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BOMSS issues gastric plication statement
The British Obesity and Metabolic Surgical Society (BOMSS) has issued advice stating that laparoscopic gastric plication is undertaken under careful scrutiny and with acknowledgment of the limitations of evidence for efficacy.
“Laparoscopic gastric plication seems to be a safe procedure but better long term data on outcomes and implications for subsequent gastric surgery are required before it can be fully endorsed,” said Mr Richard Welbourn, President of BOMSS. “Clinicians should employ it within the structure described by BOMSS Professional Standards and reflect carefully on collected outcome data.”
As novel procedures are developed it is essential that their safety and efficacy is critically assessed against existing options. In accordance with current BOMSS Professional Standards guidance, the advice adds that this procedure should be delivered with due clinical governance by bariatric units offering a range of treatment options within an appropriate multi-disciplinary team.
The National Institute for Health and Care Excellence (NICE) published procedural guidance for LGP in November 2012, which highlighted the reasonable short-term safety of the procedure and lack of long term safety evidence. Similarly, it indicates that whilst there is a limited body of evidence about the short and medium-term outcomes of laparoscopic gastric plication, there is as yet no long-term efficacy data.
NICE recommended that those wishing to employ the techniques should ensure support of their organisational governance leads, inform patients of uncertainties of procedure’s long-term efficacy and implications for further gastric surgery that may be needed and, lastly, provide patients with clear written information and access to NICE’s own public guidance.
BOMSS echoes the advice of NICE that clinicians should submit data on all patients undergoing laparoscopic gastric plication to the National Bariatric Surgery Registry under the “other procedure category”.
The cull NICE guidance can be read here.