Gastric Sleeve Plication

Gastric plication is a minimally invasive surgical procedure for weight loss. The surgeon performs the gastric sleeve plication laparoscopically through 3 to 5 small incisions. The bariatric surgeon will then fold the greater curvature of the stomach inward, followed by stapling the stomach to remain folded. This essentially reduces the stomach capacity and limits the food-intake due to the small stomach size. 

Also known as Greater Curvature Plication (GCP), this bariatric surgery is strictly restrictive like the vertical sleeve gastrectomy, without removing a portion of the stomach. It is somewhat reversible dependent on the stomach’s healing and length of time following the plication surgery. 

Although it is no-longer popular, gastric sleeve plication is less invasive compared to roux-en-y gastric bypass and duodenal switch surgery, which have a malabsorptive component increase the rate of weight loss.

How is Gastric Plication Performed?

Your surgeon will first cut 3-5 incisions in the abdomen during the operation while you are under anesthesia. The surgeon will insert a laparoscope, or small video camera, which guides the entire surgical procedure.

This minimally invasive procedure cuts down on the recovery time due to the simplicity and no-cutting method. The plication procedure utilizes a sewing and folding technique, which sews 1 to 3 folds in the stomach to reduce the stomach capacity by roughly 70%. 

This small stomach holds significantly less food, lowering how much you eat by filling you up quickly and reducing your appetite. No stapling or cutting is done to the stomach for this procedure, and it has the potential to be reversed. If needed, it can also be converted to another type of weight loss procedure, such as a gastric bypass or banding procedure. The entire surgery duration takes approximately 1-2 hours.

Recovery & Aftercare

Patients should expect to be in the hospital for about two days after the procedure. The doctor, medical team, and nurses will be monitoring your recovery and healing for two to three days post-surgery. You will be prescribed medication to improve healing, nausea, pain, and obstruction that is best suited for your postoperative needs, side effects, and possible risks. 

Postoperative Diet

The biggest challenge for the recovery period is adjusting to your new eating habits. The post-op diet begins immediately after surgery, starting with the clear liquid diet phase for at least one to two weeks. During this time, you can drink milk, fruit, juice, water, and sherbet. You will gradually start incorporating more foods as you go through the second phase of thick, pureed liquids, after two, and soft foods after the liquid diet. After 2-3 weeks, the first foods are soup with minimal vegetables, yogurt, and pudding. After this, you will slowly move your way up to solid foods. You need time to recover and adjust to the new size of your stomach.

Once you get to the solid food stage, which is 4-6 weeks after surgery, you will only be able to eat small amounts of food at a time. If you are used to three large meals a day, start getting used to 5-6 smaller meals throughout the day. Each meal is about four spoonfuls of chewed food. It takes a while to get used to the smaller amount and recognizing the signs of being full. Make sure to chew slowly and take time during your meals, allowing your body to show signs of fullness. If you overeat, your body rejects the food, and you will be vomiting.

Risks of Gastric Sleeve Plication

The risks associated with the gastric plication procedure are very similar to other types of laparoscopic procedures. They include the risk of bleeding, infection, blood clots, and potential injury to other organs during the process. If you have more severe complications, it may need to be reversed or converted to another type of procedure. This is extremely rare, however. There is a sporadic risk of leaking from the suture line. After the surgery, keep an eye out for red flags that might signal complications. This includes redness or warmth around the incision site, which might mean an infection, severe abdominal pain, dizziness, or excessive vomiting. If you have these or other problematic side effects, consult your doctor right away.