Calling all (TGVP) people!!! new procedure

[DrWatkins 13]

We have now done plication on four patients that previously had gastric bands. They mostly like the fact that the fullness is abdominal and not high in the chest and that you don't need band adjustments and there is no port. They like that they will never require an urgent unfill from getting too tight.

We also know that the plication, like any other procedure, is best to think of as a tool for weight loss and works best in conjuction with making good food choices and adding some type of calorie burning to the mix.

Regarding emotional eating, this is a complex subject and even skinny people have emotional eating and there are literally hundreds of books written on this subject, but the best book on emotional eating I have seen so far is Dr. Gould's book, "Shrink Yourself". Dr. Gould is a psychiatrist who has worked with weight loss patients for nearly 30 years in California. I learned a lot by reading his book. Basically, he helps us identify possible things in our past that might be creating "phantom hunger". It is a pretty intense book and not everyone likes it but I haven't found anything that does a better job of really understanding the kind of emotional eating that interferes with successful weight loss. It is also easier to read than many books on this subject.

Brad Watkins MD

[jodidit 0]

I had my Band removed after 5 years and had the Sleeve Plication done by Dr. Jose Rodriguez in Tijuana, Mexico. He also has an office in Juarez as well. I am maybe 10 lbs from my goal weight of 125 lbs. It has been slow going but am very happy with my decision. I have become very picky about what I put in my mouth. I have to really love it to put it in my mouth. I can take a few big gulps of liquid with no problems.

Jo

Sleeve Pication Revision

Dr. Jose Rodriguez

Tijuana Mexico

[MS LISA 1]

I have heard that after a while your stomach will stretch back to almost normal, or

the stitches will come out after a few years and im kinda worried about that.

Does anyone any insite on this?

Lisa~

[MS LISA 1]

Gastric plication and gastric imbrication are describing the same operation. The ROSE procedure is an endoscopic stitching for gastric bypass patients that have regained weight due to stretching or dilation of the connection between the gastric pouch and the small intestine.

As opposed to the sleeve gastrectomy whereby the stomach is made into a tube using staples (and the stomach is removed), the plication (or imbrication) creates a sleeve by folding the stomach in on itself and then stitching to keep it folded in on itself. Your entire stomach is still there, it's just folded in on itself with stitches to keep it there. No staples. No cutting. No stomach removal.

I have not seen ghrelin studies on gastric plication but plication patients do describe profound appetite reduction and they get full on small amounts of food so it appears to be a very good weight loss tool. Ghrelin reduction comes mainly from pressure, stretching the wall of the stomach, which occurs when the stomach volume is smaller. Ghrelin appears to be a small part of a very complex appetite mechanism of which we only have the most superficial understanding.

In my mind the only downside to the plication is that we just don't have that long-term data with hundreds of thousands of patients over ten to twenty years like we have with the bypass or the band. There is two year data out of Brazil that shows plication weight loss in the 60% excess weight loss at 2 years which compares favorably to other successful weight loss operations.

We performed our 5th plication this morning. Three were band patients that converted to plication and two were primary plication patients (plication done as the original operation). To date, I have been very pleased with the satiety the plication causes and the associated weight loss. We call it the GPS (Gastric Plication Surgery).

GPS is very different from the VBG (vertical banded gastroplasty) from years ago. VBG was simply stapling a small pouch in the upper part of the stomach. GPS (plication) creates a small tube out of the entire length of the stomach.

Hope that helps

Brad Watkins MD

Gastric Plication Surgeon

Cincinnati, OH

Do you think over time the stomach will stretch or the stiches will come out??

Lisa

[MS LISA 1]

Even though we don't have long-term information on the plication, we have placed the exact same sutures on the stomach for many years so we certainly know how they behave over the long-term. Based on our extensive past experience, I believe strongly that our sutures will hold strongly over a lifetime. I also believe that like any other weight loss operation on the stomach that a small percentage of patients will have dilation years later with weight regain. In that instance, we could place more stitches laparoscopically (tiny incisions) or you could band the top of the sleeve or you could have any other weight loss operation for that matter - plication doesn't burn any bridges - you still have your stomach.

