[obesity] Gastric Plication

Definition of LAPAROSCOPIC GASTRIC PLICATION

LAPAROSCOPIC GASTRIC PLICATION

It is about a technique of mini–invasive bariatric surgery  and very promising.
As you know it the various procedures – the sleeve gastrectomy and also the by – not – base yourselves primarily on the principle of the restriction of the quantity of the food which can be introduced at the time of the meals (in the case of the by-pass the caloric intake is increased by the short-circuit intestinal which causes an badly-absorption).
The gastric plicature is a technique which the size of the stomach and limit reduces considerably the introduction of food.

SLEEVE WITHOUT GASTRIC RESECTION or GASTRIC PLICATURE ANTÉRO POSTERIOR BY SIMPLE JOINING

Terminology in the medical literature Laparoscopic Greater Curvature Plication (LGCP) or Laparoscopic Gastric Overlap

This restriction of the gastric capacity is carried out with a plicature by simple joining of the former and posterior wall of the stomach all the way along the great gastric curve.
This intervention is also called SLEEVE WITHOUT GASTRIC RESECTION because it reproduces “with the economy” the sleeve gastrectomy

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  • Gastric plication
  • –  it release of the stomach is carried out starting from the cave until the angle of His: it is the same one as in the sleeve
    – There N is no gastric resection (not fastening)
    – The tube of calibration is the same one as one uses in the sleeve (to mow 32 french)
    it volume of the stomach is tiny room from approximately 70% by carrying out a intra-gastric invagination of the great gastric curve with joinings with the son not résorbable (separated points not résorbables more one overcasting with the son not résorbable)
    – The procedure is potentially reversible
    – The operation is mini invasive (4 small incisions: 2 of 5 mm and 2 of 10 mm): it takes approximately one to two hours of operational time
    – In the event of failure conversion into sleeve gastric or gastric by-pass is possible.

PLICATURE GASTRICQUE
PLICQTURE VERTICALE
    Définition Plicature Gastrique par coelioscopie ou  Sleeve Sans Résection Dr Vincenzo Salsano mise à jour Novembre 2016

Advantages of gastric Plication

Advantages of  gastric Plication

  • Advantages
  • Invasive mini procedure – soft –: No withdrawal or exclusion of body:  pas de fastening-section of the stomach (sleeve gastrectomy) No short-circuit intestinal with reduction in the absorption of nutrients   (by-pass) Stay runs average 3 days Fast return to the usual activities Potential disappearance of the major complications (the risk of dent is tiny) Minor complications: nauseas, vomiting, sialorrhée (important secretion) )
    Avantages plicature Gastrique ou sleeve sans  résection   Dr Vincenzo Salsano mise à jour Novembre 2016                                                                  

Complications of Gastric Plication

Complications of Gastric Plication
 

  Complications de la Plicature gastrique   Dr Vincenzo Salsano mise à jour Novembre 2016                                                                                       

Results of Gastric Plication

Results of Gastric Plication

The restriction of gastric volume it is the principle on which the sleeve gastrectomy is based which make it possible to have like results with means – length terms (3 years – 5 years) % of excess of lost weight (%EWL) of surroundings 60-70%.
The procedure should be comparable with the sleeve gastrectomy.
  • Results
  • The percentage of loss of excess of weight obtained by this technique with cort term – 1 years – is comparable with the other methods of digestive restriction
    We do not have results yet with the long court; The first results are encouraging but we do not have yet sufficient retreat systematically to propose this intervention like alternative to the sleeve gastrectomy.

 The patients must be included in a follow-up of a cohort study in order to evaluate the results.

In Brasil, Mexico, India, Lebanon, Iran the gastric plicature is a real success.
The team of Cleveland Clinique (Ohio, the USA; Stacy A, Philip Schauer) proposes this intervention in spite of the lack of financial cover of the insurances taking into account theirs
The patients pay completely: they are not refund because they miss long-term studies.
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    Les résultats de la plicature gastrique  Dr Vincenzo Salsano mise à jour Novembre 2016