Waldrep WRAP

Description

WRAP or Weight Reduction Assistance Procedure is a term our clinic uses to allow patients to easily refer to a minimally invasive surgical technique generally referred to as a gastroplasty (gastro = stomach; plasty = change the shap of), in which the stomach is folded in on itself and held in place with suture.

Similar surgical techniques have been referred to by different names, including:

• Gastric Plication Surgery (“GPS”)
• Gastric Imbrication
• Greater Curve Plication
• Total Gastric Folds
• Laparoscopic Total Gastric Vertical Plication
• Greater Curve Inversion Surgery

Possible Outcomes

• Weight loss
• Improvement in obesity related diseases
• Can be performed laparoscopically, using incisions as small as 3-5 millimeters
• Outpatient surgery takes a little more than an hour
• No cutting, opening, rearranging, or removing of the stomach or intestine
• The inside of the stomach can still be examined with a camera or x-ray later
• No plastic balloon device to adjust, break, leak, or slip
• Possible side-effects include surgical complications, nausea, vomiting, unsatisfactory weight loss, and weight regain.
• Much lower probability of leak, stricture, bowel obstruction, bleeding, dumping syndrome, long-term nausea, change in food taste
• Possibility that surgery can be repeated or reversed or add a gastric band.

Description

A silicone ring-shaped balloon is placed around the upper stomach through a tunnel created behind the stomach. The stomach is sutured around the band. Tightening or loosening the fit of the band involves puncturing a port beneath the skin with a needle every few weeks or months.

Possible Outcomes

• Weight loss
• Improvement in obesity related diseases
• Unsatisfactory amount of weight loss
• Can be performed laparoscopically
• Outpatient surgery takes about 20 – 30 minutes
• No cutting of intestine
• Anatomy remains normal
• The inside of the stomach can still be examined with a camera or x-ray later
• Difficult or painful swallowing
• Esophagus problems
• Band can move out of position and block stomach requiring surgery
• Band can create a hole in the stomach
• The port used to adjust band can “flip” requiring surgery to correct
• The system can leak requiring surgery to fix
• This artificial device can become infected
• Unsatisfactory amount of weight loss or weight regain

Description

The stomach is cut into two sections: a smaller upper section and larger lower “remnant”. The small intestine is cut in two and the lower intestine is attached to the upper stomach with stapler/sutures, the upper intestine is stapled/sewn to the lower intestine.

Possible Outcomes

• Weight loss
• Improvement in obesity related diseases
• Average hospital stay of 2 days
• Intestine leaks at staple/suture line
• Bleeding at staple/suture line
• Intestinal obstruction
• Difficulty swallowing
• Excess scaring of the pouch connection
• Ulcer that creates hole in intestine
• Unsatisfactory weight loss
• Unsatisfactory weight loss or weight regain

Description

A tube is passed through the stomach along the inside curve. The tube is used to map out a tube or “sleeve” of stomach. The rest of the stomach is cut off and thrown away.

Possible Outcomes

• Weight loss
• Improvement in obesity related diseases
• No rearrangement of intestinal tract
• No use of a permanent artificial device
• Stomach leaks at staple line
• Abscess
• Bleeding at staple line
• Difficult or painful swallowing
• Heartburn
• Sleeve may get bigger
• Stomach blockage
• Possible nutritional deficiencies related to discarded stomach
• Unsatisfactory weight loss
• Weight regain