Added by Katarzyna Szałęga on 07.08.2020 | Reviewed by

Obesity-a global problem

It is a known fact that nowadays more and more people suffer from obesity or overweight, but it is the numbers that make us realise how serious this problem has become in recent years. According to the study published in 2015 by the New England Journal of Medicine, about 2 billion people, constituting one-third of the world’s population, are obese or overweight.

This condition, troublesome enough on its own, usually leads to other health problems such as heart diseases, diabetes or cancer so it is no wonder that people resort to dieting, increased physical activity or even weight loss drugs. However, sometimes, when all other methods do not bring satisfactory results, bariatric weight loss surgery is the only way to achieve long-term success in reducing weight. What makes it so effective?

Bariatric surgery- solution to obesity

Bariatric surgery reduces the size of the stomach which helps to feel full after eating smaller amounts of food, which is the best solution for people who feel frustrated by the constant feeling of hunger and the necessity to keep a restricted diet for the majority of their lives. There are various types of popular bariatric surgeries including gastric sleeve, gastric bypass and gastric banding.

obesity (2)

Obesity is a modern world problem. If any of the standard methods of losing weight doesn’t work the solution may be in weight loss surgery which becomes more and more popular

Gastric plication weight loss surgery is a type of stomach surgery that can be strongly recommended to people whose BMI (Body Mass Index) is higher than 35 and who have at least one of the obesity-related medical conditions such as diabetes, arthritis or high blood pressure and did not succeed in losing excess weight through the healthy diet and physical activity. If the Body Mass Index (BMI) is higher than 40 but the patient does not suffer from any obesity-related conditions, he/she can also be qualified to undergo the surgery.

This restrictive procedure is most suitable for people who usually eat large portions of food. This solution is not suitable for those who like eating snacks and small portions of food with short breaks between the meals. Of course, candidates should not forget that the surgery is only the beginning of a life-changing path to weight loss and one of the methods of increasing the quality of life. The most successful patients are those who keep a healthy diet, follow post-op dietary instructions, and remember about physical activity on a daily basis.

What is gastric plication weight loss surgery?

girl reading a book

During gastric plication surgery, the size of stomach storage capacity is reduced to the tube-like shape using special folding and stitching techniques

Gastric plication weight loss surgery is a procedure that can be compared to other surgeries, such as gastric sleeve, where the size of stomach storage capacity is reduced to the tube-like shape using special folding and stitching techniques. The procedure allows to reduce the size of the stomach by about 70 to 75%. Laparoscopic gastric plication operation, which is also called laparoscopic greater curvature plication (LGCP), stomach folding or gastric imbrication is a newer, much less invasive type of surgery. Gastric plication surgery is preferred to other bariatric procedures because, unlike the gastric sleeve procedure, it does not involve removing large parts of the stomach, placing any foreign objects, such as gastric balloons, or rearranging intestines, which is necessary in the case of gastric bypass. It means that the procedure can be reversed with no significant complications to the patient, which is a welcomed development in the field of obesity and overweight treatment.

How does gastric plication work and what is its effectiveness?

The gastric plication technique can be described as creating a smaller sleeve or pouch out of the stomach that can store less amount of food. In other words, gastric plication allows patients to lower their appetite and block constant hunger, which means that they are going to be satisfied by consuming much less amount of food. In this way, they are going to lose weight more easily as the unrestrained appetite will no longer be a barrier to achieving the dream weight. What is even more important, the digestive tract is not restricted, so there will be no issues with absorbing vitamins, minerals, and other nutrients.

Gastric plication procedure- how the surgery is performed?

Gastric plication surgeons conduct a stomach operation using laparoscopy technique, which means that in order to avoid open, more invasive surgery, the surgeons make small incisions in the patient’s abdomen. The procedure may take from 40 minutes to 2 hours. During the gastric plication operation, the folding and stitching techniques are used to reduce the size of the stomach. In other words, the stomach’s lining is folded inside itself without removing any of its parts or placing foreign objects inside it. The procedure is performed with a type of video camera (laparoscope) and thin instruments which are inserted into the stomach via small incisions. In this way, the stomach capacity can be decreased by an app. 70%.

Using laparoscopic techniques is innovative and results in faster recovery after the procedure. It is also less traumatic and scary for the patients. Recovery time varies from person to person, but usually, patients can get back to work and everyday activities in about 10 days after the procedure.

How to prepare for gastric plication surgery?

