To suture or not to suture, that is the question

Boysaway · 12-07-2007, 07:51 AM

Did your surgeon suture your stomach up over the band?
Mine doesn't do this as his view is that most erosions occur because of this and that it is unnecessary. He said there is no research that proves either way which is best but he has a very low erosion rate.

Marimaru · 12-07-2007, 10:48 AM

My understanding is that the practice of suturing the stomach over the band has nothing to do with erosion and everything to do with slippage. It's to help keep the band where it's supposed to be on the stomach. I have read studies (although I don't keep these bookmarked) where this method significantly reduce slippage percentages.

Kaitiana · 12-07-2007, 05:15 PM

I haven't been banded yet but my hopefully-future surgeon does do the sutures. He seems to think that it does reduce the risk of slippage.

steph_co · 12-08-2007, 01:07 AM

Wow...I had heard that slippage is almost guaranteed without stitching the stomach. Huh. I don't see what stitching would have to do with erosion, but I'm not a surgeon, either! ;)

Ang1982 · 12-08-2007, 01:29 AM

My surgeon told me in my consult that with use of the Midband stiching is not required due to the extra width of it, etc. Perhaps that is where some confusions will lie.

faithmd · 12-08-2007, 05:21 AM

Quote:

Originally Posted by Marimaru

My understanding is that the practice of suturing the stomach over the band has nothing to do with erosion and everything to do with slippage. It's to help keep the band where it's supposed to be on the stomach. I have read studies (although I don't keep these bookmarked) where this method significantly reduce slippage percentages.

Here's a link to an article that discusses surgical technique with the Lap Band system and also has some stats about the different methods of suturing into place.
http://thinforlife.med.nyu.edu/asset...ristine_J._Ren

From what I understand the J&J band, and the Lap Band are sutured. Don't know a lot about the MidBand and can't find a lot about it, either. But it makes sense with the size of it that it may always be sutured in place. The bands themselves aren't stitched, your stomach is pulled up and over them and sutured. There are pics in the article link I provided.

BarbBee · 12-08-2007, 10:50 AM

I had the midband and my Doctor did the posterior and anterior stiching to help prevent slips.

Boysaway · 12-08-2007, 10:58 AM

I should have said mine is a Midband. The erosion occurs more in sutured stomachs (in my surgeon's opinion) because the join of the band is usually under the part of the stomach that is sutured, and with normal stomach movement and peristalsis there is a degree of rubbing goes on.
I don't know which is best but I suppose you have to trust your own surgeon.

kacee · 12-08-2007, 11:04 AM

I think MOST doctors suture the band

BarbBee · 12-08-2007, 11:57 AM

The stiches are placed away from the buckle of the band but I would imagine it does move around in there. I think once it settles into the grove of your stomach it doesn't move around too much. I know surgeons are very careful about how exactly it is placed in the stomach. The article was really interesting. I would like to know more about the different surgical techniques and outcomes.

WASaBubbleButt · 12-08-2007, 09:04 PM

I didn't know there were any surgeons NOT suturing the band.

My doc sutures the band as required and has had 2-3 erosions out of 2000.

pippinje · 12-08-2007, 11:16 PM

In my consult with my doc he stated that he sutures and like someone said earlier...it wasn't in reference to erosion, but slippage.

Ang1982 · 12-09-2007, 01:15 AM

Hmmm now you all have me wondering about the fact that my surgeon now won't be suturing with the Midband. Do I need to be concerned? When he explained it at the time it made sense but of course that was a while ago and now I don't remember.

WASaBubbleButt · 12-09-2007, 07:37 AM

Quote:

Originally Posted by Ang1982

Hmmm now you all have me wondering about the fact that my surgeon now won't be suturing with the Midband. Do I need to be concerned? When he explained it at the time it made sense but of course that was a while ago and now I don't remember.

I'm kinda hoping you misunderstood him. Is it possible he was explaining that he uses the new technique to suture? The old technique did result in many complications. Actually, it was the Mexican surgeons who perfected the technique to suture it in place due to all the complications.

There would be nothing holding the band in place if he doesn't suture your stomach up and over the band. It would just be kinda hanging there with a hope and a prayer it would stay.

The more I think about it the more I'll bet you that there was a misunderstanding. The band you refer to is just another band with a couple of small changes, it's still a band that needs to be held in place. The changes made to that band had nothing to do with how it is sutured in place, the changes were completely different. Maybe your doc is better at "doing" the job than he is at "explaining" the job?

Ang1982 · 12-09-2007, 01:03 PM

Quote:

Originally Posted by WASaBubbleButt

I'm kinda hoping you misunderstood him. Is it possible he was explaining that he uses the new technique to suture? The old technique did result in many complications. Actually, it was the Mexican surgeons who perfected the technique to suture it in place due to all the complications.

There would be nothing holding the band in place if he doesn't suture your stomach up and over the band. It would just be kinda hanging there with a hope and a prayer it would stay.

The more I think about it the more I'll bet you that there was a misunderstanding. The band you refer to is just another band with a couple of small changes, it's still a band that needs to be held in place. The changes made to that band had nothing to do with how it is sutured in place, the changes were completely different. Maybe your doc is better at "doing" the job than he is at "explaining" the job?

I don't think I was misunderstanding as I'm almost positive that he said that the recovery time would be slightly better due to the fact that they don't have to suture. I have to phone his office to book my appt with the anaesthesiologist (sp) so I will inquire about it then. If he does indeed not suture anymore should I request that he does?