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Endoscopic Gastric Plication Procedure

An endoscopic weight loss procedure is a non-surgical approach that uses an endoscope for your weight loss treatment. An endoscope is a thin, flexible tube that helps a doctor view your digestive system. Endoscopic procedures are considered very safe and less risky than surgery.  

We offer a full range of endoscopic treatment options at Brigham and Women’s Hospital, including gastric plication. Endoscopic gastric plication is a minimally invasive procedure that doesn’t require any incisions on the outside of your body and you won’t have any external scars. The recovery time is also much faster than traditional surgery.

What is gastric plication?

Gastric plication is a minimally invasive endoscopic procedure in which the stomach is folded in on itself and sutured (stitched) to make it smaller and shorter. This procedure reduces the amount of food your stomach can hold and helps you feel full faster and stay full longer. This procedure is also known as distal POSE (Primary Obesity Surgery Endoluminal).

How is gastric plication performed?

While you are sedated, your doctor inserts an endoscopic device into your digestive tract through your mouth. The system has several components that are used together to fold and fuse the stomach. Gastric plication is considered to be a very safe and low-risk procedure.

How much weight can you expect to lose from gastric plication?

Patients who have the gastric plication weight loss procedure typically lose 15 to 20 percent of their starting total body weight. 

What is recovery like after gastric plication?

Patients usually go home the same day as the procedure. You first follow a full liquid meal plan, which includes protein shakes and similar products. You then transition to a soft food plan (including easy-to-eat foods, like oatmeal, bananas and soft-cooked rice). Finally, you can return to regular eating. People usually take 1 to 2 days off work. Gastric plication is durable. However, unlike some of our other endoscopic weight loss procedures, gastric plication is not reversible.

Are there any additional health benefits to treatment, besides weight loss?

You might experience better health, like improvements in weight-related health conditions. These can include sleep apnea, high blood pressure, type 2 diabetes, fatty liver and dyslipidemia. Dyslipidemia is when you have abnormal amounts of lipids (fats) in your blood. In some cases, these conditions may even resolve completely.

Am I a candidate for gastric plication?

Your doctor can work with you to determine if gastric plication is right for you. To qualify for gastric plication, you need a body mass index (BMI) of at least 30. Healthcare professionals use BMI to determine your health risk for weight-related diseases. It’s based on a formula that considers your current weight and height. While it’s not a perfect method, BMI can be a useful health indicator for many people. To find out your BMI, you can use our BMI calculator.

How do I improve my health before the procedure and prepare for gastric plication?

You can meet with your doctor to ask any questions you may have about gastric plication. We also have dietitians who can work with you before and after the procedure to help you adopt and maintain a healthy lifestyle.

Do you offer long-term weight management support?

Yes. We take a collaborative approach to treatment that combines the expertise of many different specialists, including dietitians and mental health professionals. Our team-based approach helps us offer a very high quality of care.

Which doctors offer gastric plication? 

Christopher Thompson, MD, MSc, AGAF, FASGE, FACG
Co-director of Center for Weight Management and Wellness
Director of Endoscopy
Director of Bariatric Endoscopy

Pichamol Jirapinyo, MD, MPH, ABOM
Associate Director of Bariatric Endoscopy
Director of Bariatric Endoscopy Fellowship

How do I schedule an appointment to learn more about gastric plication?

If you would like more information or would like to schedule an appointment with a Brigham doctor, you can call us at 617-525-3597 or fill out our appointment request form.

I’m a physician. How do I refer a patient for treatment?

Physicians who are looking to refer a patient can call 617-525-3597 or email us at brighamweightloss@bwh.harvard.edu.

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