Gastric plication of the greater curvature is spreading over all the bariatric centers as a new investigational procedure for the treatment of morbid obesity. Conventional bariatric surgeries ‘gastric band’,‘sleeve gastrectomy’,‘vertical banding gastroplasty’ and ‘gastric bypass’ are associated with severe complications and a high rate of failure or weight regain.

Authors present their experience on 482 laparoscopic greater curvature plication (LGCP) performed over a period of 26 months. A total of 449 patients responded to inclusion criteria:147 men and 302 women. Their mean age was 35.99 ± 10.85 years. Their mean body mass index (BMI) was equal to 39.93 ± 6.15 kg/m².

The average percentage of excess weight loss (%EWL) at 1, 3, 6, 12, 18 and 24 months was 30.19, 47.07, 63.05, 68.15, 68.62 and 69.29% respectively. Moreover, this study was divided into two subgroups and results were studied 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.

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.

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.