Gastric Plication

Gastric plication or stomach plication is a restrictive weight loss surgery which involves reducing the gastric space through imbrication of or folding back of the stomach walls. The intent is to reduce the size of the stomach, so as to limit the food intake, which in turn will contribute to weight loss.

Also known as laparoscopic greater curvature plication or GCP, gastric plication has been the subject of a lot of speculation by obesity surgeons, patients, hospitals, and bariatric surgery societies all over the world.

Recently, the American Society for Metabolic and Bariatric Surgery (ASMBS) helped clear some air over this weight loss procedure by releasing an ASMBS Policy Statement on Gastric Plication, dated March 8, 2011. According to this statement, though gastric plication poses lower risk than other weight loss surgeries since it does not involve removal of a part of the stomach, placing a foreign device in the body, or bypassing the intestine, yet it should be considered in the investigative stage.

Despite a lack of adequate data to draw unequivocal conclusions on the efficiency and safety of this weight loss surgery, stomach plication is finding quite a few takers. In fact, stumped by high cost of weight loss surgeries back home, patients from the U.S. and Canada are hopping borders to Mexico and even traveling to far-off medical tourism destinations such as Jordan, Belgium, and India for gastric plication surgery.

An Overview of Gastric Plication Procedure

This surgery is performed minimally invasively by using a laparoscope. The imbrication of the stomach walls results in giving the sutured stomach a tube-like appearance. Because of reduced gastric space, the patient feels full on consuming a small quantity of food.

Gastric plication is a reversible procedure and is suitable for candidates with body mass index of 40 kg/m2 or more. Patients with body mass index from 35 to 39 kg/m2 but suffering from medical conditions ensuant with obesity, such as hypertension, type 2 diabetes, metabolic syndrome, and cardio vascular diseases, can also be considered good candidates for stomach plication.

The Advantages of Stomach Plication

As per results of a study “Laparoscopic gastric plication for treatment of severe obesity” by Brethauer, Harris, Kroh, and Schauer, published in the official journal of ASMBS on October 11, 2010, gastric plication surgery results in substantial weight loss in a shorter span of time compared to other weight loss surgeries. Recovery time after stomach plication is quick, on account of it being minimally invasive.

This procedure does away with the need of going for future adjustments or fills, which may be required in case of gastric banding. Since there is no need of stapling the stomach or inserting foreign devices into the body, this procedure is relatively easy on the pocket compared to other weight loss surgeries.

Downsides of Gastric Plication

Though chances of risks associated with stomach plication are low, in rare cases one can experience bleeding and infection. Infolding the stomach very tightly can lead to dysphagia; whereas, if the stomach fold is left too loose, it will result in more gastric space, which in turn will contribute to regaining weight. As a result of reduced food intake, there are chances of suffering from nutritional deficiencies, and one might have to resort to consuming nutritional supplements.

A key drawback of gastric plication is the dearth of data and studies corroborating its long term sustainability. Another drawback of opting for gastric plication is lack of insurance cover, since this procedure is considered in the investigative phase by both bariatric surgeons and insurance providers. As a result, patients will have to self-finance this weight loss procedure.

Despite it being a new form of weight loss surgery, gastric plication is being hailed by obesity surgeons all over the world as an answer to all the questions raised over the results of weight loss surgeries. Nonetheless, intended patients should exercise forethought while considering gastric plication and check from credible sources about their candidacy for the surgery.

Reference

• Brethauer, Stacy A., Jason L. Harris, Matthew Kroh, and Philip R. Schauer. “Laparoscopic gastric plication for treatment of severe obesity.” Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery 7, no. 1 (January 1, 2011).

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