Banded Plication

So I just heard about this and found it interesting.  There's a new WLS available called banded plication.  A link explaining the procedure fully is here.  Basically the idea is they combine making the actual stomach smaller with a band to bring the benefits of both a bypass and a band.  They fold the stomach over, basically creating one half the size and then place the band.  There's another link here that goes on to say how 23% of banded patients have complications such as slippage, erosion, port flips, etc.  That number sounds higher than I remember but perhaps I had rose colored glasses on.  I found this part particularly interesting -

Recently, the idea of combining the two procedures sort of a “belt and suspenders” type approach was introduced.  The theory behind this technique is that the plication is performed to begin the initial weight loss process.  The weight loss continues as the patient changes their behavior through proper eating habits and exercise.  If the patients then down the road, usually 8 months to a year later, slows to lose all the weight that they would like or if the weight loss plateaus, then the band adjustments begin.  This theoretically might decrease complications associated with the band might as many of the bands complications i.e. port site infection, flippage etc, are related to adjustments of the band.


I admit the idea of being able to do something new a year out of surgery to re-jump the weight loss is certainly appealing.  I also wonder if it provides somewhat of a safety net.  There's still no cutting, they're not rerouting anything directly to your intestines or anything.  So if plication doesn't work, you have the band and vice versa.  Would we see as many band removals this way?  Would we see less people spending thousands of dollars on surgery only to find that it wasn't the right surgery for them?  In a lot of ways, I imagine this would be a money saver in a sense.  It's still laproscopic so they can do 2 procedures in one and if you find yourself stalled,  you still have OPTIONS.  Studies are still early and big studies comparing this procedure to RNY or sleeve haven't even been done yet so it seems fairly new.


Anyway, what really interested me in this is that I heard from my doctor's newsletter that he'll be doing these as well.  I wonder if it's due to a lack of successful patients?  I've always loved my doc and he's big on aftercare and support groups and all that and it's easy to get scheduled for fills and unfills, etc.  Anyway, I found this interesting and would love to hear your thoughts on it.