GREATER CURVATURE GASTRIC PLICATION
Gastric Wrap is a purely restrictive operation similar to Vertical Sleeve Gastric Resection, just without the need for division and removal of major stomach part.
It is a bariatric procedure that brings the benefits of food restriction while reducing the potential complications associated with a permanent implant (gastric band) and with staple line (leak and bleeding in Sleeve gastric resection).
The significant reduction of stomach capacity immediately after the operation allows intake of fluids only in small amounts, which is caused by surgical narrowing of lumen together with postoperative swelling of inverted gastric wall.
The weight loss is usually quick within the first months. As the inner ridge of plicated stomach wall lose the swelling and further diminishes by involution the capacity of the stomach slightly increases.
Currently studies show very promising 3-years results in significant and lasting weight loss similar to Sleeve gastric resection, and significantly greater than the Gastric Band. Also the loss of feelings of hunger is similar to the Sleeve.
WHAT IS THE POSTOPERATIVE COURSE LIKE?
In laparoscopic surgery the postoperative recovery is short as the bodily pain from the abdominal wall is minor due to the absence of a long incision. Low doses of painkillers are usually sufficient. Also the inner organs start their work and recover sooner after laparoscopic procedure, which allows quick re-alimentation and an early discharge from hospital.
Nausea and vomiting are usual in most patients during the first couple of postoperative days. Directly after the operation, because of sewlling of the stomach mucosa which happens during the in-folding process, the stomach’s capacity is very small indeed (maybe only 20ml). This is partly why nausea is experienced. Over the following weeks the stomach’s capacity increases to approx. 50-75ml, during the transition from liquid to solid foods. Gradually over time the stomach’s capacity should increase to between 150ml - 200ml approx., provided the patient adheres to the recommended post-operative diet and eating regime. A „normal“ stomach, which has not been subject to surgery usually has a capacity of between 1litre and 1.5litres or more.
At night after the operation and the first day after the Gastric Plication tea, water and liquids only are offered, on the second day soup and yogurt.
Usually one night after the operation is spent at the ICU, hospitalization at the ward lasts a further two days.
The removal of external stitches (10th- to 20th day) could be done either by a family doctor (GP) a NHS Walk-in Centre or at the surgical outpatient department. You will be given a letter for your GP explaining him/her your surgery. It is recommended that patients should visit their GP for a blood test and general health check twice at least in the first year, to ensure there are no problems with mineral and vitamin deficiencies which could possibly occur during any period of rapid weight loss. Thereafter it is recommended that an annual test should be carried out. Some nutritional supplements of some minerals esp. calcium and iron and vitamins, especially B, D and folic acid are suitable in form of one multivitamin tablet a day especially within first months after the surgery. We strongly suggest Gastric Plication patients take 1 x multivitamin with minerals and iron, 1 x calcium (not at the same time as the iron), and 1 x Vitamin B12 supplement daily after surgery
At least written email, text message or telephone information on post-operative weight loss and progress has to be sent to BodyClinique, for onward transmission of statistical data to Dr M.Cierny.
Immediate check-up is necessary anytime in case of any problems either at home country or in Breclav Hospital.
WHAT IS THE LENGTH OF THE HOSPITALISATION?
The operation is scheduled to be performed by a minimally invasive approach, therefore if everything goes normally the discharge should be on the third postoperative day.
ARE THERE ANY SIDE EFFECTS?
Heartburn and other signs of gastro-oesophageal reflux occur frequently and have tendency to decrease. The lifelong change in eating habits has to be accepted and kept, otherwise some deglutination problems may occur. Within the phase of rapid weight loss especially within the first year after the WLS it is recommended to women not to become pregnant. Some temporary hair loss can be quite common during periods of rapid weight loss (whether the weight loss is as a result of surgery or “conservative” means). These effects can be minimised or avoided by following a protein-rich diet and ensuring daily oral vitamin & mineral supplements are taken.