Candidates tend to have a BMI over 40, or a BMI between 35 and 40 with accompanying diseases such as diabetes, sleep apnea, cardiomyopathy (heart damage) or severe joint degeneration and pain. They should have a long record of failed previous non-surgical weight loss interventions (diet, exercise) before considering gastric plication. They should be willing to implement permanent lifestyle changes in order to lose weight and maintain the weight loss permanently.
Patients who abuse drug and alcohol, have a history of binge eating, untreated major depression or psychosis, severe cardiac disease, or disorders that interfere with healing such as blood clot disorders are not good candidates for gastric plication. Gastric plication should not be considered a first-line option for weight loss and should be considered only after first exhausting non-surgical weight loss options.
You may be asked to change your diet, lose or maintain a stable weight, or alter your dietary habits (i.e. eating smaller meals throughout the day) before surgery. This increases the chance of successful, sustained weight loss after the surgery. Like other surgeries, gastric plication may require you to undergo certain general surgery procedures such as preoperative blood testing, medications, and cessation of smoking or use of pain relievers and anti-inflammatory drugs.
Typically, patients spend 24 to 48 hours after the procedure at the hospital before going home. Pain in the first 2 to 3 days after surgery in the upper left part of the abdomen is common, but can be managed with pain relievers. Pain should be minimal to nonexistent by 2 to 3 weeks after surgery. Although light walking is suggested soon after surgery, strenuous exercise should be avoided for the first few weeks. Patients usually return to normal activities and light desk work in 7-10 days.
Patients should stick to an all-liquid diet for the first two weeks, before gradually easing into soft foods and eventually back to a normal diet by four weeks post-surgery. However, portion sizes should be heavily restricted and patients should eat slowly so they can properly gauge their fullness.
Gastric plication carries the same present, but lowered risk of minimally invasive laparoscopic surgeries performed under general anesthesia, such as adverse reactions to anesthesia, infections at the wound site, allergic reactions to medication, and blood loss requiring transfusion. Complications specific to gastric plication include increased nausea and vomiting during the initial recovery period, as well as separation of stitched areas or leaks from sutured areas, which can require revision surgery. Longer-term complications are similar to other weight loss procedures, including persistent nausea, vomiting, and diarrhea.