To suture or not to suture, that is the question

WASaBubbleButt · 12-09-2007, 02:30 PM

Quote:

Originally Posted by Ang1982

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?

He's not going to change technique on your request.

I'm still banking that there is a misunderstanding somewhere.

It would be kinda like a doctor saying they don't close the skin after surgery for a long incision. Do you really need to request that be done or should that be a given?

HHWALJ · 12-09-2007, 02:58 PM

I'm not due for my surgery until 12/11/07 but my surgeon is suturing my band, and after reading all of these posts I'm glad he is.

Ang1982 · 12-09-2007, 06:57 PM

Quote:

Originally Posted by WASaBubbleButt

He's not going to change technique on your request.

I'm still banking that there is a misunderstanding somewhere.

It would be kinda like a doctor saying they don't close the skin after surgery for a long incision. Do you really need to request that be done or should that be a given?

No I understand what you are getting at, in our consult he explained how he did use sutures and now doesnt for "blah blah blah reason" (sorry I completely forget, although I know it had to do with the width of the midband). When I phone to make my other appointment though I will inquire as to the reason again. As you said, could very well be that I misunderstood so we shall find out :D

pippinje · 12-10-2007, 07:07 PM

Quote:

Originally Posted by Ang1982

No I understand what you are getting at, in our consult he explained how he did use sutures and now doesnt for "blah blah blah reason" (sorry I completely forget, although I know it had to do with the width of the midband). When I phone to make my other appointment though I will inquire as to the reason again. As you said, could very well be that I misunderstood so we shall find out :D

Ang, keep us updated! It would be very informative!

Ang1982 · 12-11-2007, 05:16 PM

Okay so my curiousity got the better of me and I emailed his office. I fully expected a member of his staff to answer that email as opposed to him and was delighted to see that he responded directly. I can tell from his email that he was a bit on the defense as he may have thought that I was saying he didn't know anything. So I've since emailed him back with an apology if he misunderstood my intention in the question...

What I asked: "in my consult I believe he told me that they do not need to use sutures when doing the Midband. Can you please tell me if I am recalling this correctly? The reason I ask is with futher research and talking to other Lap Band patients (not of his) they informed me that their surgeons were rather adament about using sutures to hold the Band in place. I know not doing sutures is a fairly new practice for him. Could you please tell me why again that he does not do these. And are having sutures an option if this is something that I felt strongly about?"

His response: "You heard correctly. With the MIDband, according to the manufacturer, and Dr. Frerer, who personally has placed over 5000 bands (1000 Swedish Bands, 1500 Lapbands, the rest MIDbands), anterior plication stitches are NOT necessary. Therefore, I do not place these stitches when I place these bands. They don't seem to do any good, at least not with the design of the MIDband. Dr. Patrick Yau, perhaps the most experienced Canadian bariatric Lap Band surgeon (Toronto) also places MIDbands, although he is trained in Inamed bands, Swedish bands and MIDbands. There are six adjustable gastric band companies whose products are available for us to place in Canada.
If I place a Swedish band (used in Europe and around the world for years, just approved in the USA Sept 28th, will be marketed this January on TV etc), then I will place anterior plication stitches, per the
manufacturer's recommendation. I am trained to place lapbands, but I need to be proctored for two cases before I can place these on my own.
I have chosen not to pursue this at this time, as I see no advantage of
this band over the Swedish band or the MIDband.

Remember, virtually all of the USA patients have lapBANDs(r). Their products are different than the ones that I use. Not better, not worse, just different . until a few months ago, USA surgeons could ONLY use one product. how could they possibly comment effectively on another band that they have no experience with? Further, most USA surgeons have only done the Lap Band since 2001, and not the 1990s like the Europeon surgeons.

