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Updated: May 28, 2026
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Published on: August 11, 2023
Fundoplication combined with mediogastric plication
1Surgical Research Laboratory, Saint Joseph University Medical School, Beirut, Lebanon. aline.khazzaka@usj.edu.lb
Background:
The purpose of this pilot study was to demonstrate the feasibility and procedural safety of laparoscopic fundoplication combined with mediogastric plication in patients with a body mass index of 32-35 kg/m(2).
Methods:
Sixteen patients underwent laparoscopic fundoplication combined with mediogastric plication. All procedures were performed with the patient under general anesthesia. The 1-year follow-up results encompassed gastroesophageal reflux disease recovery and excess weight loss.
Results:
The procedure time varied from 65 to 95 minutes. No serious procedure-related complications occurred. Gastroesophageal reflux disease-related symptoms resolved in all patients (P = .000). The excess weight loss was 10 ± 4 kg (58%) 1 year after the procedure. The 1-year follow-up excess weight was significantly less than the baseline excess weight (P = .000). The average body mass index decreased from 33.8 ± 1.9 kg/m(2) at baseline to 27.2 ± 1.7 kg/m(2) at 1 year (P = .02). Of the 16 patients, 14 had an excess weight loss of 62%, and 2 sweet-eaters had an excess weight loss of 33%. At 1 year of follow-up, the excess weight in those who smoked (n = 10) was greater than that of nonsmokers (n = 6; P = .02). However, smoking did not seem to significantly affect excess weight loss (P = .065).
Conclusion:
Fundoplication combined with mediogastric plication produced a total recovery from gastroesophageal reflux disease and an excess weight loss of 62% in 87.5% of patients after 1 year of follow-up. This procedure is technically feasible, and no serious procedure-related complications occurred. The follow-up is ongoing to investigate the efficacy and long-term durability of the procedure.
Insights
Laparoscopic fundoplication with mediogastric plication effectively treated GERD and reduced weight in obese patients. This combined procedure is safe and feasible, showing significant excess weight loss and symptom resolution within one year.
Area of Science:
- Bariatric Surgery
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Obesity and gastroesophageal reflux disease (GERD) often coexist.
- Surgical interventions are explored for managing these conditions in patients with a body mass index (BMI) of 32-35 kg/m(2).
- Laparoscopic fundoplication combined with mediogastric plication is a novel approach.
Purpose of the Study:
- To assess the feasibility and procedural safety of laparoscopic fundoplication combined with mediogastric plication.
- To evaluate the efficacy of this combined procedure in treating GERD and promoting weight loss.
- To analyze 1-year follow-up outcomes in patients with moderate obesity.
Main Methods:
- Sixteen patients with BMI 32-35 kg/m(2) underwent the combined laparoscopic procedure.
- Procedures were performed under general anesthesia.
- One-year follow-up assessed GERD recovery and excess weight loss (EWL).
Main Results:
- All patients achieved complete resolution of GERD symptoms (P = .000).
- Mean EWL was 58% (10 ± 4 kg) at 1 year, with a significant reduction in BMI from 33.8 to 27.2 kg/m(2) (P = .02).
- 87.5% of patients achieved 62% EWL; smokers had greater baseline excess weight but similar EWL.
Conclusions:
- Laparoscopic fundoplication with mediogastric plication is technically feasible and safe for treating GERD and obesity.
- The procedure resulted in significant weight loss and complete GERD symptom resolution in most patients at 1 year.
- Long-term efficacy and durability require ongoing investigation.
