Laparoscopic gastric plication in morbidly obese adolescents: a prospective study

BackgroundThe prevalence of obesity has increased rapidly among adolescents. Bariatric surgery is associated with significant weight loss and improvement in obesity related co-morbidities, but may be associated with serious complications. Therefore, attempts on finding a safe and effective bariatric procedure for adolescents are ongoing. The objective of this study was to evaluate safety and efficacy of laparoscopic gastric plication (LGP) on adolescents.MethodA prospective study was performed on adolescents who underwent LGP from 2007–2013. Measured parameters included the percentage of excess weight (%EWL), percentage of body mass index loss (%BMIL), obesity related co-morbidities, operative time, and length of hospitalization and complications.ResultsLGP was performed in 12 adolescents (9 female and 3 male). Mean (SD) age of the patients was 13.8±1 year. Mean preoperative weight and BMI were 112.4±19.7 kg and 46.0±4 kg/m², respectively. Mean (SD) %EWL and %EBMIL were 68.2±9.9% and 79.0±9.0%, respectively after 2 years. All medical co-morbidities were improved after LGP. There were no deaths. One patient required replication 4 days postoperatively due to obstruction at the site of the last knot. No other major complications were observed. No patient required rehospitalization.ConclusionLGP has the potential of being an ideal weight loss surgery for adolescents, resulting in excellent weight loss and minimal psychological disruption. It is associated with a minimal risk of leakage, bleeding, and nutritional deficiency. However, large well-designed studies with long-term follow-up are needed.