According to the largest biomedical library, the U.S. National Library of Medicine (ULM) National Institutes of Health, the demand for bariatric revision surgery is growing. This acceleration is mainly due to the growth in overall weight loss procedures being performed each year. For various reasons, these procedures can fail or lose effectiveness, requiring the need for revision surgery – either repairing the procedure or altering it in some way.
Gastric Plication Explained
Gastric plication is a laparoscopic weight loss surgery known as a restrictive procedure. The gastric plication procedure uses a minimally invasive technique to reduce a patient’s stomach size by creating folds in the stomach. None of the stomachs is removed during the procedure, and there is no cutting or stapling.
Gastric plication is appealing to both patients and surgeons as it has less hospital time post-op, poses fewer risks, and has a lessened recovery period.
The reduction in stomach volume dictates how much food is consumed during each meal. This procedure mimics VSG as far as a restriction; however, it does not change the hunger hormones and reset your metabolic system. The plication constrains the amount of food but does not reduce the number of nutrients absorbed like gastric bypass.
Why Plication Fails
Since gastric plication began, nobody knew the long-term side effects and complications due to a lack of studies. Obesity was at an all-time high, so the demand for weight loss surgery was massive. Within a few years, complications and problems became more frequent.
According to one large study, serious complication rates spiked to 15.1%, and re-operation rates grew to 3%. Less severe complications like nausea and vomiting at a rate of 1 out of every 10 patients (10.7%). Another study found the most common side effect had been gastric obstruction due to;
- Stomach folding prolapse or edema
- Fluid accumulation within the gastric fold (1.5%), leak (0.7%), and fistula (0.1%).
Notably, gastric obstruction is the main reason for reoperation. Most mild obstructions can be managed by medical treatment that needs reoperation.
Gastric Plication Revision Surgery
Case – Canadian patient had a Lap-Band and did not lose weight because of slippage. Then they tried plication since they wanted to have the reversible procedure. She felt the sleeve plication was too tight. Then doctors made it looser. The plication did not work. MBC surgical team converted that to mini-gastric bypass, and during the procedure, doctors found out that the stomach can be unfolded, and plication is reversible. She is doing well after the surgery.
- Removing Scars — Abdominal Wall
- Adhesion — Stomach to Liver
- Removing Stitches from Plication
- Making Gastric Pouch
- Ending the Gastric Pouch
- Measuring the Bowl
- Preparing the Anastomosis
- Leak Test