Gastric plication for morbid obesity: a systematic review

Gastric plication is a new bariatric procedure. Controversies exist regarding this emerging surgery. We herein present a comprehensive review of the literature regarding gastric plication approach.

Advanced Pub Med search combining the MeSH terms "Gastric plication", OR "Gastric greater curvature plication" yielded 213 abstracts. Abstracts were screened for articles in English and articles on human subjects yielding 130. Further searches revealed 121 titles to be unrelated to gastric plication. The remaining nine abstracts were analyzed for their full texts. Two articles were excluded because, one was a commentary on another article, and the other was a released ASMBS policy on gastric plication. In the end, there were seven articles published on gastric plication.

A total of 307 patients had undergone gastric plication. The mean operative time range was 40 to 150 min. The median length of hospital stay ranged between 1.3 and 1.9 days. In respect to excess weight loss (EWL), at 6 months, it ranged from 54 to 51 %, while at 12 months 67-53.4 %. The longest follow-up was 3 years with a mean of 57 % EWL.

Laparoscopic gastric plication is still in its infancy. Prospective randomized studies comparing gastric plication to other well established bariatric procedures are needed to prove the reliability and metabolic effectiveness of such new procedure.