Gastric Plication (Gastric Folding)

A Brand New Gastric Restriction Operation

Gastric Plication (Gastric Folding) is an operation where stomach is narrowed longitudinally without any transection.  This narrowing procedure may be referred with many different names.

	A brand New Gastric Restriction Operation

Names used instead of Gastric Plication:

• Gastric Folding
• Gastric Sleeve Plication
• Vertical Sleeve Gastric Plication
• Greater Curvature Plication

Stomach is reduced Without Transection

Stomach is not transected and damaged in Gastric Plication surgery.  The stomach is folded over itself and fixed with sutures.  You return to normal life rapidly after Gastric Plication operation which is applied laparoscopically.  Operation period and hospitalization periods are very shorter than all obesity surgery methods.
The operation ends within one and half hour.  You are discharged during next day following the operation.

Nutrition is started just after the surgery.  Normal feeding is passed after liquid food intake for two weeks.

Gastric Plication operation  only reduces gastric volume.  So, you eat less.  No foreign substance such as gastric band or gastric balloon is left without gastric reduction.  Therefore, problems such as excessive nausea-vomiting due to these foreign bodies are mainly eliminated. Furthermore, since no foreign body is left in your abdomen or stomach, there is not any vital risk that may occur Gastric Plication.

	Gastric reduction Operation

Stomach is reduced without transection

Your stomach is never transected in Gastric Plication operation.  Anterior and posterior wall or just anterior wall is folded on itself and sutured.  For this, two or three sutures are placed and intact connection of gastric tissue is provided.  After your stomach is reduced by this way with Gastric Plication operation, you eat less portions and obtain fullness within a short period.

It is Completely Reversible

Since the stomach is not transected it is completely reversible.

The Most Costly Effective Gastric Reduction Method

Gastric Plication operation is the most economic gastric reduction operation because the operation period is short, no foreign body is used and hospitalization period is very short.

How Is Gastric Plication Operation Applied?

Gastric Plication operation maybe applied with two different ways.

• Anterior Wall Folding (Anterior Plication)

Anterior wall folding is not a very preferred procedure.  Since most part of the posterior wall may be left liberated, it may cause enlargement of the gastric volume by stretching.  Therefore, it is not preferred much.

• Anterior-Posterior Wall Folding (Lateral Plication – Big Curvature Folding)

Big Curvature Gastric Plication operation is the most common procedure applied worldwide.  Anterior and posterior wall of the stomach is folded on itself and sutured.  The procedure is applied with laparoscopy.  There are 4 to 5 incisions which are smaller than 1 cm done and the procedure is completed within one hour with specific tools.  Gastric Plication operation is the only gastric reduction operation which is applied easily and economically because of application convenience and not requiring material.

Who are candidates for Gastric Plication Surgery?
Gastric Plication Surgery may be applied to all patients who need to be treated because of obesity.

• First stage treatment is applied as Gastric Plication Surgery because the operation period is shorter for super obese patients with BMI (Body Mass Index) over 50 kg/m².
• Gastric Plication Surgery is applied for patients who hesitate from any bypass operation because of long term problems.
• Gastric Plication Surgery is applied as an alternative for patients whom Gastric Band is planned.
• Gastric bands is removed in patients who had band complications and Gastric Plication Surgery is done.
• Gastric Plication Surgery is applied for patients who fear from problems because of the foreign body in gastric band or do not want to come to the doctor for band adjustments.
• Gastric Plication Surgery is applied because it is the simplest operation which may be converted into a long term effective operation.
• Gastric Plication Surgery may be applied for patients who hesitate from Standard Sleeve Gastrectomy operation because of risk of leak from staple line.
• Gastric Plication Surgery may be applied as an alternative which is more effective than gastric balloon and may preserve long term effects for patients whose Body Mass Index below 35 kg/m².

What are Risks of Gastric Plication Surgery?
Your stomach is never transected in Gastric Plication Surgery.  The stomach is folded on itself and fixed.  Therefore, it does not include any transection staple line. Hence, there is not any risk for leakage.

Some serious problems have been reported for Gastric Plication Surgery.  Deaths are present among these.  Gastric Plication Surgery does not have a fatal risk surgically.  However, when the operation is applied under insufficient and careless conditions by inexperienced teams, gastric wall injury which is not noticed may appear.  If the surgery team is not experienced, fatal complications may be seen because of leakages occurred from these injuries.

Gastric Plication Surgery has some systemic risks caused by obesity levels of the patients like all obesity surgery operations.  Obesity may create a limited capacity for heart pump and lung capacity.  Preoperative preparations, monitoring of these patients during the operation and postoperative period closely and carefully are very important.

The simplest complaints, even unrest of our patients during postoperative periods are vitally important for an experienced obesity surgery team.  The simplest unrests may require detailed examination.  Postoperative first month has critical importance to notice these problems.   

	How Does Gastric Folding (Gastric Plication) Operation Affect?

How Does Gastric Folding (Gastric Plication) Operation Affect?

• Your gastric volume is reduced in shape of a tube or banana by Gastric Plication Surgery.  Your meal portions reduce.  For example, while you feel full with a bowl of soup, 5 to 6 meatballs with rice or pasta and salad before the operation, you get full with 4 spoons of soup, one meatball  after the surgery.
• In sleeve gastrectomy operation, hunger hormone which is secreted from the removed part of your stomach by 70 to 80%.  name of this hormone is ghrelin.  You feel hunger less between meals because of reduction of hunger hormone (ghrelin).  Your fullness feeling lasts longer.  Your stomach is not removed in Gastric Folding (Gastric Plication) Operation.  So, cells where these are produced do not disappear.  However, when time goes by, it is considered that this part of stomach looses its effect because it is folded and sutured on itself.
• Since your stomach is shaped like a tube by Gastric Folding (Gastric Plication), your stomach empties faster.  Rapid passage of foods eaten from the stomach also increases your bowel movements.
• Since no foreign body is left by Gastric Folding (Gastric Plication), no problem related with this is experienced.
• No adjustment like gastric band is required.  It does not change anatomy of digestive system.
• The only long term side effect is partial weight gain.  A folding is performed again in case of weight gain and gastric volume may be reduced easily.  Or, it may be converted into another effective operation.  Therefore, Gastric Folding (Gastric Plication) operation is one of the most preferred operations.