To answer the latter part of your question. I prefer placing the MIDband at present, and if that is the band we go with, then I will NOT place any plication sutures. If we place a Swedish band, then, per the manufacturer's instructions, we will place anterior plication stitches. That is the choice. The price is the same with both of these. I am
comfortable placing both of these. I think that the weight loss will be
the same with both of these. The MIDband people suggest that there may be less complications with their band, and that it is softer (it feels
softer, with no rigid parts) and that their patients report that the band is more comfortable. How can they say this? In France, bands are covered as part of their 'MSP'. Some patients with failed bands from other companies may have had a MIDband placed later, and reported on the differences. I am impressed by how easily it is to place. I was most impressed by the technical skills of Dr. Frerer. If he thought stitching was necessary and useful, he would do it. "

There you have it. I am comfortable with his response and with him as a surgeon in general and will continue my persuit of the band in his capable hands. (sorry for the bad formatting, I was just copy pasting from my email)

IndioGirl55 · 12-11-2007, 05:23 PM

Quote:

Originally Posted by Boysaway

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.

I asked this question of Dr Watkins on another theard about the New Band = Here is his reply:

Most American doctors do secure the stomach over the top of the band to prevent slips. I've heard of surgeons not doing this but only in other countries, outside the U.S.

I see you are from the UK so it's a different standard than here is the USA

pippinje · 12-11-2007, 08:43 PM

Quote:

Originally Posted by Ang1982

Okay so my curiousity got the better of me and I emailed his office. I fully expected a member of his staff to answer that email as opposed to him and was delighted to see that he responded directly. I can tell from his email that he was a bit on the defense as he may have thought that I was saying he didn't know anything. So I've since emailed him back with an apology if he misunderstood my intention in the question...

What I asked: "in my consult I believe he told me that they do not need to use sutures when doing the Midband. Can you please tell me if I am recalling this correctly? The reason I ask is with futher research and talking to other Lap Band patients (not of his) they informed me that their surgeons were rather adament about using sutures to hold the Band in place. I know not doing sutures is a fairly new practice for him. Could you please tell me why again that he does not do these. And are having sutures an option if this is something that I felt strongly about?"

His response: "You heard correctly. With the MIDband, according to the manufacturer, and Dr. Frerer, who personally has placed over 5000 bands (1000 Swedish Bands, 1500 Lapbands, the rest MIDbands), anterior plication stitches are NOT necessary. Therefore, I do not place these stitches when I place these bands. They don't seem to do any good, at least not with the design of the MIDband. Dr. Patrick Yau, perhaps the most experienced Canadian bariatric Lap Band surgeon (Toronto) also places MIDbands, although he is trained in Inamed bands, Swedish bands and MIDbands. There are six adjustable gastric band companies whose products are available for us to place in Canada.
If I place a Swedish band (used in Europe and around the world for years, just approved in the USA Sept 28th, will be marketed this January on TV etc), then I will place anterior plication stitches, per the
manufacturer's recommendation. I am trained to place lapbands, but I need to be proctored for two cases before I can place these on my own.
I have chosen not to pursue this at this time, as I see no advantage of
this band over the Swedish band or the MIDband.

Remember, virtually all of the USA patients have lapBANDs(r). Their products are different than the ones that I use. Not better, not worse, just different . until a few months ago, USA surgeons could ONLY use one product. how could they possibly comment effectively on another band that they have no experience with? Further, most USA surgeons have only done the Lap Band since 2001, and not the 1990s like the Europeon surgeons.

To answer the latter part of your question. I prefer placing the MIDband at present, and if that is the band we go with, then I will NOT place any plication sutures. If we place a Swedish band, then, per the manufacturer's instructions, we will place anterior plication stitches. That is the choice. The price is the same with both of these. I am
comfortable placing both of these. I think that the weight loss will be
the same with both of these. The MIDband people suggest that there may be less complications with their band, and that it is softer (it feels
softer, with no rigid parts) and that their patients report that the band is more comfortable. How can they say this? In France, bands are covered as part of their 'MSP'. Some patients with failed bands from other companies may have had a MIDband placed later, and reported on the differences. I am impressed by how easily it is to place. I was most impressed by the technical skills of Dr. Frerer. If he thought stitching was necessary and useful, he would do it. "

There you have it. I am comfortable with his response and with him as a surgeon in general and will continue my persuit of the band in his capable hands. (sorry for the bad formatting, I was just copy pasting from my email)

Thanks for the update!