Calling all (TGVP) people!!! new procedure

[kkd 1]

I am considering gastric plication. I've had 2 nissan fundiplications in the past. One broke down after 2 years when I had a really bad stomach virus. I had really bad nausea post-op and we think I weakened the sutures from the start. The 2nd was very sucessful. No reflux, not able to vomit no matter what!

I guess I have a couple of questions.

Does anyone know if BCBS of NC covers this procedure?

Can I have it done after having the Nissen fundiplication?

How does it work using an out-of-state surgeon? Do I have to go to the other state (really interested in Dr. Watkins from all I've read).

Does anyone in NC do this procedure? And, do they have any/much experience with the procedure? I really do not want to be a guinia pig!

I appreciate this forum so much!

[MS LISA 1]

Hey Lisa

That sounds gr8 my surgery is on the 8th of November with Professor Martin Fried. How are you feeling? Will you be taking someone with you?

Regards

Letme

Letme,

Yes, I will be taking my mom with me, she goes everywere with me.

I am very nervous thanks for asking, I still have not decided for sure if I am going to have the plication or the VSG, I am having the hardest time trying to decide.

Other then that I am ok and still doing alot of research on both of them.

Were is your Dr located? And how much is your surgery going to be?

I wish the best for ya and a speedy recovery as well!

Take care, God Bless,

Ms Lisa~

[letmeeatcake 0]

Hey Lisa my surgery will be in Prague, in the Czech Republic and I will be travelling from the W. MIDS UK, the surgery, transport including flights and transfers, two nights accomodation hospital and two nights (pre and post op) in an apartment will cost me ?5,400.

If you are interested and need Nick's number I can email this to you?

Regards

Letme:svengo:

[MS LISA 1]

Ok everyone!! I am now going to talk to the dr him self about the surgery and which surgery will be best and which vsg or plication also i want to ask him alot more question but i know that i will forget every question so i am writing them down and i am asking you all to help pick some very good questions for me cause i am a scader brain please help me!!!!

[JoanieW 13]

I am considering gastric plication. I've had 2 nissan fundiplications in the past. One broke down after 2 years when I had a really bad stomach virus. I had really bad nausea post-op and we think I weakened the sutures from the start. The 2nd was very sucessful. No reflux, not able to vomit no matter what!

I guess I have a couple of questions.

Does anyone know if BCBS of NC covers this procedure?

Can I have it done after having the Nissen fundiplication?

How does it work using an out-of-state surgeon? Do I have to go to the other state (really interested in Dr. Watkins from all I've read).

Does anyone in NC do this procedure? And, do they have any/much experience with the procedure? I really do not want to be a guinia pig!

I appreciate this forum so much!

Welcome, KKD. I'm sorry, I don't know of any doctors in NC that do this procedure; however, I did travel to Cincy from GA to get my plication done with Dr. Wakins. My surgery was on Fri., and we left the next day and drove home seven hours. Dr. Watkins and his staff have stayed in touch, and I was able to have my barium swallow (required as a followup by Dr. W.) here, so I haven't had to go back.

I'm sure Dr. W. will be along and answer your questions about the fundoplication. If you choose to go to Cincy, you will be in good hands.

[kkd 1]

Hi Joanie,

Thanks for the support! I was concerned about how this would work for pre-op workup then having surgery and being so far away in case of problems/questions.

When did you have your procedure and how are you doing since? I've been researching lap-bands but this is a new procedure to me.

Karen

[DrWatkins 13]

I am considering gastric plication. I've had 2 nissan fundiplications in the past. One broke down after 2 years when I had a really bad stomach virus. I had really bad nausea post-op and we think I weakened the sutures from the start. The 2nd was very sucessful. No reflux, not able to vomit no matter what!

I guess I have a couple of questions.

Does anyone know if BCBS of NC covers this procedure?

Can I have it done after having the Nissen fundiplication?

How does it work using an out-of-state surgeon? Do I have to go to the other state (really interested in Dr. Watkins from all I've read).

Does anyone in NC do this procedure? And, do they have any/much experience with the procedure? I really do not want to be a guinia pig!

I appreciate this forum so much!

Regarding plication after Nissen fundoplication (surgery for severe heartburn/reflux/GERD):

My thoughts are that if the Nissen fundoplication is working to control the heartburn, then leave it intact - leave that area alone and then plicate the remaining stomach below that. This way, you have an intact anti-reflux mechanism and an excellent weight loss tool as well.

If the previous fundoplication was done through an open surgery (large incision in the middle of your abdomen), then the scar tissue is expected to be greater than if it were done laparoscopically and that would be something to contend with during the surgery. If the fundoplication was done laparoscopically (tiny incisions) then you would expect very little to no scar tissue and therefore this wouldn't add any grief to another operation.

When you re-operate on a patient with previous fundoplication, what you find varies quite a bit. Sometimes the wrap (fundoplication) has completely fallen apart and it looks nearly like nothing was done. Sometimes the wrap is very much still present with lots of accompanying scar tissue associated with it. Generally, if the fundoplication is still providing excellent relief from heartburn, chances are good that it is still intact. This correlates very strongly. If the heartburn has returned as bad as ever, chances are good that the wrap is apart. The status of this wrap, which would be easy to evaluate during surgery, might alter a surgeon's opinion on what is best to do surgically during plication surgery.

