Gastric plication is a bariatric surgery designed to help individuals achieve significant weight reduction. It works by physically decreasing the stomach’s capacity, which limits food intake and promotes an earlier feeling of fullness.
Understanding the Procedure
Gastric plication reduces the stomach’s size by folding and suturing its wall inward. This technique does not remove any stomach tissue, nor does it use bands or staples. Surgeons create several folds, effectively reducing the stomach’s volume by approximately 65-75%.
The procedure is typically performed laparoscopically, a minimally invasive surgical approach. This involves making several small incisions in the abdomen. Through these, surgical instruments and a camera-equipped laparoscope are inserted, allowing internal organ viewing. The stomach wall is then folded inward and secured with sutures to form a narrow tube, which restricts food intake and helps patients feel satisfied with smaller meals.
Eligibility for Gastric Plication
Eligibility for gastric plication requires a thorough health evaluation. Candidates generally have a body mass index (BMI) of 30 kg/m² or more. While other bariatric procedures often require a BMI of 35 kg/m² with obesity-related health conditions, or 40 kg/m² without, gastric plication may be considered for individuals with a BMI of 30 kg/m² or greater, particularly if they have associated health issues like type 2 diabetes, high blood pressure, or sleep apnea.
Beyond BMI, a patient’s medical history and co-morbidities are important. A comprehensive medical assessment ensures physical readiness for surgery. A psychological evaluation is also required to assess commitment to the significant long-term dietary and behavioral modifications needed post-surgery.
Potential Outcomes and Considerations
Individuals undergoing gastric plication can anticipate significant weight loss, with reported excess weight loss (EWL) ranging from 20% to 70%. This weight reduction can improve or even resolve obesity-related health conditions. For instance, some patients with type 2 diabetes may experience improved blood sugar control, though long-term effects on diabetes can vary. Improvements in conditions like high blood pressure and sleep apnea are also observed, contributing to overall health benefits.
Like any surgical procedure, gastric plication carries potential considerations and risks. Common temporary side effects include nausea and vomiting, which usually resolve within a week and can be managed with medication. Other issues include changes in bowel function, such as diarrhea or constipation. While gastric plication has a lower complication rate compared to some other bariatric surgeries because it does not involve cutting or removing stomach tissue, rare but serious complications can occur. These might include leaks from the suture lines or infection, requiring further medical intervention.
Life After Gastric Plication
Recovery after gastric plication typically involves a short hospital stay, often one to two days. Patients follow a structured dietary progression, starting with clear liquids immediately after surgery. This advances to thicker liquids within two to three weeks, then pureed or soft foods, and eventually solid foods over several weeks, usually up to 12 weeks. Patients are encouraged to consume small, frequent meals and prioritize protein intake to support healing and maintain muscle mass.
Long-term success relies on consistent adherence to dietary guidelines and regular physical activity. Patients are advised to consume sufficient fluids and may need daily vitamin and mineral supplements, such as a multivitamin, B12, calcium, D, and iron, due to reduced food intake. Regular follow-up appointments with a medical team, including a bariatric specialist and dietitian, are important to monitor progress, address nutritional concerns, and provide ongoing support for maintaining weight loss and overall health.