Laparoscopic Gastric Plication for the Treatment of Morbid Obesity: A Review

Michael Kourkoulos,Theodoros Mavromatis,Nikolaos Nikiteas,Charalampos Kokkinos,Emmanouil Giorgakis,Christos Tsigris,John Griniatsos

doi:10.1155/2012/696348

Abstract

Introduction. Laparoscopic greater curvature plication is an operation that is gaining ground in the treatment of morbid obesity, as it appears to replicate the results of laparoscopic sleeve gastrectomy with fewer complications. Aim. Review of current literature, especially results on weight loss and complications. Method. 11 (eleven) published articles on laparoscopic gastric plication, of which 1 preclinical study, 8 prospective studies for a total of 521 patients and 2 case reports of unusual complications. Results. Reported Paracentage of EWL in all studies is comparable to Laparoscopic Sleeve Gastrectomy (around 50% in 6 months, 60–65% in 12 months, 60–65% in 24 months) and total complication rate is at 15,1% with minor complications in 10,7%, major complications in 4,4%. Reoperation rate was 3%, conversion rate was 0,2%, and mortality was zero. Conclusion. Current literature on gastric plication and its modifications is limited and sketchy at times. Low cost, short hospital stay, absence of prosthetic material, and reversibility make it an attractive option. Initial data show that LGCP is effective for short- and medium-term weight loss, complication and reoperation rates are low, and GERD symptoms are unaffected. More data is required, and randomized control trials must be completed in order to reach safe conclusions.

Highlights

Laparoscopic greater curvature plication is an operation that is gaining ground in the treatment of morbid obesity, as it appears to replicate the results of laparoscopic sleeve gastrectomy with fewer complications
The aim of this study is to review current publications on Laparoscopic Greater Curvature Plication (LGCP) especially reported complications and results on excess weight loss (EWL)
The inclusion criteria for the Khazzaka and Sarkis study included an age of 18–62 years and a BMI of 32–35 kg/m2 as well as a history of gastroesophageal reflux disease (GERD) and obesity for more than 5 years with unsuccessful attempts at conservative weight-loss therapy [15], as this study was aimed at demonstrating the efficacy of LGCP with Nissen fundoplication in obese patients with GERD

Summary

Introduction

Laparoscopic greater curvature plication is an operation that is gaining ground in the treatment of morbid obesity, as it appears to replicate the results of laparoscopic sleeve gastrectomy with fewer complications. Aim. Review of current literature, especially results on weight loss and complications. Initial data show that LGCP is effective for short- and medium-term weight loss, complication and reoperation rates are low, and GERD symptoms are unaffected. Once considered a problem only of high-income countries, obesity rates are rising worldwide and affecting both the developed and developing world. These increases have been felt most dramatically in urban settings [1]

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