Sleeve Gastrectomy vs Sleeve Plication

Welcome back to my blog. Today I’d like to discuss about some differences between the gastric sleeve or sleeve gastrectomy and the newer procedure called gastric plication.
Let’s begin by explaining a little bit of this brand new surgical approach. The term plication refers to the rounded shape of the stomach made by folding it in layers. It was thought to be a safe procedure and possibly have similar results as a gastric sleeve or a gastric bypass surgery but time has shown otherwise even though this is a relatively new procedure. Let me mention that is is considered completely experimental as of today and the American Society for metabolic and bariatric surgery has not authorized this procedure at all because we still don’t know what will happen with these patients. We don’t know the results, we don??t know the complications that may arise down the road and it has been authorized only to certain centers to carry out this procedure under strict experimental protocol. What we know so far is that this surgery is not leak proof. Patients right after surgery have so much inflammation and tension in their stomach that it literally tears open from the stitches that hold it together and produce a leak or perforation that will require surgery. This is probably the most fear complication that has shown up. Other complications that have been seen are ulcers inside of the stomach where the stitches have been placed and another complication that has been seen is the migration of the sutures, which means that the stitches move out of their original place. The other concern exists is that we don’t know what will happen down the road with this folded stomach. There is no experience worldwide on unwrapping this stomach after a few years of the initial surgery. Reversibility is questionable due to scarring of the stomach and conversion to another weight loss procedure is completely unknown or probably not possible. Regarding the gastric sleeve procedure, it has many advantages over the plication procedure, starting off that the sleeve is an authorized and know procedure worldwide and it is backed-up by the International Federation for the surgery of Obesity and Metabolic disorders and also the American Society for Metabolic and Bariatric surgery. It is a procedure that we know the benefits and long-term results. But the other good thing we we know are the complications from the sleeve and how to treat them too. The gastric sleeve can be converted to other procedures down the road specially for very high BMI patients. You can convert or revise a sleeve to a gastric bypass or even a duodenal switch. Now in comparison, with the gastric plication you probably already burnt your bridge if you want to convert it to some other procedure since there is no experience world wide. Another huge difference is the Ghrelin hormone that is removed with the gastric sleeve. This is the hunger hormone and it is proven to decrease after a gastric sleeve surgery but with the plication it will still be there. The less hunger the less you will eat. If you have any further questions on the topic you can always reach us at: I’ll see you online. Dr. Alvarez