Skip to main content
Top
Published in: Obesity Surgery 8/2012

01-08-2012 | Other

Laparoscopic Greater Curvature Plication (LGCP) for Treatment of Morbid Obesity in a Series of 244 Patients

Authors: M. Fried, K. Dolezalova, J. N. Buchwald, T. W. McGlennon, P. Sramkova, G. Ribaric

Published in: Obesity Surgery | Issue 8/2012

Login to get access

Abstract

Background

Laparoscopic greater curvature plication (LGCP) is a new metabolic/bariatric surgical procedure that requires no resection, bypass, or implantable device. We report LGCP outcomes in 244 morbidly obese patients.

Methods

Between 2010 and 2011, patients underwent LGCP. Body mass index (BMI, kilogram per square meter) evolution, excess BMI loss (%EBMIL), excess weight loss (%EWL), complications, and type 2 diabetes mellitus (T2DM) changes were recorded. Repeated-measures analysis of variance (ANOVA) was used to assess weight change at 6, 12, and 18 months. Subgroup analyses were conducted to provide benchmark outcomes at 6 months. Logistic regression was used to identify characteristics predictive of suboptimal weight loss.

Results

Mean baseline BMI (±SD) was 41.4 ± 5.5 (80.7 % women, mean age 46.1 ± 11.0 years, 68 [27.9 %] patients had T2DM). Mean operative time was 70.6 min; mean hospitalization, 36 h (24–72). Sixty-eight patients (27.9 %) experienced postoperative nausea and/or vomiting that was controlled within 36 h. There was no mortality. Major complication rate was 1.2 % (n = 3). Repeated-measures ANOVA indicated significant weight loss across time points (p < 0.001). At 6 months (n = 105), BMI, %EBMIL, and %EWL were 36.1 ± 4.7, 34.8 ± 17.3, and 31.8 ± 15.9. Preoperative BMI was the only predictor of weight loss. Patients with BMI <40 lost more weight than those ≥40, although by 9 months, differences were no longer significant. In patients with preoperative BMI <40, 18-month %EWL approached 50 % and %EBMIL exceeded 50 %. At 6 months, 96.9 % of patients’ T2DM was significantly improved/resolved.

