GASTRIC

PLICATION

DR M TALEBPOUR

HISTORY

1974: Animal lab, 2002: Tehran, Plication 2002: Modification of plication:

Ant plication

Total plicationWrap and Plication

2005: SAGES: The first presentation of plication 2006: Saudi Arabi, Lebonen 2007: The first paper of plication 2007: Brezil 2010: Italy

INDICATION

Mutivation:

Excelent: Plication

Moderate (Male, BMI>50, Diabet): Gastric bypass

Weak: Ileojejunal bypass

TECHNIQUE

Greater curvature release by ligasure

Separation of anterior row of SG

Inversion of released GC by nylon

Length of plication from cardia to 4 cm to pylorus

Submucosal sutures

TRANSVERSE SECTION

VERTICAL PLICATION

BARIUM MEAL

DIET AFTER PLICATION

No 1: Liquids, 10 days

No 2: Semi liquids, 10 days

No 3: Soft diet, 10 days

No 4: Normal diet, 5 months

FUTURE OF PLICATED PATIENT

Dilation of gastric volume

60% EWL 6 months

75% EWL 12 months

Inversion of sutures in the stomach after 4 years

COMPLICATION OF PLICATION

Leakage at suture site

Stricture

Bleeding

Loosening of suture line

REGAIN OF PLICATION

Replication

Sleeve gastrectomy

Ileojejunal bypass

Gastrojejunal bypass

LOSS OF APPETITE IN PLICATION

Ghrelin

Total gastric volume

Appetite and gastric volume