An investigational study by Cleveland Clinic researchers has shown that a new type of surgery — folding a patient’s stomach in on itself and stitching it up — holds promise in promoting weight loss.
The procedure is called gastric plication, and it’s performed with a laparascope and five or six incisions in the abdomen, according to Dr. Philip Schauer, director of the Cleveland Clinic’s Bariatric and Metabolic Institute and one of the study’s leaders.
Think of the stomach as a bag, and the procedure involves folding the bag in on itself and holding the fold in place with sutures, Schauer said. The procedure can reduce the stomach’s volume by as much as 80 percent. With a smaller stomach, patients feel full sooner and don’t eat as much.
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“I’m thinking this is going to really take off in a big way because it does offer some significant advantage over existing procedures,” Schauer said.
Those advantages involve the procedure’s lower cost and the fact that it can later be reversed if the patient no longer needs a much smaller stomach. However, gastric plication’s biggest advantage is that it doesn’t require staples or cutting any stomach tissue, so it’s much safer than comparable procedures.
“By eliminating the need to cut or remove tissue, we dramatically reduce the risk of surgical complications like bleeding and infection,” Schauer said.
Gastric plication most resembles a procedure called sleeve gastrectomy, which involves stapling the stomach and removing about 80 percent of a patient’s stomach tissue. Gastric plication appears to achieve a similar outcome, but it’s cheaper and safer, according to Schauer.
The Clinic-led study involved 15 patients. A group of patients who had a smaller portion of their stomachs folded saw 23 percent weight loss, while a group with a larger portion of their stomachs folded saw 53 percent weight loss, according to a statement from the Clinic.
The biggest downsides of gastric plication? Insurance companies don’t pay for it, and it’s so new that there’s little long-term data to confirm its benefits. “There’s only a handful of places worldwide that offer it,” Schauer said.
However, as time goes by there’ll be more studies, and if the data show gastric plication is beneficial to obese patients, the procedure will become more widespread, Schauer said.
The study was funded by Cincinnati-based Ethicon Endo-Surgery Inc., a division of Johnson & Johnson (NYSE: JNJ). Schauer was paid by the company as a consultant.
