Evolving Technique of Laparoscopic Vertical Gastric Clip Placement

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Laparoscopic BariClip gastroplasty (LBCG) offers tubular restriction similar to laparoscopic sleeve gastrectomy (LSG).
• Anatomic preservation and simplicity are key advantages of LBCG.
• The risk of gastric wall slippage with the BariClip device requires investigation.

Purpose of the Study:

• To analyze the risk of slippage with the Laparoscopic BariClip gastroplasty (LBCG) procedure.
• To present an evolving LBCG technique incorporating gastric plication to mitigate slippage.
• To evaluate the impact of gastric plication on slippage rates and weight loss outcomes.

Main Methods:

• A case-controlled study compared an evolving LBCG technique with gastric plication (group A) to a previous LBCG technique (group B).
• Group A included 176 patients (Jan 2021-May 2022); Group B included 67 patients (May 2017-June 2019).
• Patients were matched by gender and BMI; postoperative complications, specifically slippage, were analyzed.

Main Results:

• The evolving LBCG technique (group A) had a slippage rate of 2.8% (5 cases).
• The previous LBCG technique (group B) had a slippage rate of 4.3% (3 cases).
• Slippage in group A was managed by repositioning (3 cases) or BariClip removal (2 cases); all cases in group B required removal.

Conclusions:

• A novel LBCG technique involving anterior/posterior gastric plication and antral volume reduction was developed.
• This evolving technique potentially reduces the rate of BariClip slippage.
• The modified LBCG approach may also enhance weight loss outcomes in bariatric patients.