Laparoscopic Greater Curve Plication in Asia: Initial Experience

Abstract

LGCP is safe and effective in achieving significant weight loss in obese ethnic Chinese patients. However, weight loss in BMI <35 is more pronounced. It is a very valid alternative to other procedures in Asian population.

A systematic review of gastric plication for the treatment of obesity

“…The overall %EWL was significantly higher for the group with a BMI o 45 kg/ m 2 compared to those who had a BMI 4 45 kg/m 2 (69.86% versus 55.49%); the percentage of inadequate weight loss was doubled for the higher compared to the lower BMI group (36% versus 18%). Another study by Mui et al [6] found that weight loss in the group with a BMI o 35 kg/m 2 is more pronounced than that in the group with a BMI 4 35 kg/m 2 .…”

“…The full text of the remaining 17 articles was reviewed for eligibility. Fourteen [3][4][5][6][7][8][9][10][11][12][13][14][15][16] of the above 17 articles were selected for this review ( Table 1). The authors excluded one article [17] which was a letter commenting on another article, one article [18] which reported American Society for Metabolic and Bariatric Surgery policy on gastric plication, and another article [2] which was a substudy of a larger series by the same group.…”

“…Only Talebpour et al [7] followed the patients for 4 10 years and the mean %EWL at 3, 4,5, and 10 years was 66%, 62%, 55%, and 42% respectively. One study by Mui et al [6] reported the weight loss in terms of the BMI decrease, and the percentage of BMI lost at 6 and 12 months was 66.4% and 60.2%, respectively. Brethauer et al [12] compared anterior plication (AP) and greater curvature placation (GCP) and reported better weight loss with GCP at 12 months (%EWL of 53.4% versus 23.3% respectively).…”

“…However, Fried et al [9] found that there were no differences between single-row plications and two-row plications in terms of weight loss and complication rates. The suture material was mainly nonabsorbable except for Mui et al [6] (nonabsorbable suture in the first row and absorbable suture in the second row) and Skrekas et al [10] (absorbable suture in the first row and nonabsorbable suture in the second row). The literature is still controversial regarding the type of stitch (interrupted, running), with conflicting reports of 2 rows of running sutures [5,7,12], 2 rows of interrupted sutures [8,10,11] and a combination of running and interrupted sutures [3,4,6,13].…”

Laparoscopic gastric plication: towards standardization

“…Some authors prefer 2 rows of running sutures, some used 2 rows of interrupted sutures and others recommend a combination of running and interrupted sutures. 3,7,8,10,11,16,17,20,21 Inner layer sutures are better to be taken in an interrupted manner to adjust the plication and to avoid suture breaking of continuous layer leading to failure. The outer layer should be running stitch to avoid herniation in between.…”