Dr. Mohammad Talebpour from Iran presented his 10 year experience in gastric plication. The results seemed promising. He founded this procedure to mimic Sleeve gastrectomy but without cutting and removing the stomach. It involves folding the stomach by invaginating the greater curvature by several rows of sutures, to make the new stomach look like the sleeve tube.
In the bariatric world however, this procedure has not proven any advantage. Cleveland Clinic experience after four years four was stopped due to the poor weight loss outcomes the patients experienced.
While other surgeons still perform this procedure, especially in the Middle East, at GBMC we do not offer this procedure anymore.
The average weight loss after 1 year is 58% in the first year. Long-term experience in this field and his experience suggest around 40% excess wt loss, with significant potential complications that can happen and mentioned in different series:
- Early nausea and vomiting in almost all patients.
- Leak: although case reports are mentioned, it is still a risk that cannot be excluded completely.
- Inadequate weight loss: high chance of not losing 50% of the excess weight.
- Unraveling of the plication: in some series up to 10%, this necessitates re-plication through laparoscopy.
- Reflux: comparable to sleeve gastrectomy in some series.
- Gastric motility issues: Delayed emptying has been reported in patients who underwent this procedure. The need to convert this procedure then to gastric bypass or other procedures, is probably needed.
For all the reasons above, and the fact that this procedure may severely affect the function of the stomach, although we can reverse it, we stopped offering this procedure to patients.