Bart Decadt

Consultant Laparoscopic Bariatric

& Upper GI Surgeon

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Gastric Plication

How is the Gastric Plication performed?

Gastric Plication surgery is a relatively new operation and is therefore currently considered "experimental". It is performed under general anaesthesia using keyhole (laparoscopic) surgery. Small incisions are created in the abdominal wall to allow small instruments to be passed into the abdominal cavity, guided by a special surgical telescope with a video camera, in order to perform the operation. Using sutures, the volume of the stomach is considerably reduced by folding in (plication) of the stomach along its outer curvature. Its main advantage is that it is reversible, as it does not involve removal of any part of the stomach or bypass of the intestine. There is no stapling involved (as in bypass or sleeve) and no foreign body is used (as in gastric band), so it should be a safer procedure.

How long does the operation take?

The average operating time for Gastric Plication is 40-60 minutes.

How long will I stay in hospital after the surgery?

Most patients will be able to go home within two days after surgery, and some will stay longer should they develop prolonged vomiting or other issues or should they have other health problems such as with their mobility, or should they lack support at home.

Who is suitable for Gastric Plication?

Like other bariatric operations, Gastric Plication surgery is indicated for the following groups of people:

When appropriate non-surgical measures have been tried but failed to achieve or maintain adequate, clinically beneficial weight loss in patients whose BMI is 40 kg/m2 or more or between 35-40 kg/m2 in association with other significant disease (for example, type 2 diabetes, heart disease or high blood pressure). Surgery is also recommended as a first-line option (instead of lifestyle interventions or drug treatment) for adults with a BMI of more than 50 kg/m2 in whom surgical intervention is considered appropriate (National Institute for Clinical Excellence). However, the need for surgery to aid weight loss and the choice of surgical procedure is dependent on discussion with the bariatric team who will provide you expert and comprehensive advice.

What are the benefits of Gastric Plication?

The laparoscopic introduction of this procedure is relatively recent, and the World experience with it is very limited. Therefore, there are no long-term results. Considerable weight loss of 50-65% of excess body weight within 12-18 months. Heavier patients (BMI >45 kg/m2) don’t do as well as lighter patients and are more likely to fail in achieving satisfactory weight loss. Weight loss is associated with marked improvement or resolution in health conditions related to obesity, particularly type-2 diabetes, hypertension, gastro-oesophageal reflux, obstructive sleep apnoea, asthma, liver disease, high cholesterol, and painful osteoarthritis. Improvement in overall physical and psychological health

What are the risks of Gastric Plication?

As with any surgical operations there are associated short and long-term complications such as prolonged vomiting, late stomach obstruction, stomach perforation and leak (less than 1%), internal bleeding, blood clot in the legs (deep vein thrombosis; DVT), blood clot in the lung (pulmonary embolism), infection, and weight regain.

Will I regain the weight?

As this operation is relatively new, here are no long-term data available. However, as with other weight loss operations, there is the potential for durable weight loss but some patients are likely to stretch the stomach and regain weight. It is essential therefore to adopt a new life style and carry it on for a durable result.

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“I enjoy attending the monthly support group sessions where I am helped by others who have experienced weight loss surgery..”

POST-OPERATIVE Care