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Banded Plication

While obesity treatments like the gastric bypass, gastric sleeve, and LAP-BAND are accepted and proved standards of care, there are also several investigational obesity treatments that surgeons are currently studying. The weight loss surgeons at New York Bariatric Group believe in staying on the forefront of innovation, and we consider our work in investigational procedures an important part of our expertise. One of the investigational procedures we are evaluating is called gastric plication, and this surgical procedure is being studied as a potential method of significantly improving weight loss with the LAP-BAND, or adjustable gastric banding.

LAP-BAND overview

Adjustable gastric banding, or LAP-BAND, is a weight loss procedure that works in a restrictive manner. A flexible ring is placed around the upper portion of the stomach, creating a small pouch of stomach above the band. When patients follow the proper eating regimen with the LAP-BAND appropriately adjusted, patients are able to eat smaller meals and stay full for longer. Patients like the gastric band surgery because of its low risk. One downside of the band, however, is that patients generally lose weight more slowly with adjustable gastric banding than with the gastric bypass or gastric sleeve surgeries.

LAP-BAND combined with plication

During adjustable gastric band surgery, a silastic band containing a plastic sleeve is placed around the upper part of the stomach. It is attached by tubing to a port that can be adjusted (tightened or loosened) at a later date in the office.

During adjustable gastric banding with gastric plication, the procedure begins with the surgeon partially cutting the tissue and vascular attachments to the stomach along the greater curve (outside part of stomach) exposing the front and back of the stomach. The surgeon then inserts the adjustable gastric banding. Once the band is inserted, the surgeon then folds the stomach below the band in on itself and uses stitches to keep the fold in place. This procedure reduces the volume of the stomach, which reduces the capacity of the stomach for food.

Some small initial studies have suggested that adding gastric plication to the adjustable gastric banding procedure accelerates weight loss and patients seem able to achieve weight loss that comes close to that of gastric bypass. Gastric plication seems to reduce the need for frequent adjustments and reduces the risk of prolapse or slippage, one of the major complications associated with gastric band surgery. However, further research is needed to insure that the weight loss holds long-term.

The gastric plication adds minimal additional risk to the adjustable gastric banding. Because there is no cutting or stapling of the stomach, the risk of leak is minimal. In addition, the intestinal tract retains its normal continuity so the risk of malnutrition remains very low.

Studies in progress

The New York Bariatric Group continues to work to advance the treatment of obesity. The New York Bariatric Group is introducing a new study designed to evaluate gastric plication as a method of significantly improving weight loss with adjustable gastric banding.

Adjustable gastric banding is a restrictive only procedure that works by creating a small pouch of stomach above the band. When following the proper eating regimen with the band appropriately adjusted, patients achieve satiety with much smaller volumes of food and lose weight. The gastric band surgery procedure is popular due to its low risk but its major downside is that patients lose weight more slowly with adjustable gastric banding than with gastric bypass or sleeve gastrectomy.

The New York Bariatric Group is announcing the start of a research study comparing the effectiveness of adjustable gastric banding to adjustable gastric band with gastric plication.

You have the opportunity to enroll in this study if you are considering adjustable gastric band surgery.

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Risk of plication

Although some positive results have been seen with banded plication, these initial studies have been small. Further research is needed to understand the long-term results of adding plication to the LAP-BAND procedure. The gastric plication procedure adds minimal additional risk to the adjustable gastric banding surgery. The intestinal tract retains its normal continuity so the risk of malnutrition remains very low.

Next steps

Like other bariatric procedures, LGCP is just a tool patients can use to achieve weight loss. Lifestyle changes that alter the way you think about and approach food remain critical to successful long-term weight loss. If you are interested in enrolling in this study of adjustable gastric banding with gastric plication, please ask your surgeon for further details, or call the New York Bariatric Group at 800.633.7446 to learn more about gastric band surgery and your bariatric surgery options.

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Our team is happy to speak with you and help you understand any of the treatments we offer, or answer any questions you have. Please call and speak with us at 800-633-8446, or read more about the surgical and non-surgical options we offer here.

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What our patients are saying

“The staff and doctors at the New York Bariatric Group are amazing! They are always patient, helpful, and very understanding and pro-active with questions, problems, etc. After Lap Band surgery I feel fantastic. For the last 6 years I have not had to worry if my clothes would fit. I have been able to maintain my weight loss, and have so much more energy.”

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"Dr. Holover has a great personality, I love him, I consider him a good friend, and I recommend him to everyone. He and his staff are amazing. I thought my recovery would be worse, but it wasn’t. It was great. After a couple of days I was back on my feet and going, with three boys you don’t have time to be down. Now, my kids have to keep up with me!"

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"My results are incredible; I can go to any store and find clothes that fit, I don’t have to go to the big and tall store anymore. My family and friends say I look great, but more so are so happy about my health. Definitely go for it, it is well worth it."

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"My recovery was very easy, I started moving around pretty quick because the nurses had me up and about. Dr. Angstadt has a great bedside manner, a cheerful disposition and is very knowledgeable. He was genuinely concerned for me, he answered all of my questions and put me at ease. I couldn’t be happier, I think it is the best decision I ever made."

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"I was concerned about my health, my blood pressure, cholesterol, my mobility, my flexibility. A few friends told me about NYBG and I went to a seminar. I wanted to live a healthier life and live a long life. My recovery was great, after a week I was 100%. My doctor, Dr. Sekhar, has the best personality in the world."

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"I had a couple of friends who had bariatric surgery done by Dr. Garber a few years back and I decided to make the appointment. My favorite thing about the surgery is not being able to eat that much, eating whatever I want but in smaller portions. My results are amazing"

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*Individual results may vary.

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