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Nazer, Alshehri, Abdo, Saeed, and Alahmady: Short-term outcome of laparoscopic greater curvature plication – a new gastric restrictive technique for morbidly obese patients

Introduction: Gastric restrictive procedures as a surgical option for treatment of morbid obesity include either gastric resection, such as vertical sleeve gastrectomy, or the use of a prosthetic device, such as adjustable gastric banding.

Objectives: The present study aimed to report the results of laparoscopic greater curvature plication (LGCP) as a new gastric restrictive procedure without the need for gastric resection by staple or the use of prosthesis.

Materials and methods: This was a prospective study, which included 32 patients (19 female and 13 male) who underwent LGCP between May 2012 and June 2013 with a mean body mass index of 41.75 ± 3.8 kg/m2 and mean age of 32.5 ± 8.6 years. Via a five-trocar port technique, dissection of the greater omentum from the greater curvature and ligation of short gastric vessels were carried out, followed by plication of the greater curvature by two rows of sutures over a 32-Fr bougie to ensure a patent lumen. Follow up of total weight loss and excess weight loss (EWL) for all cases were recorded at 1, 3, 6 and 12 months.

Results: All procedures were carried out laparoscopically without the need for conversion. There were no intraoperative complications detected. Mean operative time was 83 ± 7.5 minutes and mean hospital stay was 36.4 ± 6.1 hours. Post-operative nausea, vomiting and sialorrhea occurred in 7 patients (21.9%), 5 patients (15.6%) and 10 patients (31.25%), respectively, which disappeared within 1–2 weeks. Mean EWL after 1, 3, 6 and 12 months was 19.5%, 30.5%, 47% and 59%, respectively. There is no weight gain recorded to date in any of the patients.

Conclusions: LGCP is a new gastric restrictive technique that is both safe and effective. However, long-term follow-up and large prospective randomized controlled studies are still needed.

Acknowledgements: Special thanks to the doctors who provided the chance and guidance to participate in this study.

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