Languages of the published data were: English and Spanish. Timeframe searched was January 2000�CDecember 2011. 4. Contemporary Literature Review There are currently a total of 11 (eleven) articles in the published literature on LGCP as a standalone surgical technique. Publications referring to greater curvature plication in combination with another technique, such as Laparoscopic Gastric Banding trichostatin a mechanism of action with Greater Curvature Plication, were excluded. One variation of LGCP is Anterior Plication (AP), a technique proposed by Brethauer et al. involving plication of the anterior wall of the stomach without mobilization of the greater curvature. This study was included as there was also a group of patients undergoing LGCP, and also because omission of mobilization of the grater curvature could be an interesting idea, further reducing the risk of bleeding.
A study by Khazzaka and Sarkis on a group of obese patients with gastroesophageal reflux disease (GERD) was also included as it shows the potential of gastric plication in treating these specific patients. Research revealed 1 (one) preclinical study and 8 (eight) prospective studies. 5. Preclinical Studies As was the case with LSG, LGCP was first performed to patients and subsequently studied in animal models. Data from Dr Talebpour’s original animal trials have not been published. Menchaca et al. [8] performed a study on hound dogs, comparing the efficacy of 3 different methods for fastening the plicated gastric wall, namely, T-tags, sutures, and staples (Level of evidence II-1).
The primary endpoint of the study was to compare the short-term durability of gastric plications and serosal bonds using a variety of fastening devices and techniques. Test subjects were euthanized at around 2 months after the operation, at which point necropsy was performed by a medical or veterinary pathologist. The durability of the infolded tissue was indicated by the persistence of the original fold geometry. The presence and degree of serosal bonding were noted. In the histopathologic evaluations, connective tissue bridging and angiogenesis were considered indicators of serosa-to-serosa healing. Erosive lesions and inflammatory tissue were noted when present. Tensile testing was performed using Instron tensile testing equipment. The sections of infolded tissue were securely gripped on either side of the fold and pulled apart at a constant rate until failure occurred.
The force, displacement, and description of the failure were recorded and imaged. The authors found that all fastening devices and techniques created durable plication folds, except for the staple-suture combination. Intermittent Entinostat point failures in serosal apposition occurred in those dogs that had received only 1 row of fasteners. In regions of the fold not containing fasteners, the serosal surfaces had not bonded.