The gastric plication to lose weight
Several surgical solutions are suggested to the overweight patient in Liège or in Brussels. All the procedures however are not done by your obesity surgeon. This is the case for the gastric plication, which is a recent technique and less documented than the sleeve or the gastric bypass. Let’s see what it is and why it is not considered in our clinic.
What is a stomach imbrication?
The gastric plication is an operation conducted since 2007. The loss of weight seems than the sleeve or the bypass.
It’s about sewing the stomach on itself, to print a fold and reduce its size. This procedure is done by laparoscopy: small incisions in the abdomen allow the passage of a long surgical instrument, under the surveillance of a camera.
- It does not require foreign body implantationlike a ring that is placed around the stomach
- It does not require the loss of stomach tissue
Comparison between the gastrectomy sleeve and the gastric plication
Each of these surgeries can treat morbid obesity present some advantages and some inconveniences.
The gastric sleeve can be compared to the technique of the stomach plication. The two consists of transforming the stomach into a tube, so as to reduce the space.
- Loss of weight inferior to the gastrectomy sleeve: that is why the gastric plication is suggested by some teams to people not suffering from significant overweight
- Reversibility of the surgical process: the plication is said to be reversible during the first 6 months. Then healing would not allow it anymore. The gastrectomy sleeve is irreversible because it involves the removal of two-thirds of the stomach
- Less complications than for the sleeve: the risk of complications post-operative of the gastrectomy sleeve (let go or release of the suture, etc) is bigger. The plication may cause gastric obstructions if the tube obtained by folding is not homogenies.
Reimbursement of care costs related to obesity in Belgium
The Belgian Moniteur provides conditions to receive the report for your obesity operation. These criteria are as follows when there has not been any previous obesity surgery:
- Have a BMI equal or superior to 40
- If the BMI is between 35 and 40, comorbidity factors must be present: the pathologies linked to obesity are as follows: the arterial hypertension, diabetes, sleep apnoea
- One year of dietary documentation
- Document accepted at a multidisciplinary meeting
Any obesity surgery that is outside these criteria will not receive a reimbursement.
Your obesity surgeons operating out of Liège and out of Brussels stays informed about evolution, follow-up and results about gastric plication and new surgical techniques, such as gastric minibypass, that shows excellent results.
Your obesity surgery is a failure?
Sometimes some patients come to the obesity consulting office with different problems. The multi-disciplinary team around your bariatric surgeon try to understand the source of the failure, felt or proven. One solution can be brought for each one of them: surgical, psychologic or dietary.
- Technical problem linked to a surgical procedure: in case of a gastric obstruction, an intervention can undo the plication. Unfolding the stomach can cause perforation lesions or residual scars, but the cases of complications are rare and/or exceptional. The help brought by the gastric plication may not be sufficient and the weight loss unsatisfactory. A conversion to a gastric bypass could be possible.
- Gastric reflux: the plication will be transformed to a gastric bypass
- The patient did not understand the instructions for lifestyle given during their hospitalization (snacking, etc)
- Psychological or environmental circumstancesimpeded the weight loss hoped (alcoholic, for example, etc)
- The patient does not like their new image: psychological care is recommended