Laparoscopic Greater Curvature Plication for Morbid Obesity: Indications, Results, Perspectives

Abstract

Morbid obesity is an important health problem of our century. It is managed by diet, lifestyle changes and medication and surgery. Weight-loss surgery is the most effective treatment for morbid obesity, producing durable weight loss, improvement or remission of comorbid conditions and longer life. Bariatric surgery provides the best results in up to 75% of cases of severe obesity and obesity comorbidities. In the United States, over 200 000 patients benefit every year from bariatric procedures. That means there is a continuous evolving of the bariatric surgery. Bariatric surgery is metabolic surgery because it resolves or alleviates Type2 Diabetes, hyperlipidemia and hypertension. The most employed bariatric operations are Roux -en-Y gastric by-pass, adjustable gastric banding, biliopancreatic diversion and sleeve gastrectomy, each of them having shortage of long term results and safety. In the last eight years was introduced a new bariatric procedure, the gastric plication, in an effort to obtain similar weight loss with lesser complications and costs. We present our initial experience with 30 morbid obese patients who undergone laparoscopic gastric plication in our institution. The mean % Excess Weight Loss was 50% at 6 month and 65% at 12 month with important alleviation of comorbidities. The complications rate was 6.6% for major complications (but only in the first 6 cases) and 10% for minor complications.