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  home > weight-loss surgery > Roux en Y Gastric Bypass Surgery

Considering Gastric Plication Surgery?

Gastric plication or greater curve plication surgery is the newest weight-loss procedure and alternative to the adjustable gastric band and vertical sleeve gastrectomy (VSG), as well as an excellent option for weight loss revision surgery.

What is Gastric Sleeve Plication?

Gastric plication, sleeve plication, or greater curve plication can best be explained as a version of the more popular sleeve gastrectomy procedure, where a gastric sleeve is created by suturing, rather than cutting or stapling of the stomach. Performed laparoscopically, the gastric plication reduces the stomach volume by imbricating and plicating the stomach wall and reshaping it to a narrow tube or "sleeve." This preserves its natural nutrient absorption capabilities, while reducing the stomach by almost 60-80%.

Why choose gastric plication surgery?
  • No staples, no bands, no fills, no adjustments
  • Reduced risk of early complications
  • Reduced risk of gastric leaks or bleeding
  • The function of the stomach remains intact
  • Does not cause malabsorbtion, therefore reduced risk of malnutrition and vitamin deficiencies as compared to the DS and RNY

LapSF offers a unique approach, by offering gastric plication surgery as both a primary and revisional surgery

Who is this procedure for? In our experience, we have found that several groups may benefit from this procedure. As a primary procedure, the greater curve plication is a sensible option for those who wish to maintain their complete gastric anatomy, not be subject to malabsorption and vitamin deficiency issues, and do not want a prosthetic device in their body. This option makes sense for someone who wishes to avoid the risk of a staple line leak, which is possible in the sleeve gastrectomy. For those who have undergone a vertical sleeve gastrectomy procedure and have experienced inadequate weight loss, gastric plication surgery is an excellent alternative to more invasive and complicated revisional weight loss surgery options. LapSF has the largest case series of gastric sleeve procedures in the world, which gives us unparalleled technical expertise to revise the stomach sleeve with the least rate of complications.

Advantages

  • A less invasive approach after the sleeve gastrectomy procedure if adequate weight loss has not been achieved
  • An excellent, less invasive alternative for those seeking a weight loss surgery revision
  • Greatly reduced complication rate, as compared to other weight loss surgery revisional approaches
  • Creation of gastric restriction and reduced stomach capacity without gastric resection.
  • No loss of stomach tissue; the 'sleeve' is created by suturing and plicating (folding in) rather than removal or stapling
  • Gastric sleeve plication can be performed as ambulatory procedure - only 1 night total hospital stay

Drawbacks

  • New and relatively unproven procedure; no long-term data
  • No Ghrelin (hunger hormone) reduction, as in the traditional gastric sleeve or sleeve gastrectomy procedure
  • Potentially greater possibility of stomach expansion or stretching
  • May result in higher rates of nausea or vomiting
  • More difficult to revise later, should weight loss be inadequate
  • Most insurance companies will not cover this procedure

Things to bear in mind

Gastric sleeve complications-associated with any surgery-like infection, bleeding, reaction to anesthesia may occur. Gastric plication surgery is still in its experimental phase and is not yet recognized by medical insurance companies or the American Society for Bariatric and Metabolic Surgery (ASMBS). The long term effects of this procedure are still unknown.

AKA

The gastric or sleeve plication procedure to date has the following names in the medical literature or the internet: Gastric plication surgery, gastric sleeve plication, gastric imbrications, laparoscopic greater curvature plication, greater curvature plication, gastric imbrication, total vertical sleeve plication, etc.

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