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Beat the Band?! For Fast Intense Weight Loss Can Anything Beat the Device-Free, Laparoscopic Gastric Pleat?

Posted Jan 31 2011 6:43am

The FDA recently lowered the BMI restriction for LAP-BAND surgery, which is great news for people who don't mind the minimal risk of the procedure and the necessity of 'fills' in exchange for successful weight loss and all that brings with it. Many obesity surgeos are cheering this news, since it gives literally millions of overweight Americans a weight loss surgery option that is far less invasive and risky than the RNY gastric bypass (the current gold standard of obesity procedures) or Vertical Sleeve Gastrectomy. 


But people who object to the invasiveness of *any* device that requires surgical impantation and ongoing maintenance have not had good options to date: the intragastric balloon lacks the success rate of even LAP-BAND, and requires two procedures (insertion and removal) effectively doubling the patient's risk for no real added benefit.


And devices that require no surgery are still a ways from FDA approval: there is the so-called gastric pacemaker, developed by IntraPace, a device that emits electrical pulses said to create a feeling of fullness in the recipient. There is the  pill that when taken before meals to swell up the stomach and leave, in effect, less room at the inn.  There is an experimental device that slows the movement of food out of the stomach, as well as tubes that line the inside of the small intestine, letting food slide through without being absorbed. 


But today I was reading about this regular  webcast series for patients interested in learning more about the benefits of gastric plication, an alternative restrictive weight loss surgery proceudre that some gastroenterologists are calling 'better than band' for being devcie free, with a lower risk of early and acute complications compared to the current weight loss surgery gold standard of RNY gastric bypass.



Gastric Plication or Gastric Pleat gets it’s name from the ‘pleating’ effect of the specialized suturing involved.  It is also known as gastric imbrication or gastroplication, and it is a restrictive (vs. malabsorptive) weight loss surgery developed as a response to failed LAP BAND. The procedure, first presented at the 26th Pan-Hellenic Congress and the SFCE-MMESA Euro-Mediterranean & Middle East laparoscopic meeting in Bordeaux-France (both in 2008), and later (May 2010) reported in the Bariatric Times, involves no devices or stomach resection; Stomach capacity is restricted through the use of non-absorbable suturing.



Early pioneers of gastric pleat procedure include surgeons from Turkey and Brazil, as well as the Surgical Weight Loss Center of Utah and Mexico.  In November 20101 the 15th World Congress International Federation for the Surgery of Obesity and Metabolic Syndrome (IFSO) featured a special session "Gastric Plication: A New Option in Obesity Surgery" led by Dr. Juan Lopez Corvala, a renowend laparoscopic surery expert and gastrogenterologist surgeon who is also the President of the Mexican Association of Endoscopic Surgery and frequent presenter on obesity surgery innovations at American Society of Metabolic and Bariatric Surgery conferences.



At the IFSO session Dr. Lopez Corvala  reviewed findings from his open study of ~180 gastric plication patients (the largest in the world).  More than 50 US surgeons have since been trainedon the plication procedure by attending the  regular gastric plication surgical training sessions at Hospital Angeles Tijuana proctored by Dr. Lopez Corvala, attracted by the lower risk of early or acute complication (attributable to lack of resection and device) and patient weight loss outcomes.   



To handle the large number of inquiries, Hospital Angeles he hospital has created the free webcast  series to enable patients to address questions about the gastric plication (or any obesity surgery) to the treatment team. In an effort to encourage patient education, the hospital provides a compassionate credit of $250 toward the cost of the gastric plication medical travel program by Angeles to all webcast attendees.  (the total cost of the proceudre is then $7,250.



Facebook page for Angeles can be found here.



Findings support the consensus opinion issued by Brasilian gastroenterologist surgeons in the report ” Laparoscopic Greater Curvature Plication: An Alternative Restrictive Bariatric Procedure” published in the Bariatric Times in May 2010: i.e. that the gastric plication procedure features the benefits of minimal risk of acute or late complications, while providing patients with weight loss that comes sooner and is more intense than restrictive gastric banding.


I like the idea of webinars.  Hospital Angeles has a whole series of them which I found at, which contains (not unlike Walt Whitman) multitudes.

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