Laparoscopic Gastric Fundectomy with Greater Curvature Plication: A Feasibility Study for Obese Patients

Background: Obesity is a worldwide epidemic. Bariatric surgery is a curative management intervention. However, it is not devoid of comorbidities. Different modalities were continuously developed to increase effectiveness and safety.The aim of the work: To evaluate the feasibility of laparoscopic gastric fundectomy with greater curvature plication of the remaining part of the stomach for the management of morbid obesity. Patients and Methods: Twenty-five patients with morbid obesity were included. All patients were preoperatively assessed through full history taking and clinical examination. In addition, all underwent routine laboratory and radiological investigations to establish their fitness for surgery. After surgery, patients were followed up after one week, 1, 3, 6 months, one and two years for assessment of effective weight loss and comorbidities [e.g., bleeding, gastric leak, stricture, etc.]. Success was defined as the ability to achieve 40% or more of estimated body weight loss [EBWL].Results: Males represented 28%. The most common age group was 35 to 45 years [76.0%]. The married patients were 56%; and childhood onset of obesity was [60.0%]. Obesity-related complications were in the form of diabetes, hypertension, arthritis, and sleep apnea syndrome in 32.0%, 16.0%, 28.0%, and 8.0%, respectively. The complications included seroma, port site infection, nausea, persistent vomiting, postoperative bleeding, and cholelithiasis among 8%, 4%, 8%, 16%, and 4%, respectively. Finally, there was a progressive increase of estimated body weight loss from the first postoperative week until the end of the second year of follow-up. In addition, there was an improvement of associated comorbidities at the end of the follow-up period. The failure rate was [8%]. No mortality occurred during the follow-up period.Conclusion: Laparoscopic gastric fundectomy with greater curvature plication of the remaining part of the stomach in morbid obesity is an effective and relatively safe procedure, with promising results.