New Weight Loss Surgery

Results from pilot study are encouraging

March 2011

A new type of weight loss surgery could be a viable option for bariatric surgery patients, according to a pilot study conducted at Cleveland Clinic.

Laparoscopic gastric plication is a minimally invasive surgery that folds the stomach in on itself, reducing its volume by approximately 75 to 80 percent. Stitches hold the fold together to maintain stomach restriction.

The surgery is meant for people who have 50 to 100 pounds to lose. It's not yet covered by insurance but eventually may be cheaper than the current forms of bariatric surgeries.

A 15-person prospective study evaluating the technique was published in the online edition of the journal Surgery for Obesity and Related Diseases. It was led by Cleveland Clinic surgeons Stacy Brethauer, MD, and Philip Schauer, MD.

“We can reduce the stomach volume by more than two-thirds without removing any of the stomach because we’re not cutting or stapling,” says Dr. Schauer, Director of the Bariatric & Metabolic Institute. “Patients lose weight with gastric plication because their stomach is much smaller. It fills to capacity with a much smaller amount of food, so patients feel full quicker and therefore they eat less.”

Dr. Brethauer, the study’s lead author, says early weight loss results were encouraging. “We need to conduct further studies to determine long-term weight loss and to better evaluate the safety of this procedure,” he says. “A multicenter trial of this technique is ongoing, but our experience suggests this could be another good option for patients considering weight loss surgery.”

Twelve women and three men between the ages of 26 and 58 took part in the pilot study. Their average body mass index (BMI) before surgery was 44.3. People with BMIs of more than 40 are considered morbidly obese.

A group of patients who had a smaller portion of their stomach folded saw 23 percent excess weight loss while a group with a larger portion of the stomach folded saw 53 percent excess weight loss.

Dr. Schauer says the preliminary results of the greater curvature plication resemble the outcomes achieved through the gastric sleeve procedure, which involves removing 80 percent of the stomach.

Another commonly used surgical technique is gastric bypass, which involves creating a small pouch by dividing the upper portion of the stomach. This restricts the intake of food. A limited bypass of the intestines is then performed with a direct connection between the small bowel and the small stomach pouch.

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