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Gastric Sleeve Surgery Vs. Gastric Plication 2018-09-11T21:57:17+00:00

Gastric Sleeve Surgery Vs. Gastric Plication
Differences in BMI, Costs, Requirements, Outcomes, Side-Effects and Risks

Procedure Gastric Sleeve Gastric Sleeve Plication
AKA Vertical Sleeve Gastrectomy Greater Curvature Plication
(GCP), Gastroplication, Gastric Pleat
Price in Mexico $6,500 $6,500
Average Price in US $19,000 $15,000
Savings Compared to US $13,200 $8,500
Diagram
Method of Weight Loss Restrictive: Reduces stomach size and hunger hormone (ghrelin) release Restrictive: Reduces stomach size and hunger hormone (ghrelin) release
Stomach Alterations Stomach size reduced Stomach size reduced
Impact 70–85% of stomach removed Stomach size reduced through modification to be around 85% of its original size
Changes to Intestine No change No change
Operating time 1–3 hours 2 hours
Average Hospital Stay 2 nights 2 nights
Time off Work 2 weeks 2–3 weeks
Recovery Time 3 weeks 2–3 weeks
Pros
  • No intestinal changes: Fewer complications and side effects, such as dumping syndrome
  • Hunger depressed because of reduction in ghrelin production
  • Lifetime approach to obesity
  • Simple procedure
  • Does not alter patient’s digestive tract
  • Less invasive than other surgeries (no cutting, stapling, or bypassing), reducing risk of complications
  • Allows patients to consume a larger range of foods gastric bypass does not allow
  • Does not cut or permanently remove the stomach
Cons
  • Newer surgery with long-term results somewhat unknown
  • Stomach could enlarge
  • Requires more nutritional supplements and vitamins (not as much as gastric bypass)
  • Has not been studied as thoroughly as gastric bypass or gastric sleeve surgery
  • Reversibility of the surgery is disputed by surgeons
Surgery Description
  • Long, narrow vertical pouch (about 2–3 oz or 60–100 cc). Same shape as the duodenal switch pouch but smaller
  • No intestinal bypass
  • The VG significantly restricts the volume of food that can be eaten
  • No malabsorption of nutrients or dumping
  • Laparoscope and other instruments are placed through small incisions in the abdomen to reach the stomach
  • Calibration tube is orally passed through the stomach
  • Non-dissolvable sutures used to fold the stomach into itself to create a smaller capacity
Realistic Expectations Patients can expect to lose 60–70% of excess weight in about 2 years. Long term results not currently available. Easily converted to Duodenal Switch or Gastric Bypass if needed. Initial research suggests weight loss is comparable to gastric bypass surgery, about 70% excess weight loss after 12 months.
Post Surgery Dietary Info Patient must:

  • Eat 3 meals a day containing 600–800 calories per day (recommended for the first 24 months) and about 1,000-1,200 thereafter (no dumping or diarrhea)
Patient must:

  • Consume a large range of foods due to the less invasive nature of the procedure
Realistic Expectations Patients can expect to lose 60–70% of excess weight in about 2 years. Long term results not currently available. Easily converted to Duodenal Switch or Gastric Bypass if needed. Initial research suggests weight loss is comparable to gastric bypass surgery, about 70% excess weight loss after 12 months.
Candidate Efficacy VSG is effective for high-risk or very high BMI patients (BMI > 60 kg/m2) as a “first-stage” procedure. The complication rate is much lower than it is with the RNY Gastric Bypass or Duodenal Switch because there’s no intestinal bypass. Good candidates fall into the lower range of the BMI curve, typically 30–40 BMI.
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Gastric Sleeve Surgery Vs. Gastric Plication

