14 statements
· 1 topic
· summaries given as host listed separately
Featured statements
▶Ep 25 · 6:19
Greater curvature plication is purported to have advantages including wider acceptance in younger patients because it's not a resection, potential metabolic benefit beyond restriction, reversibility (especially early on), possibly less risk of leak, and ability to progress to full sleeve or other procedures.
Gastric plication may have a role in severely obese patients whose care providers are reluctant to remove 80% of the stomach, particularly in younger patients.
Janey Pratt, MD and David Lanning, MD - 2024 Pediatric Bariatric Surgery Update Course
▶Ep 25 · 6:19
clinicalGreater curvature plication is purported to have advantages including wider acceptance in younger patients because it's not a resection, potential metabolic benefit beyond restriction, reversibility (especially early on), possibly less risk of leak, and ability to progress to full sleeve or other procedures.↗
▶Ep 25 · 7:30
epidemiologicalThere are limited studies on gastric plication, with most done in adults and only one other study outside of the presenter's experience involving a dozen adolescent patients overseas.↗
▶Ep 25 · 8:00
epidemiologicalIn the pilot study of gastric plication, four patients aged 16-17 were enrolled with average weight 139 kg and average BMI 48 (range 41.7 to 53.7).↗
▶Ep 25 · 8:40
epidemiologicalTwo of four plication patients withdrew from the study after 90 days, both living over an hour outside of Richmond, leaving only two patients followed for the full 3 years.↗
▶Ep 25 · 10:20
clinicalThe gastric plication procedure took an average of 202 minutes with minimal blood loss, and patients were kept for 2 to 3 days.↗
▶Ep 25 · 10:50
clinicalWeight loss at 90 days after plication averaged 17.7 kg, and at 3 years for the two patients who completed the study averaged 45.7 kg, with one patient losing up to 70 kg and another losing some weight but gaining a little back.↗
▶Ep 25 · 11:20
clinicalAt 9 years post-plication, one patient went from 142-143 kg to losing about 40 kg with BMI decreasing from 55.8 to 40.4, with resolution of pre-diabetes.↗
▶Ep 25 · 11:30
clinicalPercent change of BMI after plication was 17.5% at 90 days and 39.7% at 36 months.↗
▶Ep 25 · 11:50
clinicalPlication patients reported early satiety and good hunger control for the duration of follow-up with limited nausea.↗
▶Ep 25 · 12:00
clinicalAt 9 years post-plication, a second patient (5'11" tall) went from 175 kg to 100 kg with BMI decreasing from 53.8 to 30.7, with resolution of severe sleep apnea that had required CPAP.↗
▶Ep 25 · 12:10
clinicalTwo plication patients followed long-term had mild reflux symptoms that resolved without significant long-term intervention, and one had abdominal pain that resolved on its own.↗
▶Ep 25 · 12:20
opinionGastric plication may have a role in severely obese patients whose care providers are reluctant to remove 80% of the stomach, particularly in younger patients.↗
▶Ep 25 · 12:35
clinicalThere were no major complications from plication, with only one readmission for nausea requiring a 23-hour stay.↗
▶Ep 25 · 12:40
clinicalBoth plication patients at 9 years continue to have good early satiety and hunger control.↗
Summaries David gave as host
· 2 summaries
Recaps of other experts' statements, not David's own clinical position.
Janey Pratt, MD and David Lanning, MD - 2024 Pediatric Bariatric Surgery Update Course
▶Ep 25 · 12:40
host summaryDavid Lanning summarizes what Dr. Janey Pratt said: Studies suggest gastric plication tends to do better in patients with BMI less than 40 and may have more of a role in younger patients.↗
▶Ep 25 · 14:33
host summaryDavid Lanning summarizes what Dr. Janey Pratt said: Limited studies show some metabolic changes in hormone levels with gastric plication, though not completely characterized, suggesting metabolic changes beyond just plication.↗
