Gastric Wrap (Plication ). How do you rate the wrap to the sleeve?

Gastric plication is a new procedure with no long-term follow-up studies.  The initial appeal of the procedure was that it would be reversible, since nothing is being removed.  In addition, there should be no leaks since nothing is being cut or stapled.  Finally, it should be cheaper to perform, since staplers aren't needed.Unfortunately there have been problems with the operation.  There have still been leaks.  There have been new problems such as herniation of plicated stomach through the plication suture line.  The promise of reversibility has not turned out so well either, as these stomachs are very difficult to unravel, due to the scar tissue that forms from the operation.  The only big advantage is that it is cheaper to perform.  If you are running a discount bariatric surgery center, you can do these operations for very little money and increase your profits.  Of course this isn't a good reason to have the operation if you are the patient.I see no reason to recommend this procedure at present.  You would do well with a sleeve gastrectomy.  Why not pick an operation where the risks and benefits are fairly well known?

Every surgeon has their preference, but there are few head to head comparisons done in the literature. A couple of recent reports out of the US show more weight loss and sustained weight loss with the gastric sleeve compared to the plication (wrap). In our own comparison, we found the sleeve did better.