World Journal of Laparoscopic Surgery

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VOLUME 7 , ISSUE 2 ( May-August, 2014 ) > List of Articles


Gastric Plication as a New Stand-Alone Procedure for the Treatment of Morbid Obesity

Youssef A Andraos, Dany Ziade, Rana Achkouty, Therese Youssef Andraos

Citation Information : Andraos YA, Ziade D, Achkouty R, Andraos TY. Gastric Plication as a New Stand-Alone Procedure for the Treatment of Morbid Obesity. World J Lap Surg 2014; 7 (2):49-59.

DOI: 10.5005/jp-journals-10033-1217

Published Online: 01-04-2017

Copyright Statement:  Copyright © 2014; The Author(s).



Gastric plication of the greater curvature is spreading over all the bariatric centers as a new investigational procedure for the treatment of morbid obesity. Conventional bariatric surgeries ‘gastric band’,‘sleeve gastrectomy’,‘vertical banding gastroplasty’ and ‘gastric bypass’ are associated with severe complications and a high rate of failure or weight regain.

Materials and methods

Authors present their experience on 482 laparoscopic greater curvature plication (LGCP) performed over a period of 26 months. A total of 449 patients responded to inclusion criteria:147 men and 302 women. Their mean age was 35.99 ± 10.85 years. Their mean body mass index (BMI) was equal to 39.93 ± 6.15 kg/m2.


The average percentage of excess weight loss (%EWL) at 1, 3, 6, 12, 18 and 24 months was 30.19, 47.07, 63.05, 68.15, 68.62 and 69.29% respectively. Moreover, this study was divided into two subgroups and results were studied based on the type of suturing and patient's BMI over a period of 1 year. The first subgroup included 183 patients, where gastric plication was performed with continuous suturing at the first and second row. The second subgroup included 186 patients, where gastric plication was performed with separated stitches at the first row and continuous suturing at the second row. In the second subgroup, a higher degree of %EWL was found. The complication rate was greater in the first subgroup. The overall rate of immediate surgical complications was 1.33%. Mean hospital stay was 36 hours.


Gastric plication is safe and efficient on EWL based on short-term results. Separated suturing is associated with a higher %EWL and a lower rate of complications, with a short hospital stay. Long-term data are needed to consolidate these results.

How to cite this article

Andraos YA, Ziade D, Achkouty R, Andraos TY. Gastric Plication as a New Stand-Alone Procedure for the Treatment of Morbid Obesity. World J Lap Surg 2014;7(2):49-59.

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  1. Gastric distension and gastric capacity in relation to food intake in Humans. Physiol Behav 1988;44(4-5):665-668.
  2. 10-year follow-up of laparoscopic vertical banded gastroplasty: good results in selected patients. Ann Surg 2010 Nov;252(5):831-839.
  3. International multicenter study of safety and effectiveness of Swedish adjustable gastric band in 1, 3 and 5-year follow-up cohorts. Surg Obes Relat Dis 2009 Sep-Oct;5:598-609.
  4. Evaluation of gastric greater curvature invagination for weight loss in rats. Obes Surg 2006 Feb;16(2):172-177.
  5. Comparison of anterior gastric wall and greater gastric curvature invaginations for weight loss in rats. Obes Surg 2007 Oct;17(10):1340-1345.
  6. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A 2007 Dec;17(6):793-798.
  7. Sales gastric surset: a new alternative in bariatric restrictive surgery. Rev Colomb Cir 2008;23(3):131-135.
  8. Initial results of vertical gastric plication for severe obesity. Presented at: Society of American Gastrointestinal and Endoscopic Surgeons. Phoenix, Arizona 2009 April 22-25.
  9. Am J Clin Nutr 1992 Feb;55(2 Suppl):615S-619S.
  10. Bariatric surgery: a systematic review and meta-analysis. JAMA 2005 Apr;292(14):1724-1737.
  11. Migration of adjustable gastric banding from a cohort study of 4236 patients. Surg Endosc 2005 Jul;19(7):947-950.
  12. Use of a Roux limb to correct esophagogastric junction fistulas after sleeve gastrectomy. Obes Surg. 2007 Oct;17(10):1408-1410.
  13. Treating morbid obesity with laparoscopic adjustable gastric banding. Am J Surg 2007 Sep;194(3):333-343.
  14. Sleeve gastrectomy for morbid obesity. Obes Surg 2007 Jul;17(7):962-969.
  15. Endoscopic removal of eroded adjustable gastric band. Lessons learned after 5 years and 78 cases. Surg Obes Relat Dis 2010 Jul-Aug;6(4):423-427. Epub 2009 Oct 6.
  16. Better weight loss, resolution of diabetes, and quality of life for laparoscopic gastric bypass vs banding: results of a 2-cohort pair-matched study. Arch Surg 2011;146(2):149-155.
  17. Gastrobronchial fistula as a rare complication of gastroplasty for obesity: a report of two cases. J Bras Pneumol 2007 Aug;33(4):475-479.
  18. Vertical gastric plication: an operation for gastroesophageal reflux. Ann R Coll Surg Engl 1989 Jan;71(1):31-36.
  19. Laparoscopic greater curvature plication: Initial results of an alternative restrictive bariatric procedure. Obes Surg 2010 Jul;20(7):913-918.
  20. Twelve years experience of laparoscopic gastric plication in morbid obesity: development of the technique and patient outcomes. Ann Surg Innov Res 2012 Aug 22;6(1):7.
  21. Outpatient weight loss surgery: initiating a gastric bypass and gastric banding ambulatory weight loss surgery center. JSLS 2009 Jan-Mar;13(1):50-55.
  22. Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery, Updated Position Statement on Sleeve Gastrectomy as a Bariatric Procedure. Surg Obes Relat Dis 2010 Jan-Feb;6(1):1-5.
  23. Laparoscopic gastric plication for treatment of severe obesity. Surg Obes Relat Dis 2011 Jan-Feb;7(1):15-22.
  24. Bariatric surgery in class I obesity (body mass index 30-35 kg/m2). Surg Obes Relat Dis 2013;9:e1-e10.
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