Plication - did you get reflux with your plication

[Starr 0]

Are one of the side effects with the plication reflux? Did you get it? How do you control?

Best,

Starr

[genepha 47]

Starr,

I haven't had my plication yet but when I spoke with my dr. he did

mention that this can be a side effect, at least in the beginning.

I had severe reflux with my band when I had any fill so I'm really

hoping I don't have to deal with reflux again. I'm guessing a PPI

will be given during the first few weeks. Hopefully someone who

has actually had the procedure done will respond so we can both

know more!

genepha

banded Dec, 2001

Awaiting insurance approval for band removal/replacement with self-pay plication

[DrWatkins 13]

Are one of the side effects with the plication reflux? Did you get it? How do you control?

Best,

Starr

It is critically important to strengthen the hiatus when making the stomach smaller (band, sleeve, plication, etc). In essence, hiatal hernia is present in nearly 100% of overweight people. Overweight creates chronically elevated intra-abdominal pressure which dilates the hiatus.

In doing band surgeries by the thousands over the last 8 years we have learned that you have to stitch the hiatus (basically a hiatal hernia repair) in all patients, otherwise they will have terrible reflux (heartburn) after the procedure. Plication is the same way. I always repair the hiatus with plications or bands. I have talked to patients plicated by other surgeons where this was not addressed and they have terrible reflux. I have a lot of transfer patients (patients who had surgery by other surgeons) where they have a band but no hiatal hernia repair was done and they have such terrible reflux that I have had to perform a hiatal hernia repair so they could lose weight with their bands - be able to tighten it enough for weight loss.

Many surgeons say this is unecessary but my experience tells me this is not correct. Anytime you make the stomach smaller, the hiatal hernia must be addressed. What I have learned is that you have to look for the hiatal hernia. In many cases it is not obvious untill you dissect out the hiatus. Reflux after plication is preventable by good hiatal hernia repair. Even with hiatal hernia repair, if you eat too fast or eat too much after plication you can still have heartburn, but the kind of severe heartburn that occurs even after eating a small meal and chewing carefully - that is preventable with perfect hiatal hernia repair.

I also have learned how important it is to use the proper suture material and the proper way to stitch the hiatus closed. Incorrect suture or improper technique are associated with hiatal hernia recurrence which you also don't want.

Brad Watkins MD

[Starr 0]

Thank you so much for the response Dr. Watkins. It is greatly appreciated not only by me but by others who visit here with interest in the Plication. I feel very lucky that you are here. Best,

Starr

It is critically important to strengthen the hiatus when making the stomach smaller (band, sleeve, plication, etc). In essence, hiatal hernia is present in nearly 100% of overweight people. Overweight creates chronically elevated intra-abdominal pressure which dilates the hiatus.

In doing band surgeries by the thousands over the last 8 years we have learned that you have to stitch the hiatus (basically a hiatal hernia repair) in all patients, otherwise they will have terrible reflux (heartburn) after the procedure. Plication is the same way. I always repair the hiatus with plications or bands. I have talked to patients plicated by other surgeons where this was not addressed and they have terrible reflux. I have a lot of transfer patients (patients who had surgery by other surgeons) where they have a band but no hiatal hernia repair was done and they have such terrible reflux that I have had to perform a hiatal hernia repair so they could lose weight with their bands - be able to tighten it enough for weight loss.

Many surgeons say this is unecessary but my experience tells me this is not correct. Anytime you make the stomach smaller, the hiatal hernia must be addressed. What I have learned is that you have to look for the hiatal hernia. In many cases it is not obvious untill you dissect out the hiatus. Reflux after plication is preventable by good hiatal hernia repair. Even with hiatal hernia repair, if you eat too fast or eat too much after plication you can still have heartburn, but the kind of severe heartburn that occurs even after eating a small meal and chewing carefully - that is preventable with perfect hiatal hernia repair.

I also have learned how important it is to use the proper suture material and the proper way to stitch the hiatus closed. Incorrect suture or improper technique are associated with hiatal hernia recurrence which you also don't want.

Brad Watkins MD

[TijuanaPlication 87]

I'm nearly 3 weeks out and haven't expierenced any reflux - I never had it before though. I didn't have a hernia (I guess coz I'm a relative light weight), although other people that were operated on at the same time as me got their hernias done.

I've not taken any meds for reflux either, just occasional painkillers (only a couple of times a week now). I just chew very thoroughly, have small bites and eat very slowly. I find that taking a break (a minute or so) when I've eaten a bit helps as it gives you time to realize that you're full and don't actually want any more.

Are one of the side effects with the plication reflux? Did you get it? How do you control?

Best,

Starr

[Need2LoseW 0]

I have been reading a lot about stomach acid in regard to VSP (plication). I'm wondering if this is perhaps because the whole stomach is still making acid, in a very small space? I'm wondering if this could be a drawback to plication? I'm still trying to decide between VSG and VSP. Thoughts?

Thanks!