Gastricplication Surgery or Gastric Pleat .

(Also sometimes called Gastric Imbrication Surgery)

Gastric Imbrication is a very new type of weight loss surgery. Dr. Fusco is among the first surgeons in Florida to offer this surgery. This surgery works similar to other gastric (stomach) restriction operations where the stomach is reduced in size which makes patients feel full after eating less food and helps decrease hunger. Gastric plication is most similar to sleeve gastrectomy. With sleeve gastrectomy (gastric sleeve surgery) a large portion of the stomach is removed which results in a long staple line closing the remaining stomach. Occasionally this staple line can leak which can lead to major postoperative complications. With gastric plication there is no stomach removal. Instead the stomach is folded inward and sutures are used to reduce the size of the stomach similar to the way a tailor would "take in" a dress or pair of pants. Since there is no staple line, it is thought that this operation will result in a lower chance of postoperative leak.

Advantages:

• Good early weight loss (small amount of two year data)
• Theoretically should lead to a lower leak rate
• No implanted device (foreign body) - making this operation an option for patients that can not have a lap-band because of chronic infection or erosion.
• Like Lap-Band, the surgery is done using minimally invasive techniques allowing for outpatient surgery with rapid recovery.

Disadvantages:

• Very new so significant uncertainty surrounding rates of complications and long term results
• Not adjustable: Similar to gastric bypass and gastric sleeve (which are also not adjustable). May have a higher rate of long term weight regain as is sometimes seen with the above operations.
• Unclear as to whether there is an acceptable operative salvage strategy.
• Since the procedure is new, the cost of gastric plication is not covered by health insurance. (a package cost with all routine care for a year is available with financing options available)