Laparoscopic gastric plication

	Laparoscopic gastric plication
Journal Of Wassit For Science & Medicine
Article 1, Volume 8, Issue 1, 2015, Pages 125-136
Abstract
Abstract The aim of this study is to introduce a new technique “Total Gastric Vertical Plication” (TGVP) as restrictive operation with the least risk of complication and the same result of weight loss as other restrictive techniques without any extraordinary cost especially in developing countries. Methods: Patients were placed in supine with 30-degree reverse trendelenburg position. Three troachers inserted (two 10 mm and one 5 mm). After release of the greater curvature, then interabted suturing by0 0 silk from fundus to 6 cm of pylorus, a vertical plication in one layer follow by continues suturing by 00 nylone as second row. Distance between each stitch was 2 cm, and all of them were extra mucosal and faraway of acid effect. The volume of stomach in this condition is 100 cc but just one half of it is effective. If more than 50 cc used, painful muscular movement occurs. Results: In 39 cases, young aged (18-40) ; mostly male (F/M=7:4) with average BMI=43.5 it performed. The mean weight loss in our patients in first month about 12 kg , 8.8% of “Excessive Weight Loss” (EWL) ,in second month post operatively about 8 kg , 5.7% of EWL , and 8 kg, 5.7% of EWL in third month post operatively ,then continues of weight loss in range from 4-7 kg per month depend on the patient (physical activity and social behavior ). The average time of follow up about 11 months. The mean time of operation was 120 minutes and all of them discharged from hospital after an average time of 72 hours of operation. Postoperative complications were heartburn, nausea, vomiting, and no intracapsular liver hematoma because in our surgery we just use 3 troachars. Conclusion: The percentage of EWL in this technique is comparable to other gastric volume restriction methods like sleeve gastrectomy and gastric band. No risk of leak or less risk of leak in comparison with sleeve gastrectomy and gastric bypass, no risk of vitamins and iron deficiency, even low risk of bleeding and others post-operative complication in comparison with others restrictive and malabsorptive type of surgery, and till now without any important late complications. This technique is less cost in about 2000- 4000 $ than sleeve gastrectomy and about 3500-6000 $ than gastric bypass.

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