It's worth mentioning that I've already seen quite a variation of the stitches being used and that does make a difference. In my opinion, the best way to do the plication is to perform two layers of running 2-O Ethibond suture and then place interrupted stitches to reinforce the outer layer. You don't need to reinforce the inner layer because it will remain beneath the outer layer. I've seen surgeons having trouble with Prolene suture coming undone so I would not recommend this. Prolene doesn't hold it's knots as well and does not cause any reaction from tissue. I've read reports of Prolene stitches coming undone and the patients therefore report zero restriction shortly after the surgery and it has to be redone. Ethibond is a third generation silk suture and it is intentionally designed to cause a reaction with the tissue that creates a little scar tissue at the stitch which makes the bond stronger than simply the stitch. On the outer layer, if you do this as a running (continuous) suture and then reinforce it with interrupted stitches, the plication looks really perfect and is quicker to do (less anesthesia time). Then, the interrupted stitches are easy and quick and you've got redundancy which should make the possibility of it coming undone as near zero as we can get in human healthcare.

Brad Watkins MD

How much is the surgery with you? If you dont mind me asking

Lisa

[SouthernSleever 228]

I also wanted to know if the stitches would come out or the stomach would stretch. Is it possible to pop your stitches by overeating? Does this surgery have a risk of leaks? My other question is I'm nursing my 2 year old and I believe strongly in child-led-weaning. Will I be able to continue to nurse him after the surgery? Will he take away too many calories? I've heard that toxins are stored in your fat cells, if he is nursing when I am losing weight will he consume these toxins?

[MS LISA 1]

I had my Band removed after 5 years and had the Sleeve Plication done by Dr. Jose Rodriguez in Tijuana, Mexico. He also has an office in Juarez as well. I am maybe 10 lbs from my goal weight of 125 lbs. It has been slow going but am very happy with my decision. I have become very picky about what I put in my mouth. I have to really love it to put it in my mouth. I can take a few big gulps of liquid with no problems.

Jo

Sleeve Pication Revision

Dr. Jose Rodriguez

Tijuana Mexico

Hi there, I was wondering if you can give me a update on how you are doing and how much weight have you lost?? I am getting my surgery in a few months and am curious how you are doing after 3 months. You can email me also, sisterlisa@live.com

Lisa

[sleevegenie 0]

Hi, i just saw this, i don't come to this site a lot, i should come more. I really enjoyed reading the post and by now you must be doing really well. I agree, we all have to make the best of the choices we are given. I'm hoping that it works well for everyone who gets one. whatever surgery they choose. They are always coming out with the next generation whatever,,,,improving, fine tuning, i think its great, i thank the powers that be Thank You. Look forward to hearing how you're doing. take care jeani

surgery 5/28/10 SW 240 CW 191 yeah 49 down 51 to go Thank You,

Edited August 28, 2010 by sleevegenie

[JoanieW 13]

Hi,

I replying not because I can answer your questions but because of the question regarding emotions. I had gastric plication done from the beginning 7 weeks ago. I have lost about 35 lbs but I have been fighting the emotion thing from the beginning. I guess in my mind, I thought the weight would melt off. Don't get me wrong I am pleased with the loss but I guess, for me I just thought it would be a little easier. I mean I cut my calories in half if not by more....I am not drinking pop, hardly go out to eat and when I do I get the child's menu and now I'm working out 3 days a week and still I only lose a pound to two pounds a week. One week I gained 3 lbs and the next didn't lose any. There is no doubt this is a mind game and over coming this is harder than I thought. Emotions definitly play a part in my everyday life and I don't know how to over come the fact that food is no longer my best friend. I have good days and bad and I have never regreted my surgery. This is the side that when asked if I was ready pre-surgery.....I could have ever expected this. I don't know if this makes sense but losing weight is just not exercise and diet but it is also working out who I am and focusing on picking up better habits and not relying on food to get me through.

I have read many individuals who have gone from banded to plication and have had success. I wish you all the best in your choices that you make and hope that you find what it is that you need.

Becca

Hi Becca. Congratulations on your weight loss! You're doing better than me. Looks like you have averaged about a pound a day and that's great! It has been four weeks since I started my preop diet, and I have lost 18-1/2 pounds. It is very disappointing when it starts slowing down, but I'm alot better off than I was.

