Overview of Gastric Plication
Gastric plication surgery (GPS) is one of the newest and most promising types of weight loss surgery for patients to consider. The operation compares favorably to current bariatric procedures and offers patients a less invasive and lower cost option with similar weight loss results.
The operation reduces stomach volume to limit eating and assist with weight loss, yet it keeps the natural stomach intact and does not involve gastric resection or a medical device. The procedure does not cause malabsorption like gastric bypass or require an access port or periodic adjustments like laparoscopic adjustable gastric banding.
During laparoscopic surgery, the stomach is resized and reshaped to resemble a narrow tube, similar to sleeve gastrectomy (gastric sleeve), but without cutting, stapling, or removing of any portion of the stomach. Rather, stomach tissue is folded in on itself (imbrication) and then stitched together (plication) along the greater curvature of the stomach wall. This approach allows for increased safety, quick recovery, reduced cost, and complete reversal.
Gastric plication surgery is still fairly new and study data is limited, but based upon experience to date the procedure appears promising. Initial reports indicate satisfactory weight loss and low risk of early and late complications. Patients usually feel less hunger, feel full quicker, and feel full on small amounts of food.
Several clinical trials are also ongoing as researchers continue to gather long-term data on this new weight loss surgery. Outside of clinical trials, only a few doctors in the United States perform gastric plication surgery. With further development and continued positive results, gastric plication surgery will likely become more widely available in the next few years.
About Gastric Plication Surgery
The gastric plication operation is an outpatient procedure with low-risk and a quick recovery. The procedure is performed laparoscopically, a surgical method that requires only five or six small incisions in the abdomen.
During surgery, the outer wall of the stomach is folded in on itself (imbrication) and then held together with sutures (plication). This process creates a long, narrow tube-shaped stomach with reduced capacity for food. The natural stomach is kept intact, allowing for reversal if necessary.
Other names for Gastric Plication Surgery (GPS) include Gastric Imbrication, Gastric Sleeve Plication, Vertical Gastric Plication, Vertical Sleeve Plication, Laparoscopic Gastric Plication (LGP) and Laparoscopic Greater Curvature Plication (LGCP).
Recovery from Gastric Plication Surgery
Patients are usually out of the hospital the same day and back to work in about one week. During the first few days, patients may experience nausea as they try to adapt to the new smaller stomach capacity. The recovery diet calls for liquids during the first two to three weeks and then slowly advancing to solid food over the next two to three weeks.
Advantages of Gastric Plication Surgery
- No cutting, stapling, or removing of stomach tissue
- Minimal risk of early and late complications
- Quick recovery
- Easily reversible
- Reduces hunger and restricts eating
- Weight loss comparable to other bariatric procedures
- Lower cost
Disadvantages of Gastric Plication Surgery
- Lack of long term data
- Not covered by insurance
- Performed by only a few doctors at this time
Gastric Plication vs Other Bariatric Procedures
Compared to gastric sleeve, there is no complication from leaks or bleeding due to resection as the natural stomach is not cut, stapled, or removed; also, the GPS procedure can be reversed.
Compared to gastric bypass, it does not cause malabsorption or dumping syndrome as there is no intestinal rerouting, or cause stoma problems as the natural stomach outlet is kept intact.
Compared to laparoscopic adjustable gastric banding, it does not require a medical implant, does not need periodic adjustments, and there is no complication from band problems (erosion, slippage, or leaking), port problems (displacement, leaking, or infection), or stoma blockage.
Gastric plication surgery is ideally suited for people who have 50 to 100 pounds to lose. It is not meant for those who have to lose more than 150 pounds. Pre-op requirements include nutritional counseling and psychological evaluation to determine if the patient is an appropriate candidate for the procedure.
How it Works
The procedure works by controlling diet portions and hunger to assist with weight loss. It does not interfere with dietary choices or cause malabsorption or dumping syndrome. Because the stomach is significantly smaller, patients usually feel less hunger and get full faster. When patients feel full (which happens after only a small amount of food), they should stop eating. If they eat too much, they can experience great discomfort.
Weight Loss Results
Short term results show satisfactory weight loss up to three years. The amount of weight loss is similar to other bariatric procedures, while having the lowest amount of complications. Patients in studies to date have lost an average of 60 pounds.