Laparoscopic gastric plication for obesity

Laparoscopic gastric plication for severe obesity should only be carried out in units specialising in bariatric surgery that can offer the procedure as one of a range of treatment options (1)

• laparoscopic gastric plication aims to help patients lose weight by reducing the size of the stomach
  • usually done by plicating the greater curve of the stomach, although anterior plication has also been reported. Because none of the stomach is removed, it is potentially a reversible procedure
    
    
• procedure is done with the patient under general anaesthesia, using several (usually 5 or 6) small incisions in the abdomen for the placement of a camera and ports for instruments
  • greater curvature plication involves freeing the greater curve of the stomach by dissecting it from the greater omentum and short gastric vessels
  • plication is done by folding the gastric wall inward along the greater curvature and securing this fold using rows of running sutures
    • modifications of the technique may include a double or triple plication of the greater curve, and this may need extra rows of sutures
      
      
• patients are placed on a postoperative diet that typically involves progression from fluids to semi-solid foods, avoiding intake of solid foods for approximately 6 weeks.

Reference:

• 1) NICE (November 2012). Laparoscopic gastric plication for the treatment of severe obesity