Gastric Sleeve Plication Surgery
The Gastric Sleeve Plication is a new approach and a great alternative as a restrictive bariatric procedure. It has shown to have similar results to the Gastric Bypass or the Gastric Sleeve regarding weight loss but no long-term studies exist. It is a safe procedure done in approximately 50 minutes and does not involve cutting or stapling of the stomach, making it safer as it eliminates the possibility of a leak, which is the most feared complication of a Gastric Bypass, Gastric Sleeve or Duodenal Switch.
How is the procedure done?
The first part of the procedure is done in a very similar way as the Gastric Sleeve where the greater curvature of the stomach is dissected from vessels and greater omentum. After this is done a 32 Fr calibration tube or bougie is then placed to perform the plication. At this point a first layer of non-absorbable interrupted stitches is placed to follow with two more layers of non-absorbable running sutures to form the Sleeve Plication.
With gastric plication (also called gastric pleat, or gastroplication) offers patients the following benefits:
- Noninvasive - no stomach resection
- No stomach staples, eliminating the risk of bleeding along the staple line, a rare but serious possible complication of vertical sleeve gastrectomy and gastric bypass
- No devices – with gastric plication your restriction is accomplished with non-absorbable sutures
- Faster weight loss than the popular restrictive procedure gastric banding – early weight loss outcomes are similar to gastric bypass, which offers typical weight loss of 77% of excess weight in one year
Early patient data demonstrate weight loss results similar to gastric bypass with no reports of complications. The procedure, best understood as an evolution of the more familiar sleeve gastrectomy surgery, offers weight loss surgery patients a number of very critical benefits:
- A less invasive evolution of the gastric sleeve procedure, plication is an ambulatory procedure – no surgical drains, only 2 nights total hospital stay
- No loss of stomach tissue - the 'sleeve' is created by suturing rather than removal (preserving nutrient absorption capability)
- No devices, no staples, no bands, no fills
- Reduced risk of early or late complications
- No complication from leaks or bleeding at the staple line (as compared to gastric sleeve)
- Does not impair patient dietary habits
- Early data (patients at 6-12 months post procedure) indicate resultant weight loss is comparable to gastric bypass
Some post-op symptoms are:
- Nausea and vomiting
- Excess salivation
- Gastroesophageal reflux
- Local patients can be discharged 24 hours post-op and out of town patients are advised to stay 2 nights in the hospital prior to discharge
Advantages of the Gastric Sleeve Plication:
- Safe procedure
- Done through laparoscopy (minimal invasive surgery)
- Great weight loss similar to Gastric Bypass (roux-en-y) or Gastric Sleeve (2 year study)
- No dumping as with the Gastric Bypass
- No leaks or staple line bleeding like in the Gastric Bypass, Duodenal Switch or Gastric Sleeve
- No foreign body or prosthesis as with the adjustable Gastric Band
- No adjustments needed like with the adjustable Gastric Band
- No slippage or erosion as with the adjustable Gastric Band
- No port site infection as with the adjustable Gastric Band
Disadvantages of the Gastric Sleeve Plication.
- No long-term results
- Reversibility is questionable
- Conversion or revision to another weight loss surgery is questionable
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