Gastric plication


“Modern” lifestyle is taking its toll on the amount of physical activity and on the way we eat, which leads to an increasing tendency of global obesity-associated morbidity. With the exception of a small number of cases, which relate to hormonal etiology, the main cause of obesity is given by food-related behavior. Lifestyle changes, with the inclusion of physical activities and of a low-fat diet, are essential for the treatment of overweight patients.

On the long term, physical activity and diet act only on 10% of the obese; therefore, if the lifestyle change fails, bariatric (weight loss) surgery should be considered. One of the restrictive bariatric methods, which ensures long-term efficiency, is adequate for this type of patients, while other methods (weight loss pills, hypnosis, etc.) turn out to be inefficient on the long term.

Restrictive bariatric methods are the most efficient in relation to patients who suffer from current obesity-associated morbidity, and especially those patients with a long history of high caloric intake and low level of physical activity in adolescence.

After the bariatric surgery intervention, weight loss is mildly influenced by the type of surgery, since the key factor is the patient’s cooperation in the post-operative period.

Gastric plication, sometimes called “gastric pseudo-sleeve”, is a bariatric procedure that acts like a gastric sleeve, by decreasing the size of the stomach, without its resection; therefore, the amount of food that can be ingested is reduced.

Although it is deemed a new technique of the weight loss surgery, the short-term results are very promising: substantial weight loss, important alleviation of cardiac diseases generated by obesity, as well as a low rate of postoperative complications.

Gastric plication is a restrictive surgical intervention, which reduces the size of the stomach with approx. 75%, which leads to the early appearance of satiety. Gastric plication is a procedure that allows the reduction of the stomach without resecting it (gastric sleeve), without the rerouting of food circulation (gastric by-pass, biliopancreatic diversion) or without the implant of foreign bodies (gastric band). Thus, the risk of significant postoperative complications (hemorrhage and anastomosis fistula) is lower. Since the intervention is conducted by laparoscopy, incisions on the abdomen are very small, and the duration of the intervention is approx. 2 hours. Most of the studies that have been conducted prove positive outcomes comparable with the other bariatric interventions. Short-term weight loss is 30-55% of the body mass surplus, with the alleviation of cardiac conditions and of type II diabetes mellitus.

Nevertheless, patients may suffer from nausea and/or vomiting, but they will usually feel better in the first postoperative week.

Like with the other bariatric procedures, postoperative care and strict conformity with the indications relating to postoperative diet and physical activity are very important for best results. After the postoperative diet that lasts 3 weeks and during which patients go from liquid food to solid food, they will begin to introduce new food, in increasing amounts; in this way, within 6 months, the diet will be fully integrated in the new lifestyle.

The major benefit of this intervention is given by the fact that it is reversible.

The procedure is conducted by Dr. Petre Avram and by Dr. George Sirețeanu.


source: Metropolitan Hospital Marketing & Communication Dept., May 2016