Surgical techniques

jfk · May 29, 2007

Hi everyone...

Perhaps some of you who have been banded could help me out with this question....

I went to the Inamed website, and read the directions to surgeons for implantation of the gastric band. Inamed cautions the surgeon against stitching the band to the stomach, due to increased chance of erosion. However, the date of the material was 2005. I see in the thread about Dr.s & hospitals, that some surgeons do indeed stitch the band to the stomach. Someone said that Dr. Kirshenbaum of Denver uses this procedure. Perhaps the criteria has changed since 2005? Has anyone had any complications from stitching the band to the stomach? I have a consult with Dr. Kirshenbaum tomorrow afternoon, and the procedure is scheduled for July 18th. This makes me wonder??? Another question... in my extremely rural area, I only have regular access to a PA. She has told me that should I get banded, she would learn to do the fills. Does anyone know whether there is some particular requirement that fills be done by a surgeon or other MD, and any restrictions against a PA or RN doing them? Another worry... in almost all of the criteria I've read on various gastric banding sites, it seems the maximum age they feel is best for the surgery is 55-yo. I am 58, and wondering if its going to have a greater risk at that age.... then, I remember how truly bad I feel physically on almost a daily basis, it seems I'm just better off to risk the surgery, because it seems like I will never feel any better than I do now.... I'm only going downhill...quickly!

Also, I have not yet had the courage to break the news to my DH that I am planning to have this surgery. He has always been a health nut, who keeps himself in tremendous shape.... workouts every day, eats right, etc. He has tried so hard to understand the struggle, but, for someone who has never faced a weight issue, its just an alien concept to him. I know I have to do it soon, but I am quaking inside at the prospect!

I am new to the board, and I have never before discussed this issue with anyone, and am filled with all the same doubts and fears as anyone else who contemplates such a life-altering change.

Thanks for your thoughts... I would surely appreciate so much hearing them.

jfk

cyndilou29 · May 29, 2007

I don't know about revised instructions from Inamed about stitching the band to the stomach but I would like to know - definitely! I know my surgeon did that and most surgeons that I have spoken to (I am in medical sales) that do the band do stitch it to prevent slippage.

In any case, the thing with the PA shouldn't worry you. In most states, PAs are allowed to assist in surgical procedures so they are very qualified to stick a needle in a port. My friend had cancer and had a port-a-cath put in and the LPN at the chemo center would do the sticks, so I'm sure an NP or PA will be fine. The "I'll learn to do it" part is a little disconcerting though. There is no one near you who has experience doing the fills?

Regarding your age, 58 is young girlfriend! My mother in law is 66 and she had it done in March and frankly has had fewer complications than me and I'm 39! She is definitely losing a little slower though. She's down about 25 lbs since March 9 which is still GREAT weight loss.

You're going to have to "bite the bullet" and tell your DH. I know it will be difficult at first, especially where he doesn't understand your struggle, but remind yourself that you are doing this for YOU and that, while of course his opinion is important to you, it won't change anything. And once he sees his "new" sexy hot mama who eats healthy and exercises right along with him, trust me if he ever argued about you doing it - he'll stop.

Good luck with your journey

faithmd · May 29, 2007

They don't actually stitch it to the stomach, they put a stitch in the stomach and pull it up over the band creating a little tunnel for the band to sit in. Google "pars flaccida" surgical technique, that is what band surgeons should be doing now, when you have your consult you can ask what technique he uses.

To truly understand how the band is placed and what is meant by pars flaccida and stitching, you can watch a video of the band being placed at: Tampa General Hospital?

Good luck!