Sleeve Plication (Greater Curvature Plication)

Sleeve plication is a relatively new technique similar to the vertical sleeve gastrectomy. The difference is that in the sleeve gastrectomy, most of your stomach is permanently removed from your body. In the sleeve plication, most of your stomach is folded under and stitched shut so you can't use it.1 The sleeve plication takes about 1 to 2 hours and the average hospital stay is 3 or 4 days.2 3

  1. Gebelli JP, de Gordejuela AGR, Badia AC, Medayo LS, Morton AV, Noguera CM. Laparoscopic gastric plication: a new surgery for the treatment of morbid obesity. Cirugia Espana. 2011;89(6):356-61.
  2. Ibid.
  3. Talebpour M, Motamedi SMK, Talebpour A, Vahidi H. Twelve year experience of laparoscopic gastric plication in morbid obesity: development of the technique and patient outcomes Ann Surg Rev, 2012.

Advantages and Disadvantages of Sleeve Plication

Advantages of Sleeve Plication

  • Less risk of nutritional deficiencies compared to Roux-en-Y gastric bypass
  • No bands, staples or other foreign objects in your body
  • Lower cost than gastric sleeve

Disadvantages of Sleeve Plication

  • A relatively new procedure, so not much information on long-term results
  • Not for patients with BMI over 50 (the gastric sleeve is usually a better option)

Possible Complications/Risks of Sleeve Plication

  • Gastritis (inflammation of the stomach) or esophagitis (inflammation of the esophagus)
  • Post-surgery vomiting, nausea and excess salivation
  • Need for a second surgery to redo your sutures (stitches) or convert the procedure to a sleeve gastrectomy by removing most of your stomach
  • Intolerance to certain foods
  • Gastroesophageal reflux disease, or GERD, with severe heartburn

Weight Loss and the Sleeve Plication

Restrictive surgery: since most of your stomach pouch is folded away and sewn up, only a small portion of your original stomach pouch is usable. When you eat, your stomach fills up quickly, so your hunger decreases and you stop eating sooner than without the surgery.

Weight loss with the sleeve plication is similar to the vertical sleeve gastrectomy. These are some average values.

  • 60 to 65% of excess weight loss at 1 year1
  • 70% of EWL within 2 years2
  • Maintenance of 55% of EWL within 5 years3
  1. Kourkoulos M, Giorgakis E, Kokkinos C, Mavromatis T, Griniatsos J, Nikiteas N, Tsigris C. Laparoscopic Gastric Plication for the Treatment of Morbid Obesity: A Review. Minim Invasive Surg, 2012.
  2. Talebpour M, Motamedi SMK, Talebpour A, Vahidi H. Twelve year experience of laparoscopic gastric plication in morbid obesity: development of the technique and patient outcomes Ann Surg Rev, 2012.
  3. Ibid.