The pre-surgery period is extremely important for all types of bariatric procedures and the doctors and medical staff in each clinic provide patients with pre-surgery instructions and gastric plication requirements to follow. They also prepare a list of all necessary things that a patient should have in the hospital, such as documents, clothing, cosmetics, etc.

The recommendations common for all patients who undergo bariatric surgery include:

  • Gastric plication pre-op diet it is recommended 2 or 3 weeks before the procedure. This reducing diet is rich in proteins and low in calories and its aim is to reduce liver fat.
  • List of medication that cannot be taken by patients before the surgery, e.g. the Aspirin based ones. The usage of any type of medication needs to be approved by the surgeon.
  • Quitting smoking at least two months before the planned procedure – that habit increases the risks of pneumonia, blood clots, post-surgery infections and other complications that can slow down the healing process.
  • Education and consulting – Patients should attend special courses organized in some clinics and psychological consulting to make sure that the decision to undergo a gastric plication surgery is carefully considered and the patient has proper knowledge about the procedure.

Patients should not also forget about their family and work-life that is going to be affected by their absence (child or pet care, work requirements, etc.). They should also remember that it is important to ask a close person to help and assist during this time, especially after the procedure.

Is gastric plication surgery safe?

This is a question commonly asked by patients who undergo any type of surgery. In the case of gastric plication surgery, the laparoscopic minimally invasive technique is used to increase the comfort and ensure fast recovery of patients. Moreover, unlike other procedures such as gastric bypass, gastric plication surgery may be reversible.

Gastric Plication aftercare and recovery

After the gastric plication procedure, which does not take more than 2 hours, the patient needs to stay in the hospital for two days. The full gastric plication recovery time is relatively short. Of course, it depends on a person, but the full recovery usually takes about 4 weeks. For the first 2 weeks after the surgery, patients should not go back to work and everyday responsibilities. It is common and completely understandable that patients feel tired and weak after being discharged from the hospital, but their condition gets better day by day.

Gastric Plication post-operation diet

Healthy meal

New after surgery diet should consist of smaller portions of food, low in fat and carbohydrates

One of the reasons patients should consider longer leave after the surgery is the need to stay on a full liquid diet at least for a week. During the next two weeks, some thicker liquids are allowed, e.g. juice and blended soup, and then, patients can try some high in protein semi-soft meals, fruit, vegetables, and yogurts.

The new diet, consisting of smaller portions of food, low in fat and carbohydrates, starts the weight loss process and begins after 4 weeks since the procedure.

Then, the patient can go back to his/her normal life activities but needs to follow a special diet plan and instructions provided by the surgeon. For many patients, one of the hardest restrictions is that they need to keep in mind is to eat tiny portions of food very slowly and always remember that their stomachs are much smaller than they used to be. Moreover, they cannot drink while eating. Fluids can be drunk at least 30 minutes before the meal and 30 minutes after eating. The well-being of the patients is also monitored on the post-surgery medical appointments, which is a standard procedure.

Gastric plication surgery results

Scale

Results after the surgery depend on the patient’s weight before the operation and the lifestyle after the procedure, but usually, the patient can expect to lose up to 55% of their excess body weight within the first 2 years after gastric plication surgery

Results of gastric plication surgery depend, to a great extent, on the patient’s weight before the operation and the lifestyle after the procedure. The good news is that patients usually lose up to 55% of their excess body weight within the first 2 years after gastric plication surgery. Surely, there are other important gastric plication long term results which can be observed in more than 75% of patients, e.g. lowering high blood pressure and cholesterol levels, significant reduction of diabetes and sleep apnea symptoms.

As gastric plication surgery is still perceived as an experimental procedure, long-term studies are not yet available but the improvements that can be observed within a few years after the surgery are quite impressive and encouraging. “Standardized Technique of Laparoscopic Adjustable Gastric Banded Plication with 4-Year Results”, a study published in 2015, shows that gastric plication is effective in excess weight loss. The researchers monitored the weight loss of 202 patients over a period of 4 years. The study revealed that after the first year the excess weight loss reached almost 58% and 68% after 4 years.

Can gastric plication be reversed?

The gastric plication procedure is fully reversible within a certain amount of time (current estimates say approximately 1 year) because, unlike the gastric sleeve procedure, it does not involve removing any part of the stomach, rearranging of the digestive system, or implementing devices such as a gastric balloon or gastric banding. Sutures that are used to reduce the size of the stomach can be removed if necessary.

