Expert: Karla K. - 10/17/2008

Question
I had a Gastric sleeve 1-10-08.  I was told by my surgeon that he put a mesh around my stomach so it would create a scar tissue so the stomach would not stretch.  I am able to eat 1/2 cup of food however sometimes I can eat less and I get such bad pains. Not the feeling of being full like eating to much at Thanksgiving but actually pain like I was punched in the stomach.  I am wondering if this is a normal procedure done for gastric sleeves so the stomach will not stretch out.  I am also wondering if the scar tissue can cause a stomach stricture?  If so would bypass surgery help or cause more problems?

Answer
Hi Cece:

Only one surgeon comes to mind who uses mesh around the stomach (a surgeon in Virginia)--and I have not seen any studies that show it leads to an increase in stricture.  It is not the norm, however.  

Dr. Gagner did a study regarding mesh in pigs--but I don't believe any human trials have been done.  In his study, it his limited study it did prevent dilation of the sleeve to some degree.  However, there were four pigs who died from strangulation.  
http://www.ncbi.nlm.nih.gov/pubmed/17400032?ordinalpos=5&itool=EntrezSystem2.PEn...

Pain is not good. Period.  It's not normal. It doesn't sound like the normal pain some people feel when they overeat (usually in the esophagus).   I think you need to contact your surgeon regarding the pain you're experiencing.  As for any sort of revision (such as removing the mesh or converting to a bypass or duodenal switch), you'd need to consult a surgeon.  Why don't you try and contact Dr. Michel Gagner at Mt. Sinai in Miami Beach? He's the guy who did the first lap-duodenal switch as well as pioneered the two stage DS, using a VSG as the first stage.  He might be able to offer some advice. (mgagner at msmc.com)

Sorry I can't be of more help.

Karla