Abstract
Morbid obesity is an important health problem of our century. It is managed by diet, lifestyle changes and medication and surgery. Weight-loss surgery is the most effective treatment for morbid obesity, producing durable weight loss, improvement or remission of comorbid conditions and longer life. Bariatric surgery provides the best results in up to 75% of cases of severe obesity and obesity comorbidities. In the United States, over 200 000 patients benefit every year from bariatric procedures. That means there is a continuous evolving of the bariatric surgery. Bariatric surgery is metabolic surgery because it resolves or alleviates Type2 Diabetes, hyperlipidemia and hypertension. The most employed bariatric operations are Roux -en- Y gastric by-pass, adjustable gastric banding, biliopancreatic diversion and sleeve gastrectomy, each of them having shortage of long term results and safety. In the last eight years was introduced a new bariatric procedure, the gastric plication, in an effort to obtain similar weight loss with lesser complications and costs. We present our initial experience with 30 morbid obese patients who undergone laparoscopic gastric plication in our institution. The mean % Excess Weight Loss was 50% at 6 month and 65% at 12 month with important alleviation of comorbidities. The complications rate was 6.6% for major complications (but only in the first 6 cases) and 10% for minor complications.
References.
1. Buchwald H. The Evolution of Metabolic/Bariatric Surgery. Obes Surg, 2014;24:1126-1135.
2. Kourkoulos M, Giorgakis E, Kokkinos C et al. Laparoscopic Gastric Plication for the Treatment of Morbid Obesity: A Review. Minimally Invasive Surgery, 2012. Doi: 10.1155/2012/696348.
3. Wilkinson LH, Peloso OA. Gastric (reservoir) Reduction for Morbid Obesity. Arch Surg, 1981;116:602–605.
4. Talebpour M, Amoli BS. Laparoscopic Total Gastric Vertical Plication in Morbid Obesity. J Laparoendosc Adv Surg Tech 2007;17:793–798.
5. Fusco PE, Poggetti RS, Younes RN, et al. Evaluation of Gastric Greater Curvature Invagination for Weight Loss in Rats. Obes Surg, 2006;16:172–177.
6. Menchaca HJ, Harris JL, Thompson SE, et al. Gastric Plication: Preclinical Study of Durability of Serosa-to-Serosa Apposition. Surg Obes Relat Dis, 2011;7:8–14.
7. Brethauer SA, Harris JL, Kroh M, Schauer PR. Laparoscopic Gastric Plication for Treatment of Severe Obesity. Surg Obes Relat Dis 2011;7:15–22.
8. Skrekas G, Antiochos K, Stafyla V.K. Laparoscopic Gastric Greater Curvature Plication: Results and Complications in a Series of 135 Patients. Obes Surg, 2011;21:1657-1663.
9. Andraos Y, Ziade D, Achcouty R, Awad M. Early complications of 120 laparoscopic greater curvature plication procedures. Bariatric Times 2011;8:10–15.
10. Ramos A, GalvaoNeto M, Galvao M, et al. Laparoscopic greater curvature plication: initial results of an alternative restrictive bariatric procedure. Obe sSurg, 2010;20:913–918.
11. Lopez-Corvala JA, Guzman F, Calleja C, Hermosillo C. Gastric Plication: our experience in 100 patients. Surg Obes Relat Dis, 2011;7:350–354.
12. Talebpour M,, Mohammad S, Motamedi K, et al. Twelve year experience of laparoscopic gastric plication in morbid obesity: development of the technique and patient outcomes. Annals of Surgical Innovation and Research 2012, doi:10.1186/1750-1164-6-7.
13. Sales C. Gastric plication. Review of 900 cases A Bariatric Surgery reality. Bariátrica & Metabólica Ibero-Americana 2012;2.3.3 (88-92)
14. Fried M, Dolezalova K, Buchwald JN, McGlennon TW, Sramkova P, Ribaric G. Laparoscopic greater curvature plication (LGCP) for treatment of morbid obesity in a series of 244 patients. Obes Surg, 2012;22:1298–1307.
15. Khazzaka A, Sarkis A. Fundoplication Combined with Mediogastric Plication. Surg Obes Relat Dis. In press.