Gastric plication pros and cons

When thinking about gastric plication benefits, we should remember that it contributes to sustained weight loss, with “sustained” being a keyword here. Most obese people have tried to lose weight on their own multiple times in their lives with better or worse results. They also experienced the so-called “yo-yo effect”, which means that they gained their weight back after a diet. In order to fight the potential health problems, the results of a weight loss need to be permanent. This can be ensured by bariatric gastric plication surgery.

One of the most important gastric plication benefits it the fact that the procedure does not interrupt the absorption of nutrients the way other bariatric surgeries do. However, vitamin and mineral supplements should still be taken after the surgery due to the change in diet.

The major advantages of gastric plication surgery:

  • Laparoscopic technique means smaller surgical cuts.
  • The procedure is reversible (unlike sleeve gastrectomy or gastric bypass).
  • No part of the stomach is removed during the procedure, so the patient’s recovery is much faster.
  • There is no major interference with the digestive system, which ensures a lower risk of complications.
  • No need to place foreign objects or devices into the stomach
  • The significant reduction of food intake with no nutritional deficiencies
  • Minor food restrictions (comparing to other bariatric procedures)
  • No further adjustments are required (unlike in the case of gastric band)
  • Weight loss in the first year after surgery is significant (40-70%).
  • Improvement in obesity-related conditions such as diabetes or hypertension

The major disadvantages of gastric plication surgery:

  • Using laparoscopic technique there is a risk of injuring surrounding organs, infection and bleeding.
  • Possible, but rare, leak from the area with sutures used to fold the stomach
  • The relatively new and experimental procedure means that all the costs are covered by patients.
  • Less information about the long-term success rates and possible complications than in the case of other bariatric surgeries
  • Long-term nausea and vomiting (up to a month after the procedure)

We can also list other long-term benefits of sustained weight loss through gastric plication surgery. They include:

  • Long-term remission for type 2 diabetes – as proved by Cleveland Clinic research, almost all patients with type 2 diabetes did not have to take insulin and adjunct medications for at least 3 years after bariatric surgeries
  • Depression relief – obese people are often stigmatised by society for their poor body image, and they cannot accept how their looks affect not only their everyday social life but also their health. Losing weight means the end of social isolation and depression, they can now participate in activities they used to avoid in the past. They feel like winners who gained their lives back.
  • Improvement of cardiovascular health – lower blood pressure and cholesterol levels reduce the risk of coronary and peripheral heart disease as well as strokes.
  • Improvement of male and female fertility, lower risk of pregnancy complications
  • Joint pain relief – most obese people suffer from chronic pain caused by excessive weight. The constant stress that the weight puts on joints can lead to their damage. After bariatric surgery, patients increase their mobility and stop using pain relief medications.
  • Elimination of obstructive sleep apnea

Gastric plication complications and side effects

Gastric plication is a technologically advanced laparoscopic procedure which means that the risk of complications is lower than in the case of open surgery. The most common side effects reported by patients include vomiting and nausea which can last for about a week after the surgery. Other gastric plication side effects are common for all surgical procedures and are related to general anaesthesia. There is also a possibility of mild bleeding, leaks from the sutures, and separation of the stitched areas.

Gastric obstruction, which usually causes constant vomiting after surgery, may be one of the most serious gastric plication complications because then the operation has to be performed once again. Patients with ischemia (restriction in blood supply to tissues) and those who poorly respond to medical treatment may need reoperation too. Rarely, the leaks from sutures may be a sign of gastric perforation. Treatment options in this case include another surgical procedure to repair the plication.

Also, patients should be aware that the gastric plication procedure itself cannot be treated as a remedy for obesity. When they neglect diet restrictions and their weight increases significantly, this may cause insufficient reduction of the stomach size or even plication breakdown.

In the article published on National Center for Biotechnology Information’s website titled “Twelve year experience of laparoscopic gastric plication in morbid obesity: development of the technique and patient outcomes”, the authors present statistics regarding 800 patients who had gastric plication surgery and post-op complications were reported only in 1% of the cases.

The most common complications of gastric plication surgery and side effects are:

  • Vomiting – common up to 2 days after the procedure
  • Temporary post-op gastric plication reflux – in the first week after the procedure
  • Epigastric pain – during the 1st 48h after the procedure

Postoperative complications (1% of the patients) after LGP included:

  • Perforation – 3 cases
  • Obstruction – 3 cases
  • Permanent vomiting – 1 case
  • Intracapsular liver ulcer – 1 case

In other words, laparoscopic gastric plication procedure is much safer in comparison to other bariatric surgeries such as gastric banding or gastric sleeve. We can ensure the patients that the bariatric surgeon will explain all the possible risks of gastric plication to them and make sure if this procedure is the best option for the patient. It is important to remember that the final decision always belongs to the patient.

