Reducing stomach volume through gastric plication
The operation to reduce stomach volume through gastric plication is a method of shrinking the stomach by taking a part called the “greater curvature” out of function, performed with the laparoscopic technique. The beneficial effect consists of a significant decrease in the amount of food ingested and a reduction in appetite. The intervention is recommended for patients whose eating cannot be controlled through a weight-loss diet.
Gastric plication at a glance
- Type of procedure: restrictive, laparoscopic — no resection, no implants, no metal staples
- Volume reduction: approximately 70% of the stomach’s capacity
- Duration: about 1–2 hours
- Hospitalisation: 1–2 days
- Reversible: yes — and it can be converted into another bariatric procedure
- Contraindications: hiatal hernias and gastro-oesophageal reflux disease
What is gastric plication?
Gastric plication is a restrictive bariatric procedure through which the stomach is reduced without using implants or metal staples. The method consists of making folds in the gastric wall, which are then sutured with resorbable surgical threads. Because the procedure involves no gastric resection, the risk of complications is extremely low.
Who is it recommended for?
Laparoscopic gastric plication is a suitable intervention for patients suffering from obesity who need to reduce their body weight — especially those whose eating cannot be controlled through a weight-loss diet. It is a method credited with minor risks compared with other bariatric procedures, and the intervention is reversible.
When is it not recommended?
The contraindications of the procedure include hiatal hernias and gastro-oesophageal reflux disease. These situations are checked at the preliminary consultation, through the clinical evaluation and the investigations indicated by the doctor.
How does the operation work, step by step?
- The incisions — the intervention involves making 5 or 6 small incisions in the abdomen.
- The instruments — a video camera and long, laparoscopy-specific instruments are placed through these incisions.
- The plication itself — one or more folds of the stomach are sutured inwards, reducing the gastric volume by about 70%.
- What does NOT happen — in this intervention, the stomach and the intestines undergo no cutting, removal or stapling.
- The end — the intervention is minimally invasive and lasts about 1–2 hours.
The result: the stomach holds less food, and a reduced food intake is enough for patients.
What are the advantages of gastric plication?
- involves no implantation of foreign bodies into the organism and no stomach resection
- can be combined with other types of bariatric interventions or converted into any of them
- the complication rate is low
- the laparoscopic approach favours a fast recovery, low-intensity post-operative pain and no visible scars
- there is no reduction in the body’s absorption of nutrients
- contributes to improving the metabolic conditions associated with obesity: diabetes, fatty liver disease, arterial hypertension, dyslipidaemia
- it is financially accessible, and the short and medium-term results are extremely favourable
What is the recovery like?
Most patients spend approximately 1–2 days in hospital after the intervention. Following the plication, the patient feels satiety shortly after consuming a fairly small amount of food, and this state persists longer; a reduction in appetite is also observed.
Post-operatively, the surgeon constantly follows the results, monitoring the patient’s progress in detail. For optimal monitoring of the weight-loss process, good collaboration between patient and doctor is needed: the goal is a gradual loss of the excess kilograms, because rapid weight loss can create major health risks.
Frequently asked questions
Is plication permanent?
No — it is the only fully reversible major bariatric procedure and can be converted into another intervention (sleeve, bypass) if the results require it.
Plication or gastric sleeve?
Both reduce the stomach’s volume. The sleeve permanently removes part of the stomach (including the hunger-hormone area); plication only folds it — it is reversible and lower-risk, but with a somewhat more modest effect. See all bariatric procedures.
Will there be scars?
The incisions are small (5–6 laparoscopic incisions), and the scars are minimal and hardly visible after healing.
Do I need supplements after plication?
No, the procedure does not reduce nutrient absorption. The doctor will nevertheless establish the post-operative diet and the check-ups needed to follow your progress.