'd really want to do is lose all the weight again and *then* get the lap band, because that's when I need a little extra help. And don't most dieters gain the weight back? A timely use of lap band at the low point, well, not a doctor and haven't seen any studies, but I bet this would work wonders.

Anyway, my BMI is currently only 30, has only been as high as 33, and I don't have any comorbidities. As such, insurance paying for the lap band was never an option. After much research, I decided to get the procedure done in Mexico, where they will perform the surgery on BMIs above 28. However, the center there seems to be pushing for gastric plication. The price is comparable (especially factoring in the after care for the lap band and none for gp). Both are supposed to be reversible (though one website seemed to suggest that though gp, doesn't cut into the stomach, the folding and sutures scar it so significantly that further revisions are problematic). From what I can tell, gastric plication seems more restrictive and often leads to more weight loss. But there isn't a lot of other data about it in relation to incidence of complications or long-term results. Is anyone aware of any studies? Or does anyone have anecdotal information of why one might be better than the other? Or why they selected one over the other?[/quote']

I was in a similar boat as you. My bmi was 33 to start with so my insurance wouldn't cover it. My surgeon and I talked about both options. For me the best option was the band because I needed to lose 50-60 lbs. I was concerned about the complications with the plication and with the malnutrition that comes with it. I like the idea of being able to adjust based upon my weight loss. I am 4 days post op and feel better than I had. The first couple of days were rough because I was having a hard time staying hydrated and sensing hunger. The plication is not as easy to reverse as the band but you do what is right for you. I have lost 6.8 lbs since surgery and hope by next week I can eat a little more and can do more energy wise. If you want I would be your buddy to help you through the process. Ultimately you need to do what is right for you. Good luck.

[Bos123 221]

There's a few people on here who have had the plication and band. I only have the plication. I love it, low bmi, not as strict as I should be but I'm still loosing... Down 52 pds from my highest and 9 pds from goal. There is no malabsorption issues as your whole stomach is there. They say its reversible ( not that I would want to do that). Will there be issues with that if a day comes where I would need it reversed? Maybe. But that can be the case with lb too or any other wls. At this point my whole stomach is alive and well, I can only fill part of it. Good luck with your decision;)