Conclusions

Over the short term, LGCP results in effective weight loss and significant T2DM reduction with a very low rate of complications.
Literature
1.
go back to reference Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31:1248–61.CrossRef Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31:1248–61.CrossRef
2.
go back to reference Dixon JB, Strauss BJ, Laurie C, et al. Changes in body composition with weight loss: obese subjects randomized to surgical and medical programs. Obesity (Silver Spring, MD). 2007;15:1187–98.CrossRef Dixon JB, Strauss BJ, Laurie C, et al. Changes in body composition with weight loss: obese subjects randomized to surgical and medical programs. Obesity (Silver Spring, MD). 2007;15:1187–98.CrossRef
3.
go back to reference Sowemimo OA, Yood SM, Courtney J, et al. Natural history of morbid obesity without surgical intervention. Surg Obes Relat Dis. 2007;3:73–7.PubMedCrossRef Sowemimo OA, Yood SM, Courtney J, et al. Natural history of morbid obesity without surgical intervention. Surg Obes Relat Dis. 2007;3:73–7.PubMedCrossRef
4.
go back to reference Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients [with discussion]. Ann Surg. 2004;240:416–24.PubMedCrossRef Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients [with discussion]. Ann Surg. 2004;240:416–24.PubMedCrossRef
5.
go back to reference Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.PubMedCrossRef Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.PubMedCrossRef
6.
go back to reference Buchwald H. External gastric plication. In: Buchwald’s atlas of metabolic & bariatric surgical techniques and procedures. Philadelphia: Saunders Elsevier; 2012. p. 287–92. Buchwald H. External gastric plication. In: Buchwald’s atlas of metabolic & bariatric surgical techniques and procedures. Philadelphia: Saunders Elsevier; 2012. p. 287–92.
7.
go back to reference Brethauer SA, Harris JL, Kroh M, et al. Laparoscopic gastric plication for treatment of severe obesity. Surg Obes Relat Dis. 2010;7(1):15–22.PubMedCrossRef Brethauer SA, Harris JL, Kroh M, et al. Laparoscopic gastric plication for treatment of severe obesity. Surg Obes Relat Dis. 2010;7(1):15–22.PubMedCrossRef
8.
go back to reference Neumayer C, Ciovica R, Gadenstatter M, et al. Significant weight loss after laparoscopic Nissen fundoplication. Surg Endosc. 2005;19:15–20.PubMedCrossRef Neumayer C, Ciovica R, Gadenstatter M, et al. Significant weight loss after laparoscopic Nissen fundoplication. Surg Endosc. 2005;19:15–20.PubMedCrossRef
9.
go back to reference Buchwald H, Buchwald JN. Evolution of surgery for morbid obesity. In: Pitombo C, Jones KB, Higa KD, Pareja JC, editors. Obesity surgery: principles and practice. New York: McGraw-Hill Medical; 2007. p. 3–14. Buchwald H, Buchwald JN. Evolution of surgery for morbid obesity. In: Pitombo C, Jones KB, Higa KD, Pareja JC, editors. Obesity surgery: principles and practice. New York: McGraw-Hill Medical; 2007. p. 3–14.
10.
go back to reference Cummings DE, Foster-Schubert KE, Carlson MJ, et al. Possible hormonal mechanisms mediating the effects of bariatric surgery. In: Pitombo C, Jones KB, Higa KD, Pareja JC, editors. Obesity surgery: principles and practice. New York: McGraw-Hill Medical; 2007. p. 137–47. Cummings DE, Foster-Schubert KE, Carlson MJ, et al. Possible hormonal mechanisms mediating the effects of bariatric surgery. In: Pitombo C, Jones KB, Higa KD, Pareja JC, editors. Obesity surgery: principles and practice. New York: McGraw-Hill Medical; 2007. p. 137–47.
11.
go back to reference Cummings DE, Overduin J. Gastrointestinal regulation of food intake. J Clin Invest. 2007;117(1):13–23.PubMedCrossRef Cummings DE, Overduin J. Gastrointestinal regulation of food intake. J Clin Invest. 2007;117(1):13–23.PubMedCrossRef
12.
go back to reference Kirk RM. An experimental trial of gastric plication as a means of weight reduction in the rat. Br J Surg. 1969;56(12):930–3.PubMedCrossRef Kirk RM. An experimental trial of gastric plication as a means of weight reduction in the rat. Br J Surg. 1969;56(12):930–3.PubMedCrossRef
13.
go back to reference Fusco PE, Poggetti RS, Younes RN, et al. Evaluation of gastric greater curvature invagination for weight loss in rats. Obes Surg. 2006;16(2):172–7.PubMedCrossRef Fusco PE, Poggetti RS, Younes RN, et al. Evaluation of gastric greater curvature invagination for weight loss in rats. Obes Surg. 2006;16(2):172–7.PubMedCrossRef
14.
go back to reference Fusco PE, Poggetti RS, Younes RN, et al. Comparison of anterior gastric wall and greater gastric curvature invaginations for weight loss in rats. Obes Surg. 2007;17(10):1340–5.PubMedCrossRef Fusco PE, Poggetti RS, Younes RN, et al. Comparison of anterior gastric wall and greater gastric curvature invaginations for weight loss in rats. Obes Surg. 2007;17(10):1340–5.PubMedCrossRef
15.
go back to reference Menchaca H, Harris J, Thompson S, et al. Gastric plication: preclinical study of durability of serosa-to-serosa apposition. Surg Obes Relat Dis. 2011;7:8–14.PubMedCrossRef Menchaca H, Harris J, Thompson S, et al. Gastric plication: preclinical study of durability of serosa-to-serosa apposition. Surg Obes Relat Dis. 2011;7:8–14.PubMedCrossRef
