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Gastric Plication as a New Stand-Alone Procedure for the Treatment of Morbid Obesity
10.5005/jp-journals-10033-1217
OriginaL articLe

Gastric Plication as a New Stand-Alone Procedure for

the Treatment of Morbid Obesity

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1 Youssef A Andraos, Dany Ziade, Rana Achkouty, Therese Youssef Andraos
AbSTRAcT Source of support: Nil

Purpose: Gastric plication of the greater curvature is spreading Conflict of interest: None
over all the bariatric centers as a new investigational procedure
for the treatment of morbid obesity. Conventional bariatric INTRODucTION
surgeries ‘gastric band’,‘sleeve gastrectomy’,‘vertical banding
gastroplasty’ and ‘gastric bypass’ are associated with severe Gastric plication of the greater curvature achieves weight
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complications and a high rate of failure or weight regain. loss by reducing gastric volume by 80 to 90% (Figs 1A
Materials and methods: Authors present their experience on and B).
482 laparoscopic greater curvature plication (LGCP) performed 3-7
over a period of 26 months. A total of 449 patients responded Gastric restriction is performed laparoscopically by
to inclusion criteria:147 men and 302 women. Their mean age suturing the infolded greater curvature of the gastric wall
was 35.99 ± 10.85 years. Their mean body mass index (BMI) (Figs 2A and B). Conventional bariatric surgeries, such
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was equal to 39.93 ± 6.15 kg/m . as ‘gastric band’, ‘sleeve gastrectomy’, ‘vertical banding
Results: The average percentage of excess weight loss gastroplasty’ and ‘gastric bypass’ are associated with severe
(%EWL) at 1, 3, 6, 12, 18 and 24 months was 30.19, 47.07, complications and a high rate of failure or weight regain. 8-18
63.05, 68.15, 68.62 and 69.29% respectively. Moreover, this
study was divided into two subgroups and results were studied Published short-term and midterm data on gastric plication
based on the type of suturing and patient’s BMI over a period of
1 year. The first subgroup included 183 patients, where gastric
plication was performed with continuous suturing at the first
and second row. The second subgroup included 186 patients,
where gastric plication was performed with separated stitches
at the first row and continuous suturing at the second row. In
the second subgroup, a higher degree of %EWL was found.
The complication rate was greater in the first subgroup.The
overall rate of immediate surgical complications was 1.33%.
Mean hospital stay was 36 hours.
Conclusion: Gastric plication is safe and efficient on EWL
based on short-term results. Separated suturing is associated
with a higher %EWL and a lower rate of complications, with a
short hospital stay. Long-term data are needed to consolidate
these results.
Keywords: Obesity, Overweight, BMI, %EWL, Gastric plication, A
Bariatric surgery, LGCP.
How to cite this article: Andraos YA, Ziade D, Achkouty R, Andraos
TY. Gastric Plication as a New Stand-Alone Procedure for the
Treatment of Morbid Obesity. World J Lap Surg 2014;7(2):49-59.

1,2 Chief, Anesthesiologist, Medical Student
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1 Department of General Surgery, Abou Jaoude Hospital, Beirut
Lebanon
2,3 Department of Anesthesiology (Bariatric Unit), Abou Jaoude
Hospital, Beirut, Lebanon

4 Department of Medicine,American University of Beirut, Beirut
Lebanon
B
Corresponding Author: Youssef A Andraos, Chief
Depart ment of General Surgery, Abou Jaoude Hospital, Beirut Figs 1A and B: (A) Gastric capacity reduction by folding the gastric
Lebanon-60144, Phone: +961-3-250811, e-mail: yaandraos@ greater curvature inward and (B) gastric capacity evaluation in a
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hotmail.com normal and obese person before and after LGCP as measured by
peroperative gastric filling
World Journal of Laparoscopic Surgery, May-August 2014;7(2):49-59 49