Laparoscopic gastric plication or laparoscopic greater curvature plication or gastric imbrication is a minimally invasive weight loss surgery for obese patients who are willing to experience a less risky and less expensive weight loss treatment. This method, which is popular and newer among other kinds of weight loss surgeries, was first introduced to the world by Iranian laparoscopic surgeon Dr. Talebpour. This treatment restricts the size of the stomach by folding its wall. It neither requires an external device implanted inside the stomach nor removal of any part of it. In gastric plication, your surgeon folds the stomach inwards and sews it up, making it smaller with the capacity of approximately three ounces. After the surgery, satiety is felt more quickly and you are able to manage the amount of your meal.
Why gastric plication?
Sleep apnea, hypertension, diabetes, and abnormal cholesterol levels are the negative physical effects of obesity. These diseases are the results of modern lifestyules in which physical activities are decreased and eating habits are altered. There are also other issues caused by obesity which are psychological, like depression. Although there are different methods to lose weight, doctors suggest gastric plication in order that the patient loses weight sooner (within a year) and with fewer side effects. After gastric plication, overeating will stop and the patient’s health condition improves quickly.
Are you a good candidate for gastric plication?
Gastric plication is a useful method for those who have tried to lose weight by traditional methods and never succeeded. If your body mass index (BMI) is higher than 35 and less than 40, gastric plication is suggested. Women who intend to get pregnant, and patients who do not access to near medical centers are good candidates for this surgery as there is no need for constant visits. Individuals who are prepared to change their eating habits are recommended for this surgery as gastric plication makes you eat small and controlled portions. If snacking and grazing small portion of food are your habits, be aware that this surgery is not for you as it works best on obese people with the habit of surfeit. If you are suffering from high blood pressure, diabetes and sleep apnea, you may be advised by a surgeon to undergo gastric plication. Those who adhere to their surgeon’s instructions, physical activity included, get the most satisfactory results from this surgery.
What are the advantages of gastric plication surgery?
Apart from fewer side effects, gastric plication has the following advantages compared to other weight loss surgery treatments:
- Like gastric banding, it is reversible. In the case of any problem, the stomach can be returned to its former shape.
- Compared to gastric bypass, the digestive system is not rearranged.
- Unlike gastric banding, there is no need for an additional device.
- No part of the stomach is removed.
- During the first year, between 40% and 70% of the excess body weight is lost.
- Health improvements, like resolution of diabetes and high cholesterol levels, are more noticeable than other weight loss surgeries.
- There is no need for periodical and constant visits.
- It costs less than other methods.
- It is minimally invasive and does not possess open surgery disadvantages, like scarring.
- The patient is released from hospital within 24 hours or at most 48 hours.
- The patient feels less pain as there are no large incisions and the surgery is done by laparoscopy.
- Due to its restrictive quality, the patient does not necessarily need much supplement or medication.
- Normal activities are doable within a week.
- In the case of weight gain, the procedure can be repeated to restrict the mass of stomach.
How is a gastric plication performed?
It is performed under general anesthesia. As it is not an open surgery, five or six slight incisions are made in the abdomen of the patient. A laparoscope (a long instrument like a tube with a video camera at its end) and other long instruments are introduced to the body. With no stapling or removal, your surgeon will plicate and sew the wall of your stomach. There would be four bites chosen on the gastric wall; two bites located in the anterior and two in the posterior. By sewing these sections, a large part of the stomach is restricted and folded. So, your stomach transforms to a tube-like shape. Depending on the case and the doctor, it takes from 40 minutes to 2 hours. One day after the surgery, the patient is able to go home.
What to do before a gastric plication?
Like other surgeries, there are some general pre-operative things to be done in order that you have a better surgery:
- It is forbidden to eat 12 hours before the appointment.
- It is forbidden to drink 6 hours before the appointment.
- Consult a nutrition specialist.
- Psychological counseling is needed.
- Have a blood test.
- Talk to your surgeon before the surgery and make sure you know everything about the complications and post-operative cares.
- Make arrangements for your transportation.
- Stop drinking alcohol before the surgery.
- Quit smoking at least one week before the appointment.
- Make sure that you are psychologically and mentally prepared for the surgery.
- Do not take medication without your surgeon’s permission.
What are gastric plication recovery and post-operative care?
The first month needs special care and diet to adhere to. Within the first two weeks, only liquids are permitted, such as water, black tea, milk, fruit juices, sherbets, etc. within the second two weeks after the surgery, you are permitted to take soft foods, like soup, fruits, yogurt and blended foods. Thick foods are permitted a month after the surgery, when your stomach is recovered, but in a small amount. If you desire to have a continual fat loosing, make sure that you consider what is listed below:
- Eat slowly and chew carefully to have an easy digestion.
- Use a small spoon.
- Take proteins daily. You may use milk, red meat, and/or eggs.
- To avoid vomiting, do not drink while eating. There is not enough room for both liquids and solid foods at the same time.
- Avoid alcohol, sodas, and confections.
- Snacks are permitted.
What are common side effects and risks of gastric plication?
As laparoscopic gastric plication is a surgery, it may carry some risks. In addition to that, complications and risks related to this surgery are less than other surgical operations. Most of them are preventable if the patient follows the doctor’s instructions and diet. Some possible risks are:
- Slight bleeding
- Injury to other organs
- Leakage from the suture areas of the stomach
- Complications related to general anesthesia
- In the case of overeating, stomach expansion is possible up to 15%
How much does a laparoscopic gastric plication cost?
As any surgical operation, the price of gastric plication is dependent on the hospital and the surgeon. It is also dependent on the area where you choose to undergo the surgery. In the United States, depending on the hospital, it costs around $10,000 to $15,000. It is important to talk about the price of your surgery before booking it. As it is a very important and delicate procedure, it really matters who and where you choose for your surgery.
Laparoscopic gastric plication in Iran
Gastric plication was first introduced to the medical world by Iranian surgeons. With acceptable results and fewer side effects compared to other weight loss surgeries, gastric plication became famous among both surgeons and patients from all around the world. We can conclude that Iran is one of the countries with many professional doctors in this field. There are well-equipped clinics in different cities of Iran, like Tehran, Tabriz, Shiraz, Mashhad, Isfahan, Kish Island and other cities, which perform gastric plication. They provide a safe surgery and equipment with great quality.
Gastric plication cost in Iran
Like other surgeries, gastric plication is much more affordable in Iran than other countries. Gastric plication cost in Iran is around $3500-$5000 while in some areas of the U.S., it costs up to $20,000, in the U.K. over £4,000, and in Lebanon $4667.
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Weight Loss Surgery archived questions and answers
Q1: Am I allowed to do physical activity after gastric sleeve surgery?
You can easily do your routine activity after a week and also light activities such as walking (not jogging and running )is also allowed.Heavy activities such as weight lifting, body building is not allowed for a month and half after the surgery.
Q2: How long should I stay in Iran for a rhinoplasty?
The gastric sleeve Surgery takes around 2 hours to perform. The patients may leave the hospital one or two days after the surgery and abroad patients can go back to their country after 4 days of stay.
Q3: How long should I have to be off work after weight loss surgery?
Most patients return to work after a week. You may have lack of energy for the first week but there is nothing to be worried about. By consulting with your doctor you can find solutions to reduce the post-surgeries discomfort. After one week you can back to your work.
Q4: Will I need additional surgery after my weight loss surgery?
Most of people losing weight in large amount for enhancing their look and beauty of their skin may need additional plastic surgeries on their abdomen which is totally optional.