Gastric Plication: A Bariatric Option for Overweight Patients

The gastric plication is a bariatric intervention that is not so well known in Romania, but which can offer effective solutions for certain medical situations. This procedure involves interrupting the blood vessels on the large curvature of the stomach, thus allowing the stomach to fold (fold and inward twisting).

Unlike other bariatric procedures, gastric plication is less “intense”. For example, compared to gastric sleeve, plication does not involve removing part of the stomach. This makes it a viable option for patients with a body mass index (BMI) between 25 and 30, i.e. overweight people. For patients with a BMI above 30, who fall into the category of grade 1 obesity, more aggressive interventions such as gastric sleeve or gastric bypass are recommended, depending on the individual’s health status.

In the experience of the multidisciplinary team of Dr. Dejeu, gastric plication was ineffective for patients who did not adequately qualify for the procedure. The team encountered numerous cases in which morbidly obese patients (BMI over 40) underwent gastric plication, only to regain weight later. In these situations, conversion to a more effective procedure, such as gastric sleeve, is necessary. However, this conversion is not always easy and may complicate the initial situation.

The reason for choosing gastric plication

Dr. Viorel Dejeu confesses that an impressively large number of patients opt for gastric sleeve because it is cheaper or because the surgeon they have chosen is not familiar with other bariatric procedures. But, nevertheless, “bariatric procedures need to be tailored to the patient’s needs and condition, not the same solution for everyone just because it is more affordable or familiar”.

It does not mean that gastric plication is an ineffective procedure. For the right patients, who need to lose between 15-20 kg, plication can work excellently. However, long-term success depends a lot on continuous care and maintaining rigorous post-operative discipline. A patient who has a small excess of pounds and loses these pounds through plication must be extremely vigilant not to regain the lost weight.

Unlike a 150 kg patient who reaches 70 kg and regains 20 kg, a patient who is slightly overweight would lose the full benefit of the intervention if he or she gains back a few pounds. Thus, accurate and complete patient information is essential. The patient must understand both the benefits and limitations of gastric plication.

Gastric plication is a reversible procedure and can be highly effective when correctly indicated. Tailoring the procedure to the patient’s specific needs and thoroughly informing the patient are key factors for long-term success. Doctor Dejeu’s team in Romania is dedicated to providing the best bariatric solutions to patients around the world, ensuring that each procedure is tailored to the individual’s needs and health.