Like so many situations in surgery, great judgment is required to evaluate the endless potential findings and make good decisions about how to proceed. This is an example of evaluating what you are dealing with and making decisions to maximize benefit to the patient while minimizing complications and/or frustration post-operatively.

The simple answer is, it would be possible to perform plication after Nissen fundoplication. Surgical findings would dictate how best to proceed regarding takedown the fundoplicatino and plicate the full length vs. leave the fundoplication intact and plicate distal to that.

Brad Watkins MD

[JoanieW 13]

Hi Joanie,

Thanks for the support! I was concerned about how this would work for pre-op workup then having surgery and being so far away in case of problems/questions.

When did you have your procedure and how are you doing since? I've been researching lap-bands but this is a new procedure to me.

Karen

Hi Karen. I had my surgery on Aug. 6, and I'm doing very well. I've lost 24 pounds including the one week preop diet I was on. Unfortunately, I didn't lose any last week. You will sometimes hit a stall. If you click on Dr. Watkins' name in one of his posts, you can read everything he has written regarding the plication. That will give you a lot of information.

Joanie

[lguidry 5]

Well, I will be having my plication surgery 10/4/10 and I'm excited. Would love to communicate with anyone who has had this procedure.

[genepha 47]

Well, I will be having my plication surgery 10/4/10 and I'm excited. Would love to communicate with anyone who has had this procedure.

Hi,

Congrats on your surgery date. Who is performing your surgery?

Good luck and please keep us updated on how your surgery goes.

genepha

[lguidry 5]

Hi,

Congrats on your surgery date. Who is performing your surgery?

Good luck and please keep us updated on how your surgery goes.

genepha

Dr. Ortiz will be doing my procedure at the Obesity Control Center in TJ, Mexico.

[lguidry 5]

Hi Karen. I had my surgery on Aug. 6, and I'm doing very well. I've lost 24 pounds including the one week preop diet I was on. Unfortunately, I didn't lose any last week. You will sometimes hit a stall. If you click on Dr. Watkins' name in one of his posts, you can read everything he has written regarding the plication. That will give you a lot of information.

Joanie

Want to stay in touch with anyone who has had this procedure. Welcome any comments from those who have "gone before me". Keep posting please!!!

[JoanieW 13]

Want to stay in touch with anyone who has had this procedure. Welcome any comments from those who have "gone before me". Keep posting please!!!

Hi Lguidry,

I'm sorry to be late in posting, but I haven't been on here for a few days. I am doing great. I'm down 27 pounds since my preop diet. My surgery was on Aug.6. I think my weight loss has slowed down a little because I came off of one of my blood pressure pills, and it was a diuretic. But just being able to come off my BP meds is great news! I'll be taken off the other one soon, and it's a diuretic as well. I've gone from 210 to 183 in two months, just 33 more to go. I feel good and no more joint pain. Let me know if there are any specific questions you have.

[lguidry 5]

Hi Lguidry,

I'm sorry to be late in posting, but I haven't been on here for a few days. I am doing great. I'm down 27 pounds since my preop diet. My surgery was on Aug.6. I think my weight loss has slowed down a little because I came off of one of my blood pressure pills, and it was a diuretic. But just being able to come off my BP meds is great news! I'll be taken off the other one soon, and it's a diuretic as well. I've gone from 210 to 183 in two months, just 33 more to go. I feel good and no more joint pain. Let me know if there are any specific questions you have.

Thanks for posting and Congrats on the weight loss!! Any advise pre and post surgery? What to eat? How to eat? Any suggestions??

[JoanieW 13]

Thanks for posting and Congrats on the weight loss!! Any advise pre and post surgery? What to eat? How to eat? Any suggestions??

Most of what to eat and when is decided by your physician. I had Dr. Watkins, and he required one week of liquids preop and 800 calories, but I think for a higher BMI it was two weeks on liquids before the surgery. Liquids are anything you can sip through a straw. So, you could mix Soup in a blender. One thing I liked was to whip up a Protein smoothie with cottage cheese. It took away some of the sweetness and was very good. I think some other doctors want you on just liquids. You also need to be around 60-65 gm of protein a day and 60 oz of fluids. The first week after my surgery, I was on one week of liquids (sip through a straw type) and two weeks of mushies which is any food that is mushy, i.e. scrambled eggs, cottage cheese, mashed potatoes, etc.

I don't know that I have any advice for preop surgery other than to follow your doctor's recommendations. Postop diet is a little hard, because mushies go through you pretty fast, as do liquids, so you need to eat a little more often. Keep in mind, you will get hungry, but are easily satisfied on less. I now understand why this is called a tool. You still have to watch what you eat, because you can put a lot of ice cream and potato chips in that little stomach. But it's not the same hunger as before, and it's a lot more manageable and easily satisfied. I think the best part of this is that once I have lost all the weight, It will be easier to keep it off.

Postop, I didn't have any pain or gas, and I think that was thanks to Dr. Watkins. There must be something he does differently, but I'm not sure. I hope that's what you wanted to know. Let me know of any other questions you might have.

So I guess you decided on the plication?