Gastric Plication (Folding) Surgery in Turkey

Gastric plication, also called stomach folding surgery or laparoscopic gastric plication, is a weight loss procedure designed to reduce the amount of food the stomach can hold. Rather than removing part of the stomach or rerouting the intestines, the surgeon folds the stomach wall inward and secures the folds with sutures.

The procedure may appeal to people looking for a restrictive bariatric surgery option without stomach removal. However, gastric plication is less commonly performed than established procedures such as sleeve gastrectomy and gastric bypass, and its potential benefits, limitations, and likelihood of future revision should be discussed carefully with an experienced bariatric surgeon.

What Is Gastric Plication Surgery?

Gastric plication is usually performed using laparoscopic surgery. This minimally invasive approach uses several small abdominal incisions through which the surgeon inserts a laparoscope, a thin instrument with a camera, and specialized surgical instruments.

During the operation, the outer curve of the stomach is folded inward. The surgeon then places sutures to hold the folded stomach in position, creating a smaller, tube-like stomach. Because no part of the stomach is removed, gastric plication does not involve the staple line created during sleeve gastrectomy.

Gastric plication is a restrictive procedure. It works mainly by limiting meal size rather than by changing how the intestines absorb calories or nutrients.

How Does Gastric Plication Work?

After gastric plication, the stomach has less space available for food. Patients generally feel full after eating smaller portions, which can help reduce overall calorie intake when combined with long-term dietary and lifestyle changes.

Unlike gastric bypass, gastric plication does not bypass part of the small intestine. Food continues to follow its normal route through the digestive tract, so the procedure does not intentionally create malabsorption.

• Smaller meal portions may be more satisfying.
• Patients are encouraged to eat slowly and chew thoroughly.
• Protein-rich, nutrient-dense foods become especially important after surgery.
• Regular exercise, hydration, and follow-up appointments support long-term weight management.

Although intestinal absorption is not surgically reduced, nutritional monitoring remains important. Reduced food intake, vomiting, poor tolerance of certain foods, or inadequate supplementation can still contribute to nutritional problems after any bariatric procedure.

Gastric Plication vs. Sleeve Gastrectomy and Gastric Bypass

Gastric plication differs from other bariatric operations in the way it changes the stomach and digestive system. The most suitable option depends on a person’s body mass index, obesity-related health conditions, eating patterns, previous surgeries, and treatment goals.

Gastric Plication

Gastric plication reduces stomach capacity by folding and suturing the stomach wall. No stomach tissue is removed, and the intestines are not rerouted. The procedure may be technically reversible in some situations, but reversal or conversion can become more complex over time because scar tissue and changes in the stomach may develop.

Sleeve Gastrectomy

Sleeve gastrectomy removes a large portion of the stomach, leaving a narrow sleeve-shaped stomach. It is irreversible and is among the more established bariatric procedures. It may be considered for patients who need a durable restrictive operation and are appropriate candidates after full medical assessment.

Gastric Bypass

Gastric bypass surgery creates a small stomach pouch and connects it to a lower part of the small intestine. It changes both food intake and digestion. It may offer important metabolic benefits for selected patients, but it also requires lifelong nutritional follow-up because the risk of vitamin and mineral deficiencies can be higher.

Who May Be a Candidate for Gastric Plication?

Eligibility for gastric plication should be determined individually by a multidisciplinary bariatric team. A surgeon will consider whether surgery is appropriate, whether gastric plication is available and suitable at the treating center, and whether another bariatric procedure may better support the patient’s health goals.

Assessment commonly considers:

• Body mass index and weight-related health concerns.
• History of attempts at medically supervised weight loss.
• Type 2 diabetes, high blood pressure, sleep apnea, fatty liver disease, or other obesity-related conditions.
• Previous abdominal or bariatric surgery.
• Gastroesophageal reflux disease and other digestive symptoms.
• Ability to follow long-term nutrition, activity, and follow-up recommendations.
• Smoking status, alcohol intake, medications, and general fitness for anesthesia.

Bariatric surgery is not a substitute for lifestyle support. It is most effective when patients are prepared to make lasting changes in eating habits, physical activity, and follow-up care.

Is Gastric Plication Safe?

All surgical procedures involve risks, including risks related to anesthesia, bleeding, infection, blood clots, pain, and injury to nearby structures. Gastric plication may avoid certain features of other operations, such as stomach removal or intestinal rerouting, but it has its own possible complications and limitations.

Published research has reported concerns about the long-term durability of the stomach fold, including dilation or prolapse of the plicated section of stomach. These changes can contribute to discomfort, reflux, vomiting, inadequate weight loss, or the need for revisional surgery. For this reason, patients should receive balanced counseling about the evidence and alternative treatment options before choosing this procedure.

Possible Risks and Complications

• Nausea, vomiting, abdominal pain, or difficulty tolerating food during recovery.
• Bleeding, infection, blood clots, or anesthesia-related complications.
• Acid reflux or worsening reflux symptoms.
• Obstruction or narrowing that affects stomach emptying.
• Stomach fold dilation or prolapse over time.
• Insufficient weight loss or later weight regain.
• A need for revision, reversal, or conversion to another bariatric procedure.

