Gastric Sleeve Surgery Vs. Gastric Plication
Differences in BMI, Costs, Requirements, Outcomes, Side-Effects and Risks

ProcedureGastric SleeveGastric Sleeve Plication
AKAVertical Sleeve GastrectomyGreater Curvature Plication
(GCP), Gastroplication, Gastric Pleat
Price in Mexico$6,500$6,500
Average Price in US$19,000$15,000
Savings Compared to US$13,200$8,500
Diagram
Method of Weight LossRestrictive: Reduces stomach size and hunger hormone (ghrelin) releaseRestrictive: Reduces stomach size and hunger hormone (ghrelin) release
Stomach AlterationsStomach size reducedStomach size reduced
Impact70–85% of stomach removedStomach size reduced through modification to be around 85% of its original size
Changes to IntestineNo changeNo change
Operating time1–3 hours2 hours
Average Hospital Stay2 nights2 nights
Time off Work2 weeks2–3 weeks
Recovery Time3 weeks2–3 weeks
Pros
  • No intestinal changes: Fewer complications and side effects, such as dumping syndrome
  • Hunger depressed because of reduction in ghrelin production
  • Lifetime approach to obesity
  • Simple procedure
  • Does not alter patient’s digestive tract
  • Less invasive than other surgeries (no cutting, stapling, or bypassing), reducing risk of complications
  • Allows patients to consume a larger range of foods gastric bypass does not allow
  • Does not cut or permanently remove the stomach
Cons
  • Newer surgery with long-term results somewhat unknown
  • Stomach could enlarge
  • Requires more nutritional supplements and vitamins (not as much as gastric bypass)
  • Has not been studied as thoroughly as gastric bypass or gastric sleeve surgery
  • Reversibility of the surgery is disputed by surgeons
Surgery Description
  • Long, narrow vertical pouch (about 2–3 oz or 60–100 cc). Same shape as the duodenal switch pouch but smaller
  • No intestinal bypass
  • The VG significantly restricts the volume of food that can be eaten
  • No malabsorption of nutrients or dumping
  • Laparoscope and other instruments are placed through small incisions in the abdomen to reach the stomach
  • Calibration tube is orally passed through the stomach
  • Non-dissolvable sutures used to fold the stomach into itself to create a smaller capacity
Realistic ExpectationsPatients can expect to lose 60–70% of excess weight in about 2 years. Long term results not currently available. Easily converted to Duodenal Switch or Gastric Bypass if needed.Initial research suggests weight loss is comparable to gastric bypass surgery, about 70% excess weight loss after 12 months.
Post Surgery Dietary InfoPatient must:

  • Eat 3 meals a day containing 600–800 calories per day (recommended for the first 24 months) and about 1,000-1,200 thereafter (no dumping or diarrhea)
Patient must:

  • Consume a large range of foods due to the less invasive nature of the procedure
Realistic ExpectationsPatients can expect to lose 60–70% of excess weight in about 2 years. Long term results not currently available. Easily converted to Duodenal Switch or Gastric Bypass if needed.Initial research suggests weight loss is comparable to gastric bypass surgery, about 70% excess weight loss after 12 months.
Candidate EfficacyVSG is effective for high-risk or very high BMI patients (BMI > 60 kg/m2) as a “first-stage” procedure. The complication rate is much lower than it is with the RNY Gastric Bypass or Duodenal Switch because there’s no intestinal bypass.Good candidates fall into the lower range of the BMI curve, typically 30–40 BMI.
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The Basics: Gastric Sleeve Surgery Vs. Gastric Plication Surgery

Anybody considering gastric surgery needs to understand all the options that are open to them before making a decision. There are many factors to review when deciding what works best for you. Below, we compare two possibilities: gastric plication and gastric sleeve surgeries.

Gastric plication functions on the principal of folding the stomach into itself and using sutures, or stitches, to reduce the total volume, while gastric sleeve helps with weight loss by removing a part of your stomach and stapling the rest of it closed. Both operations carry excellent weight-loss results, including significant and sustained weight loss. The operative effect of both surgeries is to reduce the size of the stomach to a small, banana-shaped pouch without major changes to the intestine. They offer the benefits of not rerouting the intestines (like gastric bypass or duodenal switch) or leaving an implanted device within your body.

Although gastric plication surgery is relatively new, it is most similar in effect to gastric sleeve surgery.  Generally speaking, most people view gastric plication as less invasive, although it does come with its own set of concerns. It is also considered potentially reversible, like lap band, although there is some contention around that. Unfortunately, gastric plication does have less short-term weight loss and generally poses a higher risk of post-operation nausea or vomiting.

Going with the gastric sleeve should result in few negative side effects and prove to be a simple procedure. It’s effect is apparent in how it reduces the production of the hunger hormone ghrelin. However, having the surgery involves a big investment, and data is still being collected on this relatively new method.

Questions? We’re here to help!

We hope you find the information above useful as you consider your options for surgery. At MedicalMex our exceptional surgeons and case managers are always on hand to help and guide you through your choice. Do not hesitate to contact us if you have further questions.

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