Laparoscopic total gastric vertical plication in morbid obesity

Area of Science:

• Bariatric Surgery
• Minimally Invasive Procedures
• Gastrointestinal Surgery

Background:

• Obesity is a global health concern requiring effective bariatric interventions.
• Restrictive bariatric operations aim for significant weight loss with minimal complications.
• Developing countries face challenges with high-cost bariatric procedures.

Purpose of the Study:

• To introduce and evaluate the Total Gastric Vertical Plication (TGVP) as a novel restrictive bariatric surgery.
• To assess the efficacy and safety of TGVP, particularly its cost-effectiveness.
• To compare TGVP with existing bariatric procedures in terms of weight loss and complications.

Main Methods:

• TGVP involves continuous sutures from the fundus to the pylorus in one or two layers.
• Sutures are placed 2 cm from the lesser curvature, ensuring submucosal placement.
• The procedure was performed by a single surgeon over three years in private hospitals.

Main Results:

• 100 patients (mean age 32, BMI 47) underwent TGVP.
• Mean excessive weight loss (EWL) reached 54% at 6 months and 61% at 12 months.
• Average operation time was 98 minutes, with a 1.3-day hospital stay; minimal early complications were noted.

Conclusions:

• TGVP achieves rapid and comparable EWL to other restrictive methods.
• The technique demonstrates minimal early postoperative complications and no significant late complications.
• TGVP requires surgical expertise and is time-consuming, necessitating long-term follow-up.