Gastric plication and pregnancy

Pregnancy after weight loss surgery is a commonly discussed subject. Losing weight means significant benefits not only for the patient but also for future children.

Obese women who are pregnant, compared to women of healthy weight, are more likely to:

  • have emergency caesarean delivery
  • suffer from chest, genital and urinary tracts infections
  • be depressed and withdrawn
  • experience headaches and migraines
  • suffer from heartburn
  • have gestational diabetes

Pregnancy after weight loss surgery means:

  • lower risk of high blood pressure
  • better chance of delivering a baby of healthy birth weight, which can mean a lower risk of the child’s obesity in the future
  • lower possibility of premature delivery that can be dangerous for the baby
  • fewer complications such as gestational diabetes
pregnant

Pregnancy after weight loss surgery has many benefits. It is recommended to wait 18 months after the surgery to become pregnant

The decision to undergo weight loss surgery before pregnancy is a decision that affects the whole life of the future child. A study conducted by researchers at the Laval University in Quebec, Canada, revealed that the risk of obesity and obesity-related metabolic disorders in children born after the mother undergoes weight loss surgery is significantly lower. The doctors compared children the women had before and after the weight loss surgery and noted some significant differences. For example, 17% of the children born after their mothers’ weight loss surgery were obese while the same was true for 49% of the children born before their mother decided to undergo a weight loss procedure.

When is it safe to become pregnant after weight loss surgery?

Patients after weight loss surgeries experience the greatest weight loss during the first 18 months. During this time it is not recommended for women to get pregnant because, due to the possible (but rare in the case of gastric plication procedure) lower levels of vitamins and minerals, it would be difficult to ensure that both the mother and the baby receive all the nutrition they need. Of course, every situation can be different but the woman should not make a decision about pregnancy without consulting her doctor.

Alternatives to gastric plication

Patients often ask “what is the best surgery for weight loss” and they may often hear that gastric sleeve or gastric bypass are the best methods, probably because they are the most popular and laparoscopic gastric plication is still considered as new and experimental. However, as it has already been explained in the previous parts of the article, the risk of complications in the case of gastric plication procedure is lower when compared to other methods.

The most popular alternatives to gastric plication surgery are gastric sleeve, gastric band, gastric bypass and gastric balloon.

Gastric sleeve

Gastric sleeve (a sleeve gastrectomy) is a bariatric surgery that involves removing 70-80% of the stomach. During this procedure, a small sleeve-shaped pouch is created and the other part of the stomach is removed.

Clinic Hunter- Gastric Sleeve

Gastric plication vs gastric sleeve

The major difference between these two surgeries is that the gastric sleeve procedure cannot be reversed as most of the stomach pouch is permanently removed while the gastric plication is less invasive and considered as reversible.

Gastric bypass

Gastric bypass (also called Roux-en-Y Gastric Bypass) can be described as creating a new, smaller stomach pouch that can accommodate the only 30ml of food. During the procedure, the surgeon transects the stomach to divide it into a small upper pouch and larger lower pouch (that is excluded from digestive processes) and connects them to the small intestine.

Clinic Hunter gastric bypass

Gastric plication vs gastric bypass

The major difference between the two procedures is that gastric plication does not involve rerouting and reconnecting intestines. The stomach is not divided, so the procedure itself is less invasive. Also, the bypass reduces the absorption of nutrients and vitamins to a greater extent than in the case of gastric plication. What is most important, gastric plication procedure can be reversed.

Gastric band

Gastric band is also called gastroplasty. During this procedure, a silicone band is placed around the upper part of the stomach. Then, it needs to be tightened or loosened using saline water to adjust the band to the stomach walls. The size of the stomach is reduced to accommodate only small portions of food. The gastric band used to be a leading weight loss procedure several years ago, but now it is used less often. It is recommended for patients with high complications risk who cannot undergo other types of bariatric surgeries.

CH_gastric_band_820x450

Gastric balloon

Gastric balloon (Orbera balloon) is a surgery that involves placing a soft silicone balloon in the stomach for about 6-12 months. The balloon fills the stomach, which reduces the amount of food a patient can eat to feel full. This is a relatively fast and simple procedure that lasts about 30 minutes. However, the procedure is temporary and the patient needs to undergo another surgery to remove the balloon.