I'm so sorry you're still have emotional issues about eating. So far, that has not been my problem. Please let me know if you ever want to talk. You can PM me, and I'll give you my number.

Thanks again for meeting me at the surgery center. It meant a lot to me.

[JoanieW 13]

Hi, i just saw this, i don't come to this site a lot, i should come more. I really enjoyed reading the post and by now you must be doing really well. I agree, we all have to make the best of the choices we are given. I'm hoping that it works well for everyone who gets one. whatever surgery they choose. They are always coming out with the next generation whatever,,,,improving, fine tuning, i think its great, i thank the powers that be Thank You. Look forward to hearing how you're doing. take care jeani

surgery 5/28/10 SW 240 CW 191 yeah 49 down 51 to go Thank You,

Hi Jeani. Glad to see you over here. Congratulations on your weight loss! It seems like just yesterday you were Jeaniwantasleeve.:confused1:

[Beccatatqueen 11]

Hi Becca. Congratulations on your weight loss! You're doing better than me. Looks like you have averaged about a pound a day and that's great! It has been four weeks since I started my preop diet, and I have lost 18-1/2 pounds. It is very disappointing when it starts slowing down, but I'm alot better off than I was.

I'm so sorry you're still have emotional issues about eating. So far, that has not been my problem. Please let me know if you ever want to talk. You can PM me, and I'll give you my number.

Thanks again for meeting me at the surgery center. It meant a lot to me.

Hey Joanie,

Glad to hear you are doing well. I am doing better than I have been. I am now faithfully working out 3 times a week and that is helping. I actually look forward to it. I also, question myself before i stick something in my mouth. lol...18+pounds is great. Just think it might be slower but it is definitely coming off and that is what counts. Keep up the great work.

Becca

[sleevegenie 0]

I have my sleeve already but i'm very interested in this. Is this done by going down the throat? or is this done laparascopically? or both.? i saw a surgery on youtube but it was a band revision so they had to take the band out first. Couldn't find one that wasn't a band revision. Thanks in advance if someone can answer this for me, jeani

[sleevegenie 0]

Hey Joanie, congratulations on your surgery. Today is three months post op and down 50 lbs, 50 more to go, what a great ride. Hope all is well with you, take care jeani

Edited August 29, 2010 by sleevegenie

[Cknorte 7]

I have my sleeve already but i'm very interested in this. Is this done by going down the throat? or is this done laparascopically? or both.? i saw a surgery on youtube but it was a band revision so they had to take the band out first. Couldn't find one that wasn't a band revision. Thanks in advance if someone can answer this for me, jeani

The surgery is done laparascopically, sort of like the traditional sleeve. I have 5 incisions, 4 really small ones, and one between my boobs around 1 inch. They go down your throat with the bougie to measure out size of sleeve and sew against it, sort of like the staples on traditional sleeve. I think the main difference is that they leave your stomach intact, the fold it onto itself to create a sleeve. I have had great restriction and I can eat anywhere between 1/2 cup to 3/4 cup of food at a time, depending on density. If it is liquid, I can get in maybe a cup before I feel full.... It has been a little over 5 weeks for me and I'm down 28lbs. So far so good. I don't get the insane hunger anxiety "need to eat now or I will kill" feeling. I feel satisfied. If I take the extra bite after being full, I get a pang in my belly and I know one more will make me hurl. We follow the same diet progression as traditional sleeve, we just seem to move through it faster, I was on soft foods week 3 and by week 4 I was eating chicken and steak (ok very thin steak)..... I think this is a great option for those of us who were a little aprehensive about losing or cutting out an organ, or had family who were aprehensive about it. Like all other WLS it is a tool and it depends on us to make the correct food choices...I can either drink milk shakes all day or have healthy protein....you know the drill..... Hope this helps some....congrats on your surgery....and success

[sleevegenie 0]

cool, thanks for the 411 I could swear ive heard talk of it being done thru the mouth with no insisions but i haven't seen anything about it. I also heard they can do it vaginally as well. its truly amazing what they can do. Congratulations to you on your surgery and success. Yes I'm sure that the post op is the same basically, its still a sleeve and my post op diet was the same as yours, my doctor was fairly lenient with us compared to some post op diets i've heard of, :confused1:) jeani

three months post op 50lbs gone forever, halfway to goal yahoo!!