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GASTRIC PLICATION

GASTRIC PLICATION. DR M TALEBPOUR. HISTORY. 1974: Animal lab, 2002: Tehran, Plication 2002: Modification of plication : Ant plication Total plication Wrap and Plication 2005: SAGES: The first presentation of plication 2006 : Saudi Arabi , Lebonen

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GASTRIC PLICATION

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  1. GASTRIC PLICATION DR M TALEBPOUR

  2. HISTORY • 1974: Animal lab, • 2002: Tehran, Plication • 2002: Modification of plication: Ant plication Total plication Wrap and Plication • 2005: SAGES: The first presentation of plication • 2006: Saudi Arabi, Lebonen • 2007: The first paper of plication • 2007: Brezil • 2010: Italy

  3. INDICATION • Mutivation: Excelent: Plication Moderate (Male, BMI>50, Diabet): Gastric bypass Weak: Ileojejunal bypass

  4. TECHNIQUE • Greater curvature release by ligasure • Separation of anterior row of SG • Inversion of released GC by nylon • Length of plication from cardia to 4 cm to pylorus • Submucosal sutures

  5. TRANSVERSE SECTION

  6. VERTICAL PLICATION

  7. BARIUM MEAL

  8. DIET AFTER PLICATION • No 1: Liquids, 10 days • No 2: Semi liquids, 10 days • No 3: Soft diet, 10 days • No 4: Normal diet, 5 months

  9. FUTURE OF PLICATED PATIENT • Dilation of gastric volume • 60% EWL 6 months • 75% EWL 12 months • Inversion of sutures in the stomach after 4 years

  10. COMPLICATION OF PLICATION • Leakage at suture site • Stricture • Bleeding • Loosening of suture line

  11. REGAIN OF PLICATION • Replication • Sleeve gastrectomy • Ileojejunal bypass • Gastrojejunal bypass

  12. LOSS OF APPETITE IN PLICATION • Ghrelin • Total gastric volume • Appetite and gastric volume

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