Contact the surgical team urgently after discharge if severe or worsening abdominal pain, repeated vomiting, fever, shortness of breath, chest pain, fainting, or an inability to drink fluids develops.

The Gastric Plication Procedure: Step by Step

Gastric plication is performed under general anesthesia. The exact technique and operating time can vary according to the patient’s anatomy and the surgeon’s approach.

1. General anesthesia is administered so the patient is asleep throughout the procedure.
2. Small incisions are made in the abdomen for the laparoscope and surgical instruments.
3. The surgeon examines the stomach and prepares the outer curve for plication.
4. The stomach wall is folded inward to reduce the internal volume of the stomach.
5. Sutures are placed to secure the folds and create the new stomach shape.
6. The surgeon checks the stomach and surrounding area before removing the instruments.
7. The incisions are closed, and the patient is transferred to a recovery area for monitoring.

Hospital stay and discharge timing vary. Some patients may leave hospital after short-term observation, while others may need longer monitoring based on their recovery, medical history, and the surgeon’s instructions.

Preparing for Gastric Plication

Preparation begins well before the day of surgery. Patients may undergo blood tests, imaging, nutritional assessment, anesthesia evaluation, and consultation with specialists when needed. The care team may also recommend a preoperative diet to reduce liver size and support safer laparoscopic access.

• Stop smoking and nicotine use within the timeframe advised by the care team.
• Discuss all prescription medications, supplements, and allergies.
• Follow instructions regarding blood-thinning medication, diabetes medication, and fasting.
• Arrange support at home for the first days after discharge.
• Prepare appropriate fluids and approved postoperative foods before surgery.
• Understand the staged nutrition plan and follow-up schedule in advance.

Open discussion is essential. Patients should ask how frequently the surgeon performs gastric plication, what alternatives are available, what results are realistic, and what revision options may be needed if the procedure does not provide sufficient long-term benefit.

Gastric Plication Recovery: What to Expect

Recovery varies from person to person. Early recovery focuses on pain control, walking safely, hydration, and gradually progressing through the postoperative diet prescribed by the bariatric team.

First Few Days

Patients are monitored for pain, nausea, hydration, and signs of complications. Walking soon after surgery is commonly encouraged to support circulation and reduce the risk of blood clots. The care team will advise when it is safe to begin drinking small amounts of fluid.

First Weeks

The diet usually progresses in stages, beginning with clear liquids and moving to full liquids, pureed foods, soft foods, and eventually carefully introduced solid foods. The timeline is individualized and should always follow the surgeon’s and dietitian’s instructions.

Returning to Daily Activities

Many patients can resume light daily activities within a short period, but heavy lifting and strenuous exercise should be avoided until the surgical team confirms that healing is progressing appropriately. Return-to-work timing depends on the type of work, recovery progress, and individual medical advice.

Diet and Lifestyle After Gastric Plication

Long-term outcomes depend on more than the operation itself. A structured nutrition plan helps protect the stomach, support healing, preserve muscle mass, and encourage sustainable weight loss.

• Eat small, planned meals and avoid grazing throughout the day.
• Prioritize protein according to the dietitian’s recommendations.
• Drink fluids regularly, but follow guidance about separating drinking from meals.
• Avoid carbonated drinks, high-sugar beverages, and foods that are difficult to tolerate.
• Take prescribed vitamins or supplements and attend blood test appointments.
• Build physical activity gradually, starting with walking and progressing as advised.
• Seek support for emotional eating, stress, or concerns about adjusting to dietary changes.

Gastric Plication Surgery Cost in Turkey

The cost of gastric plication surgery in Turkey can vary according to the hospital, surgeon’s experience, preoperative tests, anesthesia, length of stay, aftercare needs, and whether additional treatment is required. International patients should request a treatment plan that clearly explains what is included in the proposed package.

It is also important to consider the quality and continuity of care rather than comparing prices alone. Before traveling, patients should confirm the surgeon’s credentials, hospital standards, emergency support, postoperative follow-up arrangements, and the plan for managing complications after returning home.

Bariatric Care at Medical Park Hospitals

Medical Park Hospitals provide multidisciplinary assessment and care for patients considering bariatric surgery in Turkey, including the gastric plication procedure. Depending on individual needs, the care pathway involves collaboration between general surgeons, gastroenterologists, endocrinologists, dietitians, anesthesiologists, and other specialists.

Before treatment, the bariatric team carries out a detailed evaluation of the patient’s medical history, weight-related health conditions, previous weight loss efforts, medications, nutritional status, and surgical suitability. This assessment helps ensure that the recommended procedure aligns with the patient’s individual health needs, expectations, and long-term weight management goals.

Patients also receive guidance on preparation, postoperative nutrition, physical activity, and the lifestyle changes needed to support lasting results. Regular follow-up appointments allow the care team to monitor recovery, address dietary tolerance, assess weight loss progress, and provide further support when needed.

For international patients, Medical Park supports coordinated care before, during, and after treatment, including medical-record review, consultation planning, hospital coordination, and postoperative guidance. A bariatric consultation can help determine whether gastric plication or another evidence-based weight loss treatment is appropriate for the patient’s health needs and long-term goals.