Gastric Plication : Good Results Impose

Ali Fardoun, MD, Mohammad Talebpour, MD. The Lebanese-Italian Hospital , Lebanon

Introduction: after many years of the presence of gastric plication(9 years) and the insistance of Dr Talebpour to spread this techinique initialy invented to avoid the high price of staplers and for the low rate of complications specially the gastric leak. This technique is common in many centers and the results making it a very save procedure with good results compared to laparoscopic gastric sleeve.

Method ; I have started this technique in base of seminars celebrated monthly in the Lebanese-Italian Hospital, Tyre, Lebanon . The age of our patients was between 16-47 years old and BMI between 37- 52 kg/m² . number of the patients is 17. position of the trocars and number varies between 4 and 5 and between prone or supine position but without changing the surgical technique inside the abdomen releasing the stomach as in the sleeve . We start plicate giving a stich in gastro-esophageal juntion stomach to stomach( fundus to the right side of the stomach) This stich is the clue to start good plication. We proceed with 2 zero nylon or prolyne non-cutting needle calculating 2 cm from posterior edge to anterir edge with running stich reaching at 6 cm of the pylorous.

Results; hospital stay was 1-2 days . pain 4/10 scale. food intake ; next day of surgery after a gastrografin control starting with liquid diet and continue as gastric sleeve regimen. Leak ; zero cases . Bleeding zero cases. stenosis one case out of 17 in the immediate postoperative period which needed another look to release one of the stitches in the antrum and discharged next day. Excess body weight loss on 3-9 months was beteen 5-12 kg per month with full satisfaction of the patients .

Conclusion: the Gastric Plication is a promising procedure for morbidly obese patients and it is gaining space between the other procedures in Bariatric surgery with less rate of complications and reversibility. It gives a big hope for adolescent and young age group as easy and reversible. Also the cost of the surgery will make it very popular in underdeveloped countries