A pilot study of laparoscopic gastric plication in adolescent patients with severe obesity.

BACKGROUND: Metabolic and bariatric surgery in adolescents with severe obesity has been demonstrated to be safe and have long-term treatment efficacy. However, less than 0.1% of adolescents meeting criteria undergo surgery.

METHODS: A prospective pilot study of adolescents who underwent laparoscopic gastric plication (LGP) was conducted to evaluate safety and effects on anthropometrics and weight-related medical and psychological comorbidities.

RESULTS: Four adolescents enrolled and underwent LGP; two withdrew 90 days postoperatively and two were followed through 36 months. Preprocedure body mass index was 41.7-53.7 kg/m2 with decreases in % change of BMI of 17.5% and 39.7% at 36 months after surgery. Patients reported early satiety, good hunger control, and limited nausea at all time points. There were no major complications. Mild gastroesophageal reflux and abdominal pain occurred; both resolved without surgical intervention. Minor improvements in psychological comorbidities were also reported.

CONCLUSIONS: LGP can be safely performed in adolescents with severe obesity and achieves modest weight loss. Although limited by its small sample size, this study provides preliminary support for LGP as an appropriate surgical option for adolescents. A larger, multidisciplinary study is planned.

TYPE OF STUDY: Prospective case series review.

LEVEL OF EVIDENCE: Level IV evidence: case series without comparison.