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1、TheReportofLaparoscopicTotalGastricVerticalPlicationInMorbidObesityInIranMOHAMMADTALEBPOUR,MD;BAZMANSA`ADATAMOLI,MDLAPAROSCOPICSURGICALWARD,SINAHOSPITAL,TEHRANMEDICALUNIVERSITY,TEHRAN,IRANBackground:Theaimofthisstudyistointroduceanewtechnique“TotalGastricVerticalPlication”(TGVP)
2、asanrestrictiveoperationwiththeleastriskofcomplicationandthesameresultofweightlossasotherrestrictivetechniqueswithoutanyextraordinarycostespeciallyinthirdwordcountries.Methods:Thistechniqueusedduring2yearsbyonesurgeoninprivatehospitals,Tehran,Iran.Patientswereplacedinsupinewith3
3、0-degreereversetrendelenburgposition.Trocarsinsertedbasedonergonomicassessment(Three5mmsanda10mm).Afterreleaseofgreatercurvature,bycontinuousoonylonsuturingfromfundusto3cmofpylorus,averticalplicationinoneortwolayersperformed.Distancebetweenstitchandlessercurvatureinanteriorandpo
4、steriorandbetweeneachstitchwas2cmandallofthemwereextramucosalandfarawayofacideffect.Thevolumeofstomachinthisconditionis100ccbutjustonehalfofitiseffective.Ifmorethan50ccused,painfulmuscularmovementoccurs.Results:In42middleaged(35yearsold,SEM=2.4)cases;mostlyfemale(F/M=31/11)andwi
5、thaverageBMI=46(36-51)itperformed.Themeanweightlossinourpatientswas21.4%of“ExcessiveWeightLoss”(EWL)afteronemonthofoperation,55%after6months,61%after12monthsand62.3%after24months.Theaveragetimeoffollowupwas1110months.Themeantimeofoperationwas107(75–152)minutesandallofthemdischar
6、gedfromhospitalafteranaveragetimeof24hoursofoperation.Postoperativecomplicationswerepermanentvomiting(1case,secondarytoadhesionoffundustotraumatizedliver),intracapsularliverhematomaproducinglateabscessformationonitafter6monthofoperationsecondarytobacteriamia(1case),hypocalcaemia
7、atearlypostoperativeperiodduetopromotingsilentdisease(asymptomatichypercalciuria)inonecase.Conclusion:ThepercentageofEWLinthistechniqueiscomparabletoothergastricvolumerestrictionmethodsbutEWLappearsmorerapidly.Earlypostoperativecomplicationofthismethodisminimal,withoutanyimporta
8、ntlatecomplications.Thistechniqueneedsmoreexper