16.
go back to reference Clinical Issues Committee, American Society for Metabolic and Bariatric Surgery (ASMBS). Policy statement on gastric plication, March 8, 2011. Surg Obes Relat Dis. 2011;7(3):262.CrossRef Clinical Issues Committee, American Society for Metabolic and Bariatric Surgery (ASMBS). Policy statement on gastric plication, March 8, 2011. Surg Obes Relat Dis. 2011;7(3):262.CrossRef
17.
go back to reference Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A. 2007;17:793–8.PubMedCrossRef Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A. 2007;17:793–8.PubMedCrossRef
18.
go back to reference Sales Puccini CE. Surset gástrico de Sales: una alternative para cirugía bariátrica restrictive. Rev Colomb Cir. 2008;23(3):131–5. Sales Puccini CE. Surset gástrico de Sales: una alternative para cirugía bariátrica restrictive. Rev Colomb Cir. 2008;23(3):131–5.
19.
go back to reference Ramos A, Galvao Neto M, Galvao M, et al. Laparoscopic greater curvature plication: initial results of an alternative restrictive bariatric procedure. Obes Surg. 2010;20:913–8.PubMedCrossRef Ramos A, Galvao Neto M, Galvao M, et al. Laparoscopic greater curvature plication: initial results of an alternative restrictive bariatric procedure. Obes Surg. 2010;20:913–8.PubMedCrossRef
20.
go back to reference Gebelli JP, de Gordejuela A, Badía A, et al. Laparoscopic gastric plication: a new surgery for the treatment of morbid obesity. Cir Esp. 2011;89(6):356–61.CrossRef Gebelli JP, de Gordejuela A, Badía A, et al. Laparoscopic gastric plication: a new surgery for the treatment of morbid obesity. Cir Esp. 2011;89(6):356–61.CrossRef
21.
go back to reference Skrekas G, Antiochos K, Stafyla VK. Laparoscopic gastric greater curvature plication: results and complications in a series of 135 patients. Obes Surg. 2011;8(9):10–5. Skrekas G, Antiochos K, Stafyla VK. Laparoscopic gastric greater curvature plication: results and complications in a series of 135 patients. Obes Surg. 2011;8(9):10–5.
22.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef
23.
go back to reference Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.PubMedCrossRef Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.PubMedCrossRef
24.
go back to reference Mechanick JI, Kushner RF, Sugerman HJ, et al. AACE/TOS/ASMBS Guidelines: American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surg Obes Relat Dis. 2008;4:S109–84.PubMedCrossRef Mechanick JI, Kushner RF, Sugerman HJ, et al. AACE/TOS/ASMBS Guidelines: American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surg Obes Relat Dis. 2008;4:S109–84.PubMedCrossRef
25.
go back to reference Consensus Development Conference Panel. NIH conference: gastrointestinal surgery for severe obesity. Ann Intern Med. 1991;115:956–61. Consensus Development Conference Panel. NIH conference: gastrointestinal surgery for severe obesity. Ann Intern Med. 1991;115:956–61.
26.
go back to reference World Medical Association (WMA). Declaration of Helsinki—ethical principles for medical research involving human subjects. Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964, amended by the 59th WMA General Assembly, Seoul, October 2008. World Med J. 2008;54(4):122–5. World Medical Association (WMA). Declaration of Helsinki—ethical principles for medical research involving human subjects. Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964, amended by the 59th WMA General Assembly, Seoul, October 2008. World Med J. 2008;54(4):122–5.
27.
go back to reference Dixon JB, McPhail T, O’Brien PE. Minimal reporting requirements for weight loss: current methods not ideal. Obes Surg. 2005;15:1034–9.PubMedCrossRef Dixon JB, McPhail T, O’Brien PE. Minimal reporting requirements for weight loss: current methods not ideal. Obes Surg. 2005;15:1034–9.PubMedCrossRef
28.
go back to reference American Society for Bariatric Surgery Standards Committee, 2004–2005. Guidelines for weight calculations and follow-up in bariatric surgery. Surg Obes Rel Dis. 2005;1:67–8.CrossRef American Society for Bariatric Surgery Standards Committee, 2004–2005. Guidelines for weight calculations and follow-up in bariatric surgery. Surg Obes Rel Dis. 2005;1:67–8.CrossRef
29.
30.
go back to reference Miller MA. A calculated method for the determination of ideal body weight. Nutr Support Serv. 1985;5(3):31–3. Miller MA. A calculated method for the determination of ideal body weight. Nutr Support Serv. 1985;5(3):31–3.
31.
go back to reference Metropolitan Height and Weight Tables, 1993. Metropolitan Life Foundation. Stat Bull. 1983;64(1):2–9. Metropolitan Height and Weight Tables, 1993. Metropolitan Life Foundation. Stat Bull. 1983;64(1):2–9.
Metadata
Title
Laparoscopic Greater Curvature Plication (LGCP) for Treatment of Morbid Obesity in a Series of 244 Patients
Authors
M. Fried
K. Dolezalova
J. N. Buchwald
T. W. McGlennon
P. Sramkova
G. Ribaric
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 8/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0684-2

Other articles of this Issue 8/2012

Obesity Surgery 8/2012 Go to the issue