Surgeon Study Stomach Folding Procedure to Treat Obesity

Surgeons Study Stomach-Folding Procedure To Treat Obesity
December 22, 2010

A new type of weight loss surgery involving folding a patient’s stomach inside itself and then stitching it could be a viable option for bariatric surgery patients, according to a pilot study conducted at Cleveland Clinic.

The 15-person prospective study was published in the online edition of the journal Surgery for Obesity and Related Diseases. It was led by Stacy Brethauer, M.D. and Philip Schauer, MD, Director of the Bariatric and Metabolic Institute at Cleveland Clinic.

The study evaluated the use of a technique called gastric plication, where the stomach is folded inside itself and then sutured in order to reduce its size.

“We can reduce the stomach volume by more than 2/3 without removing any of the stomach because we’re not cutting or stapling,” Dr. Schauer said. “Patients lose weight with gastric plication because their stomach is much smaller. It fills to capacity with a much smaller amount of food, so patients feel full quicker and therefore they eat less.”

Dr. Brethauer, the study’s lead author, said early weight loss results were encouraging.

“We need to conduct further studies to determine long-term weight loss,” he said. “A multi-center trial of this technique is ongoing, but our experience suggests this could be another good option for patients considering weight loss surgery.”

Twelve women and three men between the ages of 26 and 58 took part in the pilot study. Their average body mass index (BMI) before surgery was 44.3. People with BMIs of more than 40 are considered morbidly obese.
A group of patients that had a smaller portion of their stomach folded saw 23 percent excess weight loss while a group with a larger portion of the stomach folded saw 53 percent excess weight loss.

Dr. Schauer said the preliminary results resemble the outcomes achieved through gastric sleeve procedures, which involves removing 80 percent of the stomach.

Gastric bypass is another commonly-used surgical technique. It involves creating a small pouch by dividing the upper end of the stomach, which restricts the intake of food. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach.

Disclosures: The study was funded by Ethicon Endo-Surgery; Drs. Brethauer, Schauer and their co-author, Matthew Kroh, MD, are consultants and speakers for Ethicon Endo-Surgery.