Abstract
Gastric plication was selected for cases with potential for continuous diet and exercise after operation. The appetite of patients decreased after operation due to total gastric volume restriction. The study aimed at finding if it is worth or not to plicate in relation to excess body weight loss (EBWL). 47 patients were enrolled in the study between May 2014 till Nov 2015 with follow up till Nov 2015 with body mass index (BMI) of 38 -65. Laparoscopic gastric placation (LGP) was done to all using two rows of continuous o prolene thread aided with harmonic scalpel. BMI and EBW were calculated prior to LGP then EBWL was estimated at six months and one year. The following scale was applied regarding EBWL 0- 14 %failure, 15% -39% poor, 40%- 69% medium, 70% or more excellent outcome, while regain of 10% or more marked as regain. We had one (2.1%) deplication, six (12.7%) regained weight, two (4.2%) failures, fourteen (29.7%) poor, sixteen (34%) medium outcome and eight (17%) with excellent outcome regarding EBWL. We concluded that it is very difficult to roll out LGP, we found it is worth to do LGP although only 17% got excellent EBWL and 34% got medium EBWL which was acceptable to those patients which represent more than 50% of our patients. This acceptance was supported by the low cost, safety and the potential reversibility of the procedure.
Highlights
Restrictive methods (RM) are the most conservative bariatric surgery
The price of hospitalization and instruments used in gastric plication was 2000$, while gastric bypass would cost 4500$ and sleeve or banding 4000$ [4]
It is noteworthy in comparison to other restrictive methods like gastric banding or sleeve gastrectomy
Summary
Restrictive methods (RM) are the most conservative bariatric surgery. Malabsorptive method has longer effect on weight loss but the risk of late complications due to vitamin deficiency and anemia is noticeable [1]. The wide range of weight loss resulted from different methods of restrictive bariatric surgery means the main reason of weight loss is not just a specific technique; and could be mostly the patient’s motivation to keep appropriate lifestyle [6]. Shrinkage of plicated fold and extension of elastic gastric wall were two main factors for limited effective time of Mohamed Salah Abdelhamid et al.: Excess Body Weight Loss After Laparoscopic Gastric Plication plication (4 years) [7]. Effective time of all restrictive methods is limited to 3 to 4 years, so risk of regain is the problem of all kinds of bariatric surgeries. There is about 10% to 20% of emergency band removal (happening in wide range of time after surgery) in gastric banding operation because of balloon leakage, band erosion/migration, deep infection and reaction to foreign body [11]
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