Medical Minute 12-8: Internal Tummy Tuck: Gastric Plication

By: Andrew McIntosh Email
By: Andrew McIntosh Email

Up the slide and down the slide. Swinging and soccer. Ryan is full of energy and because of her weight, his mom just couldn't keep up.

"I didn't want to sit on the sidelines and just watch him go through life I wanted to enjoy it with him," said Tracey Bartholow/Had Gastric Plication.

Of all her options, she decided to take part in a case student for gastric plication.

"We're not removing anything. We're simply in-folding the stomach on itself," said Stacy Brethauer, Bariatric Surgeon.

The stomach's sutured and becomes tubular. It's volume's reduced by 80-percent, so patients can eat less and feel full. The operation's less invasive than gastric bypass or a gastric sleeve procedure.

They involve removing part of the stomach or re-routing the intestines.

"We've seen overall less risk with this procedure than we have with some of the other procedures that we do."

While still investigational, it could be used to augment a lap-band, are removable device to aid weight loss. There's also a possibility gastric plication could be undone.

"We think that it's going to be feasible to restore the anatomy so that you can convert it to another procedure if you needed to."

Bariatric surgeon Stacy Brethauer says gastric plication can help get rid of 50 to 55 percent of excess weight. that's more than the lap band, but less than the gastric sleeve or bypass. And, if your body mass index is over 50, this may not right for you.

"So, most people who want to lose somewhere between 50 and 100 pounds are going to do quite well with this operation."

Tracey's thrilled with her results.

For more information on other series produced by Ivanhoe Broadcast News contact John Cherry at (407) 691-1500,

1) WHAT IS BARIATRIC SURGERY? Bariatric surgery alters the digestive system to help people with severe weight-related health problems lose weight. Bariatric refers to the causes, prevention and treatment of obesity. Bariatric surgery, or weight loss surgery, works in three basic ways:

1) Restricting how much food your stomach can hold at any time
2) Preventing your digestive system from absorbing all the nutrition in the food you eat.
3) A combination of these two ways. In general, doctors operate on people who have been unable to achieve lasting weight loss with lifestyle changes and medications aimed at weight loss. Types of bariatric surgery include.

• Gastric banding and gastroplasty ("stomach stapling"): restrictive procedures that decrease the stomach size from about six cups to one.
• Malabsorptive procedures: block food absorption (ex: gastric bypass).
• "Roux-en-Y" gastric bypass: combines both approaches and is the most common weight loss surgery in the U.S. It reduces the size of the stomach and prevents the absorption of calories in the small intestine. (

RISKS: For bariatric surgery, the risk of dying is less than 1% and serious complications are rare. Possible complications include: pouch stretching back to stomach's original size, vomiting from eating more than the stomach pouch can hold, the band disintegrating, band and staples falling apart-reversing the procedure, stomach contents leaking into the abdomen, gallstones from excess weight loss, nutritional deficiencies and health problems. Another possible side effect is "dumping syndrome," which occurs after gastric bypass when stomach contents move too rapidly through the small intestine. Symptoms include nausea, sweating, faintness, weakness after eating sweets and diarrhea. (

GASTRIC PLICATION: Gastric Plication is the newest weight-loss procedure to be introduced. Some are promoting it as “the most exciting advancement in weight loss surgery since adjustable gastric banding.”

Basically, the procedure can best be understood as a version of the more popular gastric sleeve or gastrectomy surgery, where a sleeve is created by suturing rather than removing stomach tissue, thus preserving its natural nutrient absorption capabilities. There is no cutting, stapling, or removal of the stomach or intestines during the Gastric Plication. The Gastric Plication may potentially be reversed or converted to another procedure if needed. The procedure is minimally invasive and takes approximately one to two hours to complete. (,

For More Information, Contact:

Tora Vinci
Media Relations
Cleveland Clinic
(216)444 -2412

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