Clinic Hunter gastric balloon

Gastric plication cost

In general, bariatric weight loss surgeries are considered expensive because it is quite difficult to have it refunded by NHS, and they are usually performed in private clinics. The prices vary from region to region, but they usually range from 3,995 GBP to 15,000 GBP throughout the UK. The price of gastric plication surgery is high but still attractive when compared to other bariatric procedures. Below, we present the starting prices provided by some private clinics where the patients can undergo the procedure in the UK:

  • London Obesity Centre: from 5,963 GBP
  • Beautiful Beings: from 3200 GBP
  • Body Clinique: from 3800 GBP

Is gastric plication refunded on the NHS?

Some weight-loss surgeries such as a gastric sleeve or gastric bypass are available on the NHS for people who meet certain criteria (a list of criteria may be found on the NHS website). Gastric plication surgery is still considered as an experimental procedure and that is why it is not refunded on the NHS. Gastric plication surgery may also be offered as part of a clinical trial, which, for some people, may be worth considering.

Gastric plication abroad - best place to get the surgery

People who decide to undergo gastric plication surgery cannot expect it to be refunded by the NHS. Sometimes the cost of surgery in the UK is so high that they cannot afford it in their country. People often decide to go abroad for gastric plication surgeries, because the popularity of this method made it available at lower cost outside the UK. Patients in the US must cope with a similar situation. There, the price for gastric plication surgery may reach even 15 000 USD. That is why many people decide to use the benefits of medical tourism. In the case of American patients, Mexico, with prices starting from 6500 USD, seems to be the most attractive and close destination.

Fortunately, medical tourism in Europe gives patients a great variety of choice when it comes to the number of destinations and available bariatric procedures.

However, when comparing costs of the surgery in different countries, please be aware that although the majority of clinics offer the whole packages, sometimes the given price refers only to the cost of the surgery itself and other services such as travel costs, stay in the clinic, examinations before the surgery, medications, anaesthesia, dietician and psychologist consultations need to be paid separately, which significantly increases the cost of gastric plication procedure. Also, it is a common practice that clinics usually post on their websites the lowest possible price for certain procedures and the real costs may differ from person to person as each patient is different and needs individual adjustment of the offer.

Gastric Plication Abroad – top medical tourism destinations

Prices of gastric plication’ surgery may be twice or even three times lower than in the UK. This is the reason patients decide on medical tourism options. There are many places abroad where the gastric plication can be done at the highest standards with affordable prices

In the field of affordable bariatric surgeries, the leading countries are Poland, Turkey and the Czech Republic. Medical services in these countries are highly developed and trustworthy, so the patient risks absolutely nothing when he/she chooses to undergo the treatment abroad while the financial benefits are significant. Prices of gastric plication’ surgery may be twice or even three times lower than in the UK. The clinics are prepared to treat foreign patients, the surgeons are qualified and licensed to perform weight loss surgeries. It is easy to get information about the particular clinic, its equipment, medical staff and sanitary conditions as they usually run websites in English.

Also, the cost of travel is not as high as it used to be in the past and the variety of flight connections has increased significantly, so getting to the destination place is fast and comfortable. Patients should not worry about the language barrier as the surgeons and medical staff speak English and other languages.

What increases the patient’s convenience, even more, is the choice of accredited medical agencies which offer medical procedures in the form of full, all-inclusive packages comprising surgery, flights, stay in the hotel and clinic and other aspects of the trip as well as the post-op control visits in the clinic.

Of course, we should not forget that medical tourism gives patients an opportunity to visit a foreign country and spend some time travelling, sightseeing and giving themselves a chance to rest and relax during this short vacation time.

Gastric plication in Turkey

Gastric plication in Turkey is one of the most popular bariatric surgery destinations. The main advantage of undergoing this procedure in Turkey is the low price – probably the lowest available on the medical market. The prices start from approximately 2900 GBP with the best clinics in Istanbul, Antalya and Alanya. Patients can also use services of many medical tourism agencies which will help them to find a place with the best medical staff and avoid hospitals and surgeons with a bad reputation. In recent years, the political situation in Turkey was not stable, so the popularity of medical tourism in this country also varied but currently, there are no contradictions to a safe visit there.

