Gastric Sleeve Surgery Vs. Gastric Plication

You have options when it comes to losing weight and keeping it off. One of these options includes opting for a weight loss surgery or procedure. When you’re considering gastric surgery you must understand all the possibilities that are open to you before making a decision. There are many factors and elements to review as you try to determine which will work best for you.

There are two possible solutions worth diving deeper into and comparing, such as gastric plication and gastric sleeve surgeries. Take the time to learn more about each so you get a better idea of what they entail and the benefits and possible risks of the procedures. After you are informed you can use your knowledge to have a conversation with a surgeon about which procedure may be ideal for you. 

 

Gastric Sleeve Surgery

 

 

Gastric sleeve surgery is a procedure that’s widely standardized and a known weight loss surgery option worldwide. The benefits and long-term results are proven and clear. It is not reversible. If there are complications that arise, surgeons know how to treat them. It can be converted to other procedures too. You can convert or revise a sleeve to a gastric bypass or even a duodenal switch, for instance. Another point to mention and that makes it different from gastric plication is that the Ghrelin (or hunger) hormone decreases dramatically, due to the removal of a large portion of the cells that secrete this hormone with this procedure. It’s proven to decrease after gastric sleeve surgery but with the plication, it will still be there.

A gastric sleeve helps with weight loss by removing a part of your stomach and stapling the rest of it closed. It significantly restricts the volume of food that can be eaten. With gastric sleeve surgery, patients can expect to lose 60–80% of excess weight in about two years. Overall, choosing the gastric sleeve should result in few negative side effects and is proven to be a simple procedure.

 

Gastric Plication

 

 

Gastric plication is a new procedure to consider. The term plication refers to the rounded shape of the stomach made by folding it in layers. Gastric plication functions on the principle of folding the stomach into itself and using sutures, or stitches, to reduce the total volume. A laparoscope and other instruments are placed through small incisions in the abdomen to reach the stomach. In general, most people view this choice as less invasive, although it does come with its own set of concerns.

This procedure is reversible. One of the most significant possible complications of this procedure is that it can cause a lot of inflammation and tension in your stomach right after surgery. You may experience a higher risk of experiencing more symptoms right after the procedure. With gastric plication, initial research suggests weight loss is about 60% excess weight loss after 12 months.

Comparing Your Options

In both cases, the stomach size is reduced and there are no changes made to the intestine. Operating times are minimal and both take under 1 hour. You’ll stay at the hospital overnight and your recovery period and time off work will be anywhere between one to two weeks. Both of these options have been known to show excellent weight-loss results that are significant and sustained over time.

The pros and cons of each are as follows:

Gastric Sleeve

Pros:

  • No intestinal changes: Fewer complications and side effects, such as dumping syndrome
  • Metabolic changes are comparable with gastric bypass.
  • Hunger depressed because of reduction in ghrelin production
  • Lifetime approach to obesity
  •  Simple procedure

 

Cons:

  • Not reversible
  • Newer surgery with long-term results somewhat unknown
  • Requires some nutritional supplements and vitamins (not as much as gastric bypass)

Gastric Plication

Pros:

  •         Does not alter the patient’s digestive tract
  •         Less invasive than other surgeries (no cutting, stapling, or bypassing), reducing the risk of complications
  •         Allows patients to consume a larger range of foods gastric bypass does not allow
  •         Reversible, does not cut or permanently remove the stomach

 

Cons:

  •         It does not have a metabolic effect for the procedure per se, but from the weight loss achieved.  
  •         The stomach stretches and allows you to eat more compared with a gastric sleeve. 

The post-surgery dietary info and guidelines are a bit different for each procedure. For instance, with the gastric sleeve patients need to eat three meals a day containing 600–800 calories per day (recommended for the first 24 months) and about 1,000-1,200 thereafter. As for the gastric plication option, patients should consume a large range of foods due to the less-invasive nature of the procedure.

Deciding What to Do

You may be wondering what makes you a good candidate for each of these options. Gastric sleeve is effective for high-risk or very high BMI patients as a “first-stage” procedure. The complication rate is much lower than it is with the RNY Gastric Bypass or Duodenal Switch because there’s no intestinal bypass. As for the gastric plication surgery, good candidates fall into the lower range of the BMI curve, typically 30–40 BMI, or adolescents.

Conclusion

If weight loss has always been a struggle for you and you want to be healthier and feel better then you may be considering moving forward with one of these procedures. It’s not an easy decision and you’ll need to make sure you’re the right fit and that you know what to expect before and after the surgery. Keep these details handy and think through them before you reach out to a surgeon and start to discuss your options and weight loss journey goals.

You now know more about gastric sleeve surgery and gastric plication in detail. This information should help you in your decision-making process when trying to determine which procedure may be suitable and best for you. If you have further questions then it’s wise to reach out and consult with a surgeon who can provide more insights and details about each and work with you to figure out which one you may be a candidate for and any next steps.  

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Recent Blog Post: Gastric Sleeve vs Gastric Bypass

DR. GABRIELA RODRIGUEZ RUIZ MD Ph.D. FACS

Dr. Gabriela Rodriguez specializes in General and Laparoscopic Bariatric Surgery. She brings to VIDA Wellness and Beauty a wealth of experience in bariatrics. Dr. Rodriguez is a founding associate of the Mexican College of General Surgeons. A world-class bariatric surgeon with double certification in the US and Mexico.