Comparison of Gastric Fundus Invagination and Gastric Greater Curvature Plication for Weight Loss in a Rat Model of Diet-Induced Obesity

Abstract

Gastric fundus invagination (GFI) is a novel weight loss procedure. The gastric fundus is invaginated inside the gastric lumen and anastomosed to the gastric antrum. In gastric plication (GP), the greater curvature is plicated inside the gastric lumen leaving a narrow gastric channel for food passage. This study compares GFI to GP in a diet-induced obesity rat model. Twenty Long-Evans male rats were fed a 60% high fat diet for 6 weeks. At 14 weeks of age, the rats underwent either GFI (N = 10) or GP (N = 10) surgery. Body weight and food intake were measured for 6 weeks. Serum adipokines and ghrelin hormone were assayed. Six weeks after surgery, all rats were euthanized and the stomachs examined. The two-sample t test was used to compare the results between the two groups. All GFI rats had an intact fundus invagination at 6 weeks following surgery. The greater curvature plication unfurled in three out of ten GP rats. Part of the fundus herniated through the plication suture line in one GP rat. There was no significant difference between the mean percent weight change for the GFI (4.2 ± 4.1%) and GP (8.8 ± 6.0%) groups. There was no difference in food intake between both groups. GFI was associated with a significant lower fasting ghrelin levels (101.1 ± 13.1 versus 137.3 ± 27.4; p = 0.044) compared with GP. GFI offers a more effective and more durable surgical alternative for weight loss than GP.