Gastric plication in Poland

During the recent two decades, Poland has proved to be one of the top European destinations for different medical and dental procedures. “Weight loss surgery Poland” is a frequently searched phrase among the potential patients from abroad when it comes to medical tourism and “gastric plication Poland” is definitely one of them. There are several reasons for that, the most important being the fact that Poland offers affordable prices for top-quality clinics with excellent equipment, experienced bariatric surgeons and professional medical staff in the biggest cities including Warsaw, Cracow, Gdansk and Wroclaw. There is a variety of convenient direct flight connections (both budget and business class) to these destinations from most major European cities. The flight itself lasts about 2 hours. Also, the network of medical agencies is well-developed, so patients will not have difficulties in finding a suitable all-inclusive package that best suits their needs. For example, we can recommend KCM Clinic in Jelenia Gora, situated in the heart of the beautiful Karkonosze mountains, where the gastric plication surgery prices are very attractive. The All Inclusive Medical Treatment package is available for 4072 GBP and includes all medical costs – diagnostic, consultations, anaesthesia, hospitalization in a private room with wifi and medical treatment.

Gastric plication in Czech Republic

The Czech Republic is an European country well known for its high-quality medical treatment and affordable prices. It is possible to find clinics that offer laparoscopic gastric plication procedure for prices lower than 3500 GBP. The Czech Republic may be a good choice for anyone who would like to combine undergoing a medical procedure with relaxing vacation and sightseeing as the majority of top standard clinics are situated in Prague, the capital of Czech Republic. If someone prefers a more peaceful city, Brno will be the best choice for them. The gastric plication procedure prices are similar to those in Prague.

Gastric plication summary

The laparoscopic gastric plication surgery also called stomach folding, laparoscopic greater curvature plication (LGCP) or gastric imbrication is an innovative method in the field of bariatric surgeries. The procedure can be understood as the newest alternative to the more popular gastric sleeve surgery. In this procedure, the size of the stomach pouch is reduced by about 70 to 75% using the technique of folding and stitching of the parts of the stomach. This type of bariatric surgery is considered less invasive, because, unlike in the case of gastric sleeve, parts of the stomach are not permanently removed, also, no foreign objects are placed in the stomach (unlike in the gastric balloon procedure) and the intestines do not have to be rearranged (unlike in the gastric bypass). What is more, the risk of complications is lower than in the case of other methods and surgery can be reversed, which is one of its greatest advantages.

Gastric plication requires a special post-op diet, which at first is only based on fluids, because the new stomach pouch can accommodate very small portions of food. Thanks to that, the feeling of hunger, triggered by the hormone ghrelin, can be easily blocked. After some time, patients’ diet is more diverse, but they need to remember that they must keep a healthy, balanced diet in order to experience a true long-term weight loss. Keeping in mind these guidelines helps patients to lose even 60% – 80% of their starting weight and get rid of many obesity-related medical conditions such as hypertension, diabetes and joint pain relief.

Another important thing to know is that the gastric plication procedure is not refunded by the NHS, which means that patients may undergo the procedure only in private clinics, which can be quite expensive. Fortunately, there is a less expensive alternative guaranteed by medical clinics abroad. For European patients, we can recommend three leading destinations – Poland, Turkey and Czech Republic where they may find the same procedure even three times cheaper than in their country.

So, it is important to remember that when patients are considering undergoing gastric plication surgery or any other weight loss surgery, they are fighting for a better, more joyful and healthier life. We are happy to answer all the questions about laparoscopic gastric plication surgery as well as provide all the details about any other types of stomach surgery.

Sources

https://www.nejm.org/doi/full/10.1056/NEJMoa1614362#t=abstract

https://www.cnbc.com/2017/06/14/one-third-of-the-world-is-now-obese-or-overweight-but-us-adults-arent-faring-worst.html

https://health.ucsd.edu/specialties/surgery/bariatric/weight-loss-surgery/Pages/gastric-plication.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575507/

https://columbiasurgery.org/weight-loss/post-operative-care

www.bariatric-surgery-source.com/gastric-plication-surgery.html#procedure

www.yourbariatricsurgeryguide.com/gastric-plication/

www.hehealthclinic.eu/eng/bariatric-surgery/gastric-plication/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738629/

https://oxfordmedicine.com/view/10.1093/med/9780190608347.001.0001/med-9780190608347-chapter-37

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444326/

https://europepmc.org/article/med/28365201

Katarzyna Szałęga

Katarzyna Szałęga graduated from the John Paul II Catholic University in Lublin in 2016 with a degree in English philology and translation studies. She used to be a teacher in one of the language schools in Lublin for several years. Now, she is passionate about working for an organisation that provides Trial Master File services for pharmaceutical companies conducting clinical trials.
She is a big animal and nature lover who enjoys travelling and mountain hiking. She cannot imagine her day without coffee and a good book.

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