Laparoscopic Greater Curvature Plication

Laparoscopic Greater Curvature Plication

About the procedure:
In this experimental procedure, the stomach is folded in on itself and stitched into position to create a small stomach pouch which results in fullness after a small meal.  The natural outlet of the stomach is maintained.  This opening is designed to pace the emptying of stomach contents.  The pouch is thought to be similar in form and function to that of a sleeve gastrectomy, without the increased risks associated with cutting and stapling the stomach. This operation is only perfomed under a research protocol and is not yet funded by insurance companies.

How It Works:
The small gastric pouch restricts meal volume, but more importantly, it allows early and prolonged satiety. Patients feel full with a small amount of food, and they are not hungry or looking for food between meals.

Indications:
The LGCP is indicated for use in weight reduction for severely obese patients with a Body Mass Index (BMI) of at least 40 or a BMI of at least 35 – 39 with one or more severe co-morbid conditions, or those who are 100 lbs. or more over their estimated ideal weight.  A patient with a BMI of 40 usually weights about 100 lb above their ideal body weight.

Malabsorption:
No decrease in the absorption has been seen with Greater Curvature Plication.

Vitamin Requirement:
Daily Multivitamins due to decreased nutrient intake.  Vitamin D as needed.

Dietary Restrictions:
Patients may experience difficulty with thick breads and fibrous foods.  Patients must take care to thoroughly chew food after surgery to prevent regurgitation.  A low carbohydrate diet enhances the effectiveness of this procedure.

Laparoscopic:
Yes

Number of incisions:
1 to 4 incisions. Single incision surgery available to appropriate patients.

Intestinal Rerouting:
No

Cutting or stapling:
No

Hospital Stay:
Inpatient – Patients usually stay 1-2 night in the hospital

Recovery:
Most patients return to normal activity in two weeks. Full surgical recovery occurs in two to three weeks.

Post Op Diet:
As with all surgical weight-loss programs, it is imperative that LGCP  patients adhere to a strict post-operative diet. Patients must stick to a liquid protein diet for 3 weeks after surgery. Patients then graduate to a soft protein based diet for 2 weeks and then at 8 weeks, patients transition to a low carb solid diet. Once goal weight is achieved, usually 2-3 years after surgery, most patients consume a normal healthy diet with the appropriate number of calories for their height and build to maintain their weight.

Mortality:
There is no long term data on this procedure regarding mortality.

Hair Loss:
Patients may experience hair loss during period of rapid weight loss, but hair growth usually normalizes with weight maintenance.

Bone Disease or Osteoporosis:
No increase in risk.

Iron Deficiency Anemia:
No increase in risk.

Reversible?:
Not enough data is known to determine if the sutures placed  during the procedure are reversible.

Easily Adjustable:
No. The LGCP can only be adjusted through an additional surgical procedure.

Pregnancy:
It is not recommended that you become pregnant during the weight loss period following LGCP, due to inability to intake adequate nutrition.  Weight loss after LGCP occurs because the patient cannot intake enough nutrition to support themselves, rendering them incapable of providing adequate nutrition to support a developing baby.

Contraindications:
LGCP is not recommended for non-adult patients (will be evaluated on a case-by-case basis), patients with conditions that may make them poor surgical candidates or increase the risk of poor results, who are unwilling or unable to comply with the required dietary restrictions, or who currently are or may be pregnant.

Weight Loss:
Typical patients lose weight at a rate or 2-3 pounds per week.  Weight loss is rapid but usually slows by twelve to eighteen months post op. Long term data is not available yet.