lgcp restrictive bariatric procedure similar to vertical sleeve gastrectomy without the need for...
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LAPAROSCOPIC GREATER CURVATURE PLICATION IN
MORBID OBESITY
LGCP Restrictive bariatric procedure similar to
vertical sleeve gastrectomy without the need for gastric resection
Reducing risks of complications associated with a permanent implant, such as a gastric band
Minimizing the possibility of leaks from staple lines
the procedure
the stomach’s volume is reduced by dissecting the greater omentum and short gastric vessels, as in VSG
and the greater curvature is invaginated using multiple rows of non-absorbable sutures performed over a bougie or endoscope to ensure a patent lumen.1
Restrictive operation
ADVANTAGE Laparoscopic Conservative Low price Reversible Volume residue: 50 cc EWL: 60% during 6 month Unrelated to technique morbidity: 2% Reoperation: 2% Regain: (10.9%) reoperation with different methods Safe alternative between restrictive operations
RESULT OF METHOD False positive sense of thirsty
Effective volume of stomach: 50 cc
Pain or reflux secondary to more intake
Gradually dilation of remnant volume (2 to 4 years) 50 cc to 200 cc
Psychological control to continue diet
Early results demonstrate that LGCP , a bariatric weight loss procedure, may
have a potentially lower risk profile than other bariatric procedures.1,2,3 Additional studies are needed to assess long-term efficacy.
1Ramos A, Galvao Neto M, Galvao M et al. Laparoscopic Greater Curvature Plication: Initial Results of
an Alternative Restrictive Bariatric Procedure. Obes Surg 2010; 20 (7): 913-918. [DSL 10-1229] 2Brethauer SA, Harris JL, Kroh
M et al. Laparoscopic gastric plication for the treatment of severe obesity. Surgery for Obesity and Related Diseases May 2010:6 (3):S16. [DSL-10-0550]
3Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc A
dv Surg Tech A 2007;17(6):793–8. [DSL 09-1251]
Has the same result of weight loss as others
Invasiveness of methods
METHOD EFFECTIVE TIME RESULT
Diet & Exercise Permanent <10% EFF
Intra gastric balloon 2 to 6 months 15% EWL, Intolerance in 30%
TVGP 4 years 63% EWL, 2% Complication
GB 4 years 65% EWL, 10-20% Complication, 1% Mortality
GBP 5-7 years 70% EWL, 15% Complication, 1% Mortality
IJB Long term 80% EWL, 1.5% Mortality, 25% Complication
DSB Permanent 85% EWL, 2.5% Mortality,33% Complication
7 YEARS OUTCOME OF TVGP
EWL% NOMBER OF CASES DURATION
60 197 6 MONTHS
64 151 1 YEAR
62 110 2 YEARS
59 68 3 YEARS
56 40 4 YEARS
55 27 5 YEARS
52 17 6 YEARS
50 8 7 YEARS
Obesity surgery Volume20, Number 7, 913-918, DOI: 10.1007/s11695-010-0132-0
Results All procedures were completed laparoscopically. Mean operative time was 50 min and mean hospital stay was 36 h. Patients returned to their regular activities at an average of 7 days
following surgery. No intra-operative complications occurred. All patients experienced excess weight loss (EWL) of at least 20%
after 1 month. Mean EWL was 62% (45% to 77%) in nine patients after 18 months.
There has been no record of weight regain in any patient to date.
Conclusions LGCP is feasible, safe, and effective for at least 18 months when
performed on morbidly obese patients. Longer follow-up and prospective comparative trials are needed.
Laparoscopic view
Endoscopic view
Patent lumen after LGCP
Publications
Ramos A, Galvao Neto M, Galvao M et al. Laparoscopic Greater Curvature Plication: Initial Results of an Alternative Restrictive Bariatric Procedure. Obes Surg 2010; 20 (7):913-918. [DSL 10-1229]
Brethauer SA, Harris JL, Kroh M et al. Laparoscopic gastric plication for the treatment of severe obesity. Surgery for Obesity and Related Diseases May 2010:6(3):S16. [DSL 10-0550]
Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A 2007;17(6):793–8. [DSL 09-1251]
Brethauer SA, Harris JL, Chand B, Kroh M, Rogula T, Schauer PR. Initial results of vertical gastric plication for severe obesity. Society of American Gastrointestinal and Endoscopic Surgeons. Phoenix, Arizona. April 22-25, 2009. [DSL 09-1253]
Brethauer S. Gastric Plication as a Bariatric Procedure. Minimally Invasive Surgery Symposium. San Diego, CA. Feb 22-27, 2010. [DSL 10-0256]
Ramos A, Galvao Neto M, Galvao M et al. Laparoscopic Greater Curvature Plication: An Alternative Restrictive Bariatric Procedure. Bariatric Times. Bariatric Times. May 2010;7(5):8–10.
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