Differences in BMI, Costs, Requirements, Outcomes, Side-Effects and Risks

Procedure Gastric Sleeve Gastric Sleeve Plication
AKA Vertical
Sleeve
Gastrectomy
Greater Curvature
Plication (GCP),
Gastroplication,
Gastric Pleat
Price in
Mexico
$6,500 $6,500
Average
Price
in US
$19,000 $15,000
Savings
Compared
to US
$13,200 $8,500
Diagram
Method
of Weight
Loss
Restrictive: Reduces stomach
size and hunger hormone
(ghrelin) release
Restrictive: Reduces stomach
size and hunger hormone
(ghrelin) release
Stomach
Alterations
Stomach size reduced Stomach size reduced
Impact 70–85% of stomach removed Stomach size reduced through
modification to be around 85%
of its original size
Changes
to
Intestine
No change No change
Operating
time
1–3 hours 2 hours
Average
Hospital
Stay
2 nights 2 nights
Time
off
Work
2 weeks 2–3 weeks
Recovery
Time
3 weeks 2–3 weeks
Pros
  • No intestinal changes:
    Fewer complications
    and side effects, such as
    dumping syndrome
  • Hunger depressed
    because of reduction in
    ghrelin production
  • Lifetime approach to
    obesity
  • Simple procedure
  • Does not alter patient’s
    digestive tract
  • Less invasive than other
    surgeries (no cutting,
    stapling, or bypassing),
    reducing risk of
    complications
  • Allows patients to
    consume a larger range
    of foods gastric bypass
    does not allow
  • Does not cut or
    permanently remove the
    stomach
  • Newer surgery with
    long-term results
    somewhat unknown
  • Stomach could enlarge
  • Requires more
    nutritional
    supplements and
    vitamins
    (not as much as
    gastric bypass)
  • Has not been studied as
    thoroughly as gastric
    bypass or gastric sleeve
    surgery
  • Reversibility of the
    surgery is disputed by
    surgeons
Surgery
Description
  • Long, narrow vertical
    pouch (about 2–3 oz
    or 60–100 cc). Same
    shape as the duodenal
    switch pouch but
    smaller
  • No intestinal bypass
  • The VG significantly
    restricts the volume
    of food that can be
    eaten
  • No malabsorption of
    nutrients or
    dumping
  • Laparoscope and other
    instruments are placed
    through small incisions
    in the abdomen to reach
    the stomach
  • Calibration tube is orally
    passed through the
    stomach
  • Non-dissolvable sutures
    used to fold the stomach
    into itself to create a
    smaller capacity
Realistic
Expectations
Patients can expect to lose
60–70% of excess weight in
about 2 years. Long term
results not currently
available. Easily converted to
Duodenal Switch or Gastric
Bypass if needed.
Initial research suggests
weight loss is comparable to
gastric bypass surgery, about
70% excess weight loss after 12
months.
Post
Surgery
Dietary
Info
Patient must:

  • Eat 3 meals a day
    containing 600–800
    calories per day
    (recommended for the
    first 24 months) and
    about 1,000-1,200
    thereafter (no dumping
    or diarrhea)
Patient must:

  • Consume a large range
    of foods due to the less
    invasive nature of the
    procedure
Realistic
Expectations
Patients can expect to lose
60–70% of excess weight in
about 2 years. Long term
results not currently
available. Easily converted to
Duodenal Switch or Gastric
Bypass if needed.
Initial research suggests
weight loss is comparable to
gastric bypass surgery, about
70% excess weight loss after
12 months.
Candidate
Efficacy
VSG is effective for high-risk
or very high BMI patients
(BMI > 60 kg/m2) as a
“first-stage” procedure.
The complication rate is
much lower than it is with
the RNY Gastric Bypass or
Duodenal Switch because
there’s no intestinal
bypass.
Good candidates fall into the
lower range of the BMI curve,
typically 30–40 BMI.

The Basics: Gastric Sleeve Surgery Vs. Gastric Plication Surgery

Anybody considering gastric surgery needs to understand all the options that are open to them before making a decision. There are many factors to review when deciding what works best for you. Below, we compare two possibilities: gastric plication and gastric sleeve surgeries.

Gastric plication functions on the principal of folding the stomach into itself and using sutures, or stitches, to reduce the total volume, while gastric sleeve helps with weight loss by removing a part of your stomach and stapling the rest of it closed. Both operations carry excellent weight-loss results, including significant and sustained weight loss. The operative effect of both surgeries is to reduce the size of the stomach to a small, banana-shaped pouch without major changes to the intestine. They offer the benefits of not rerouting the intestines (like gastric bypass or duodenal switch) or leaving an implanted device within your body.

Although gastric plication surgery is relatively new, it is most similar in effect to gastric sleeve surgery.  Generally speaking, most people view gastric plication as less invasive, although it does come with its own set of concerns. It is also considered potentially reversible, like lap band, although there is some contention around that. Unfortunately, gastric plication does have less short-term weight loss and generally poses a higher risk of post-operation nausea or vomiting.

Going with the gastric sleeve should result in few negative side effects and prove to be a simple procedure. It’s effect is apparent in how it reduces the production of the hunger hormone ghrelin. However, having the surgery involves a big investment, and data is still being collected on this relatively new method.

Questions? We’re here to help!

We hope you find the information above useful as you consider your options for surgery. At Angeles Hospital our exceptional surgeons and case managers are always on hand to help and guide you through your choice. Do not hesitate to contact us if you have further questions.

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