LGCP Restrictive bariatric procedure similar to vertical sleeve gastrectomy without the need for gastric resection Reducing risks of complications associated with a permanent implant, such as a gastric band Minimizing the possibility of leaks from staple lines the procedure the stomach’s volume is reduced by dissecting the greater omentum and short gastric vessels, as in VSG and the greater curvature is invaginated using multiple rows of non-absorbable sutures performed over a bougie or endoscope to ensure a patent lumen.1 Restrictive operation ADVANTAGE Laparoscopic Conservative Low price Reversible Volume residue: 50 cc EWL: 60% during 6 month Unrelated to technique morbidity: 2% Reoperation: 2% Regain: (10.9%) reoperation with different methods Safe alternative between restrictive operations RESULT OF METHOD False positive sense of thirsty Effective volume of stomach: 50 cc Pain or reflux secondary to more intake Gradually dilation of remnant volume (2 to 4 years) 50 cc to 200 cc Psychological control to continue diet Early results demonstrate that LGCP , a bariatric weight loss procedure, may have a potentially lower risk profile than other bariatric procedures.1,2,3 Additional studies are needed to assess long-term efficacy. 1Ramos A, Galvao Neto M, Galvao M et al. Laparoscopic Greater Curvature Plication: Initial Results of an Alternative Restrictive Bariatric Procedure. Obes Surg 2010; 20 (7): 913-918. [DSL 10-1229] 2Brethauer 3Talebpour SA, Harris JL, Kroh M et al. Laparoscopic gastric plication for the treatment of severe obesity. Surgery for Obesity and Related Diseases May 2010:6 (3):S16. [DSL-10-0550] M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc A Surg Tech A 2007;17(6):793–8. [DSL 09-1251] dv Has the same result of weight loss as others Invasiveness of methods METHOD EFFECTIVE TIME RESULT Diet & Exercise Permanent <10% EFF Intra gastric balloon 2 to 6 months 15% EWL, Intolerance in 30% TVGP 4 years 63% EWL, 2% Complication GB 4 years 65% EWL, 10-20% Complication, 1% Mortality GBP 5-7 years 70% EWL, 15% Complication, 1% Mortality IJB Long term 80% EWL, 1.5% Mortality, 25% Complication DSB Permanent 85% EWL, 2.5% Mortality, 33% Complication 7 YEARS OUTCOME OF TVGP EWL% NOMBER OF CASES DURATION 60 197 6 MONTHS 64 151 1 YEAR 62 110 2 YEARS 59 68 3 YEARS 56 40 4 YEARS 55 27 5 YEARS 52 17 6 YEARS 50 8 7 YEARS Obesity surgery Volume20, Number 7, 913-918, DOI: 10.1007/s11695-010-0132-0 Results All procedures were completed laparoscopically. Mean operative time was 50 min and mean hospital stay was 36 h. Patients returned to their regular activities at an average of 7 days following surgery. No intra-operative complications occurred. All patients experienced excess weight loss (EWL) of at least 20% after 1 month. Mean EWL was 62% (45% to 77%) in nine patients after 18 months. There has been no record of weight regain in any patient to date. Conclusions LGCP is feasible, safe, and effective for at least 18 months when performed on morbidly obese patients. Longer follow-up and prospective comparative trials are needed. Laparoscopic view Endoscopic view Patent lumen after LGCP Publications Ramos A, Galvao Neto M, Galvao M et al. Laparoscopic Greater Curvature Plication: Initial Results of an Alternative Restrictive Bariatric Procedure. Obes Surg 2010; 20 (7):913-918. [DSL 10-1229] Brethauer SA, Harris JL, Kroh M et al. Laparoscopic gastric plication for the treatment of severe obesity. Surgery for Obesity and Related Diseases May 2010:6(3):S16. [DSL 10-0550] Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A 2007;17(6):793–8. [DSL 09-1251] Brethauer SA, Harris JL, Chand B, Kroh M, Rogula T, Schauer PR. Initial results of vertical gastric plication for severe obesity. Society of American Gastrointestinal and Endoscopic Surgeons. Phoenix, Arizona. April 22-25, 2009. [DSL 09-1253] Brethauer S. Gastric Plication as a Bariatric Procedure. Minimally Invasive Surgery Symposium. San Diego, CA. Feb 22-27, 2010. [DSL 10-0256] Ramos A, Galvao Neto M, Galvao M et al. Laparoscopic Greater Curvature Plication: An Alternative Restrictive Bariatric Procedure. Bariatric Times. Bariatric Times. May 2010;7(5):8–10.