ASMBS statement

ASMBS policy statement on gastric plication

Weight loss surgery is the most effective intervention for addressing obesity and related metabolic disorders such as diabetes. We describe common surgical procedures as well as emerging and investigational procedures in terms of their capacity to induce weight reduction and their risk profiles. We then discuss the impact of weight loss surgery on important obesity related disorders including diabetes, cardiovascular disease, and non-alcoholic fatty liver disease. The question of operative choice is discussed with respect to benefits and risks of common procedures. Reoperative weight loss surgery, an increasingly common element of weight loss surgical practice, is reviewed. We briefly discuss the metabolic mechanism of action of weight loss surgery. Lack of access to and under-utilization of weight loss surgery represent important challenges to adequate obesity treatment, and we review these topics as well.

Laparoscopic gastric plication (LGP) is a relatively new restrictive bariatric procedure that requires no gastrectomy or foreign body placement.

The authors’ aim in this article is to conduct a systematic review of the currently available literature regarding the outcomes of LGP for the treatment of obesity.

University Hospital, China

The authors’ systematic review yielded 14 studies encompassing 1,450 LGP patients. Perioperative data were collected from each study and recorded.

Mean preoperative body mass index (BMI) ranged from 31.2 to 44.5 kg/m², and 80.8% of the patients were female. Operative time ranged from 50 to 117.9 minutes (average 79.2 min). Hospital stay varied from .75 to 5 days (average 2.4 days). The percentage of excessive weight loss (%EWL) for LGP varied from 31.8% to 74.4% with follow-up from 6 months to 24 months. No mortality was reported in these studies and the rate of major complications requiring reoperation ranged from 0% to 15.4% (average 3.7 %).

Early reports with LGP are promising with a favorable short-term safety profile. However, it remains unclear if weight loss following LGP is durable in the long term. Additional prospective comparative trials and long-term follow-up are needed to further define the role of LGP in the surgical management of obesity.

Bariatric surgery may prove an effective weight loss option for those struggling with severe obesity, but it is difficult to determine levels of interest in such procedures at the population level through traditional approaches. Analysis of Google Trend information may give providers and healthcare systems useful information regarding Internet users’ interest in bariatric procedures. The objective of this study was to gather Google Trend information on worldwide Internet searches for “bariatric surgery”, “gastric bypass”, “gastric sleeve”, “gastric plication”, and “lap band” from 2004–2012 and to explore temporal relationships with relevant media events, economic variations, and policy modifications.

Data were collected using Google Trends. Trend analyses were performed using Microsoft Excel Version 14.3.5 and Minitab V.16.0.

Trend analyses showed that total search volume for the term “bariatric surgery” has declined roughly 25% since January 2004, although interest increased approximately 5% from 2011 to 2012. Interest in lap band procedures declined 30% over the past 5 years, while “gastric sleeve” has increased 15%. Spikes in search numbers show an association with events such as changing policy and insurance guidelines and media coverage for bariatric procedures.

This report illustrates that variations in Internet search volume for terms related to bariatric surgery are multifactorial in origin. Although it is impossible to ascertain if reported Internet search volume is based on interest in potentially undergoing bariatric surgery or simply general interest, this analysis reveals that search volume appears to mirror real world events. Therefore, Google Trends could be a way to supplement understanding about interest in bariatric procedures.