DOI: http://dx.doi.org/10.18203/2349-2902.isj20182211

Laparoscopic greater curvature plication as a stomach sparing gastric sleeve: is it a worthy weight losing procedure for morbid obesity?

Adel M. Abdallah, Mohamed E. El Nemr

Abstract


Background: Although laparoscopic sleeve gastrectomy (SLG) considered a gold standard way of management of morbid obesity, it still has serious complications as bleeding and staple line leak. Laparoscopic greater curvature plication (LGCP) was introduced as a trial gastric restrictive procedure and recently modified and standardized to obtain a gastric sleeve without resection and hence lower complications rates with the advantage of being a reversible procedure.

Methods: 28 patients suffered from morbid obesity with body mass indices less than 50 kg/m2 filling the selection criteria of the study were prepared for Stomach Sparing Gastric Sleeve (SSGS). After devascularization of the greater curvature, double in-folding of the greater curvature using non-absorbable 2-0 sutures starting at the angle of His to 3-4 cm proximal to the pylorus, were done.

Results: 28 patients with preoperative mean total body weight (TBW) of 118.7±15.5 kg and a mean BMI of 38±6.5 kg/m2 were the target of this study. The mean operative time was 103±11 min. Early minor postoperative complications were detected in 18 patients (64%) and included nausea, vomiting and sialorrhea. Postoperative reflux esophagitis was detected in 2 patients (7%). Postoperative % EWL (excess weight loss) was 32.2% at 1 month, 48.9% at 3 months, 53.3% at 6 months, 66.7% at 12 months and 70.2% at 15 months. The improvement of the pre-existent co-morbidities occurred in 7 patients (53.8%).

Conclusions: SSGS is a promising low cost restrictive bariatric operation. It is reversible and effective weight losing procedure in the short term.


Keywords


Greater curvature plication, Laparoscopy, Morbid obesity, Stomach sparing sleeve

Full Text:

PDF

References


Prentice AM. The emerging epidemic of obesity in developing countries. Int J Epidemiol. 2006;35(1):93-9.

Buchwald H, Avidor Y, Braunwald E, Jansen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724-37.

Casella G, Soricelli E, Rizzello M, Trentino P, Fiocca F, Fantini A, et al. Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy. Obesity Surg. 2009;19:821-6.

Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide. Obesity Surg. 2013;23:427-36.

Tretbar LL, Taylor TL, Sifers EC. Weight reduction. Gastric plication for morbid obesity. J Kans Med Soc. 1976;77(11):488-90.

Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. Journal Laparoendosc Advanced Surg Tech. 2007;17(6):793-8.

Huang CK, Asim S, Lo CH. Augmenting weight loss after laparoscopic adjustable gastric banding by laparoscopic gastric plication. Surg Obesity Related Dis. 2011;7(2):235-6.

Huang CK, Lo CH, Shabbir A, Tai C-M. Novel bariatric technology: laparoscopic adjustable gastric banded plication: technique and preliminary results. Surg Obesity Related Dise. 2012;8(1):41-5.

Grubnik VV, Ospanov OB, Namaeva KA, Medvedev OV, Kresyun MS. Randomized controlled trial comparing laparoscopic greater curvature plication versus laparoscopic sleeve gastrectomy. Surg Endoscopy. 2016;30:2186-91.

Rodríguez G, Martínez A, Viramontes-So M, Sanmiguel L, Jiménez JA, Limon J, et al. A new bariatric procedure: the stomach sparing gastric sleeve. Surg Tech Int. 2015;27:116-22.

Fried M, Doleralova K, Buchwald IN, McGlennon TW, Sramkova P, Ribaric G: Laparoscopic greater curvature plication (LGCP) for treatment of morbid obesity in a series of 244 patients. Obesity Surg. 2012;22:1298-130.

Brethauer SA, Harris IL, Kroh M, Shauer PR. Laparoscopic gastric plication for treatment of severe obesity. Surg Obesity Related Dis. 2011;7:15-22.

Abdelbaki TN, Huang C, Ramos A, Neto MG, Talebpour M, Saber AA. Gastric plication for morbid obesity: a systematic review. Obesity Surg. 2012;22:1633-9.

Shi X, Karmali S, Sharma AM, Birch DW. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obesity Surg. 2011;20:1171-7.

Skrekas G, Antiochos K, Stafyla VK. Laparoscopic gastric greater curvature plication: results and complications in a series of 135 patients. Obesity Surg. 2011;21:1657-63.

Rodríguez G, Martínez A, Viramontes-So M, Sanmiguel L, Jiménez JA, Limon J, et al. A New bariatric procedure: the stomach sparing gastric sleeve. Surg Technol Int. 2015;27:116-22.

Shen D, Ye H, Wang Y, Ji Y, Zhan X, Zhu J, et al. Comparison of short-term outcomes between laparoscopic greater curvature plication and laparoscopic sleeve gastrectomy. Surg Endoscopy. 2013;27:2768-74.

Kourkoulos M, Giorgakis E, Kokkinos C, Mavromatis T, Griniatsos J, Nikiteas N, et al. Laparoscopic gastric plication for the treatment of morbid obesity: a review. Minimally Invasive Surg. 2012;2012.

Albanese A, Prevedello L, Verdi D, Nitti D, Vettor R. Laparoscopic gastric plication: an emerging bariatric procedure with high surgical revision rate. Bariatric Surg Pract Patient Care. 2015;10(3):93-8.

Tsang A, Jain V. Pitfalls of bariatric tourism: a complication of gastric plication. Surg Obesity Related Dis.. 2011;27:231.

Gebelli JP, de Gordejuela AG, Badía AC, Medayo LS, Morton AV, Noguera CM. Laparoscopic Gastric Plication: a new surgery for the treatment of morbid obesity. Cirugía Española. 2011;89(6):356-61.