Abstract
Introduction
Laparoscopic BariClip gastroplasty (LBCG) will address a similar tubular restriction than the one achieved with the laparoscopic sleeve gastrectomy (LSG) at the level of the gastric fundus, while maintaining the advantage of simplicity and anatomic preservation. The purpose of the current study was to analyze the risk of slippage and to present the evolving technique by adding gastro-gastric plication of the gastric wall covering the BariClip at those areas where the gastric wall “slips” between the limbs of the clip.
Methods
All patients undergoing LBCG with the evolving technique of gastric plication around the device associated with antral gastroplasty from January 2021 to May 2022 were included in the study group (group A). A control group (group B) was designed with patients who underwent previous LBCG technique between May 2017 and June 2019. This is a case-controlled group with patients matched by gender and BMI. We have analyzed the postoperative complications and more notably the slippage.
Results
One hundred seventy-six patients (44 male and 132 female) with a mean age of 33 years (± 11) underwent evolving technique of LBCG. A control group of 67 patients who underwent previous technique of LBCG was included. All procedures were completed by laparoscopy with no intraoperative complication. For the study group, we have recorded a number of 5 slippages (2.8%). The diagnosis occurred during the first 6 months after the operation. The management consisted of repositioning—3 cases—and BariClip removal—2 cases. For the control group, we have recorded a number of 3 slippages (4.3%). All three patients underwent BariClip removal, with no repositioning.
Conclusions
We reported a new technique of placement of the BariClip with additional gastric plication anterior, posterior, and volume reduction in the antrum to potentially reduce the rate of slippage and improve weight loss outcomes.
Graphical Abstract
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Data Availability
The patient were included in different registries and protocols of research in different countries.
References
Eisenberg D, Shikora SA, Aminian A, et al. American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis. 2022;18(12):1345–56.
Jason Moy, Alfons Pomp, Gregory Dakin et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008;196(5):e56–9.
Clapp B, Ponce J, DeMaria E, et al. American Society for Metabolic and Bariatric Surgery 2020 Estimate of Metabolic and Bariatric Procedures Performed in the United States. Surg Obes Relat Dis. 2022;18:1134–40.
Fayad L, Cheskin LJ, Adam A, et al. Endoscopic sleeve gastroplasty vs intragastric balloon insertion: efficacy, durability and safety. Endoscopy. 2019;51(6):532–9.
De Miranda Neto AA, de Moura DTH, Ribeiro IB, et al. Efficacy and safety of Endoscopic Sleeve Gastroplasty at midterm in the management of overweight and obese patients: a systematic review and meta-analysis. EGH Obes Surg. 2020;30(5):1971–87.
Jacobs M, Zundel N, Plasencia G, et al. A vertically placed clip for weight loss: a 39-month pilot study. Obes Surg. 2017;27(5):1174–81.
Noel P, Eddbali I, Nedelcu M. Laparoscopic clip gastroplasty with the BariClip Obes Surg. 2020;30(12):5182–3.
Noel P, Nedelcu AM, Eddbali I, et al. Laparoscopic vertical clip gastroplasty-quality of life. Surg Obes Relat Dis. 2018;14(10):1587–93.
Rebibo L, Tricot M, Dembinski J, et al. Gastric leak after sleeve gastrectomy: risk factors for poor evolution under conservative management. Surg Obes Relat Dis. 2021;17(5):947–55.
Genco A, Castagneto-Gissey L, Gualtieri L, et al. GORD and Barrett’s oesophagus after bariatric procedures: multicentric prospective study. Br J Surg. 2021;108(12):1498–505.
De la Plaza LR, Díaz Candelas DA, Ramia JM. Laparoscopic removal of a displaced vertical gastric clip causing gastric outlet obstruction. Obes Surg. 2020;30(7):2856–7.
Gentileschi P, Campanelli M, Sensi B, et al. Safety and efficacy of laparoscopic vertical clip gastroplasty: early results of an Italian multicenter study. Obes Surg. 2022. https://doi.org/10.1007/s11695-022-06364-7.
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Dr Natan Zundel and Dr Patrick Noel served as training surgeon for ABT. All other authors have no commercial associations that might be a conflict of interest in relation to this article.
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Key points
• The current manuscript reports the evolved operative technique over the last few years with several modifications aimed at decreasing the incidence of slippage.
• A gastro-gastric plication of the gastric wall covering the BariClip was added. In addition, we performed an additional plication of the gastric antrum.
• Our current study showed a decrease of slippage rate from 4.3 to 2.8% with an evolving technique of the BariClip device.
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Noel, P., Nedelcu, M., Olmi, S. et al. Evolving Technique of Laparoscopic Vertical Gastric Clip Placement. OBES SURG 33, 1012–1016 (2023). https://doi.org/10.1007/s11695-023-06492-8
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DOI: https://doi.org/10.1007/s11695-023-06492-8