Bariatric surgery · UK
Laparoscopic greater curvature plication, explained honestly.
A historic bariatric procedure that folds in the greater curvature of the stomach with sutures — no cutting, no stapling. UK use is limited and declining. We explain when it might still fit, and why sleeve, bypass or ESG usually don’t.
Why patients choose us
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An honest bariatric conversation first
Plication is a historic option with weaker long-term evidence than sleeve or bypass. We say so out loud before you commit.
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Modern alternatives on the table
Endoscopic sleeve gastroplasty, sleeve, bypass, band or balloon — we compare them against plication so the choice is yours.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What plication costs — and what modern alternatives cost.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options — including sleeve, bypass and ESG for comparison.
In short
Plication is £6,000–£9,000, sleeve is £9,000–£14,000, bypass £11,000–£16,000.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Laparoscopic greater curvature plication (LGCP) | £6,000–£9,000 | 60–90 min | Day-case / 1 night |
| Endoscopic sleeve gastroplasty (ESG) | £7,000–£11,000 | 60–90 min | Same day |
| Sleeve gastrectomy | £9,000–£14,000 | 60–90 min | 1–2 nights |
| Roux-en-Y gastric bypass | £11,000–£16,000 | 90–120 min | 1–2 nights |
| Gastric band | £6,000–£9,000 | 45–60 min | Day-case |
| Consultation only | £200–£400 | 30 min | Same visit |
Plication is rarely NHS-commissioned in the UK. Prices vary by surgeon, clinic, calibrating bougie and any hiatal repair added on the day. We come back with a firm quote within one working day.
The problem
A procedure with real trade-offs — not a cheaper sleeve.
Plication was once promoted as a reversible, tissue-preserving, less-expensive alternative to sleeve gastrectomy. The long-term outcomes told a different story. We put the numbers alongside the marketing.
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Weight loss is modest
Around 30–40% excess weight loss at 12 months — meaningfully less than sleeve (55–65%) or bypass.
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Regain is common
Roughly half of patients regain to under 20% EWL by three to five years as the plication stretches.
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Alternatives usually win
ESG matches the concept endoscopically; sleeve, bypass and duodenal switch outperform on durable weight loss.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to long-term dietitian follow-up.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what you are hoping for
A short, confidential form. Weight, BMI, comorbidities, previous diets, and whether reversibility matters to you.
- 02
Before
A bariatric MDT view
Within one working day: whether plication is a sensible fit, or whether sleeve, bypass, ESG, band or balloon suits you better. Indicative pricing included.
- 03
Before
We arrange the appointment
Pre-op bloods, dietitian review, and a liver-shrinking diet for two weeks before surgery. Any blood-thinners are reviewed with the team.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the surgeon and anaesthetist. General anaesthetic, laparoscopic set-up in a proper theatre.
- 05
On the day
The procedure itself
60 to 90 minutes. The greater curvature is invaginated with 2 to 3 rows of non-absorbable sutures over a 32–40 Fr calibrating bougie.
- 06
On the day
Day-case or one night
Most patients go home the same day or after one night. Clear fluids only for the first 24 hours.
- 07
After
Recovery and review
Liquid for one to two weeks, puree, then soft, then normal by six weeks. Dietitian follow-up at 2, 6 and 12 weeks.
Typical end-to-end: 3–4 weeks from enquiry to procedure. Full dietary progression: 6 weeks.
When it fits
The narrow situations where plication might still fit — and where it doesn’t.
The specific patient preferences plication was designed for, plus the situations where a different procedure is clearly better.
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BMI 30–40 with comorbidities
Historically offered to patients seeking a stapler-free, tissue-preserving option in this range.
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Reversibility is a priority
In principle the sutures can be released, though in practice this is rarely done.
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Concern about staple-line leaks
No cut edge means no staple-line leak — a specific worry some patients raise about sleeve gastrectomy.
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Cost-sensitive private choice
Slightly cheaper than a sleeve in some UK centres, though the price gap has narrowed.
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Not suitable — BMI over 50
Very high BMI is better treated with duodenal switch or bypass — plication under-delivers here.
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Not suitable — severe reflux
Plication can worsen reflux. Bypass is usually the better option if you already have GORD.
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Not suitable — T2 diabetes remission
For durable diabetes remission, bypass and sleeve outperform plication.
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Red flag: emergency after surgery
Severe abdominal pain, persistent vomiting, fever or breathlessness after surgery — same-day A&E, not a clinic call.
Alternatives
Plication is one option — there are better ones for most patients.
What each modern bariatric option involves — and where plication actually sits alongside them.
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Laparoscopic greater curvature plication (LGCP)
The procedure this page is about — greater curvature folded in with sutures over a bougie. Historic option with weaker long-term data.
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Endoscopic sleeve gastroplasty (ESG)
The analogous concept done through the mouth with no laparoscopy. Growing evidence base including the MERIT trial. See our ESG page.
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Sleeve gastrectomy
The current UK workhorse — around 55–65% excess weight loss at 12 months and durable comorbidity resolution. See our sleeve page.
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Roux-en-Y gastric bypass
Comparable weight loss to sleeve and superior for type 2 diabetes remission and reflux. See our bypass page.
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Duodenal switch / SADI-S
For BMI over 50 or where sleeve alone has failed to deliver. See our duodenal switch page.
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Gastric band
Adjustable and reversible. Use has declined but suits some patients who want the least anatomical change.
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Gastric balloon
A temporary, non-surgical option for 6 to 12 months. Useful as a bridge or trial before committing.
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Consultation only
An honest discussion of whether any procedure is the right step, and which one fits — no obligation.
Our vetted UK network
A small panel of bariatric surgeons, we picked them.
Consultant bariatric surgeons in London and across the UK, all aligned with BOMSS practice. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every bariatric surgeon in our network.
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Consultant bariatric surgeons on the GMC specialist register
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BOMSS-aligned practice, with multidisciplinary team review
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Modern alternatives (sleeve, bypass, ESG, band, balloon) offered honestly
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Dietitian and psychology support built into the pathway
Safety and outcomes
What plication really delivers — and where it falls short.
The honest picture on weight loss, regain, complications and where UK practice now sits.
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Modest weight loss — 30 to 40% EWL
At 12 months plication delivers around 30–40% excess weight loss, meaningfully less than sleeve gastrectomy at 55–65%.
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Regain is common by 3 to 5 years
Around half of patients regain much of the loss by year three to five as the plication stretches or partially unfolds.
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Persistent nausea and vomiting
Very common in the first weeks — the pouch can be extremely tight. It usually settles but is more marked than after a sleeve.
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Suture dehiscence and unfolding
If the sutures give way the plication unravels, symptoms recur, and revision surgery is often needed.
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Reflux may appear or worsen
New or worsened GORD is a recognised issue. If you already have reflux, bypass is usually a better fit.
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Rare but serious complications
Gastric obstruction from an over-tight plication, gastric ischaemia, port-site hernia, DVT and PE are all recognised.
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BOMSS 2020 position
The British Obesity and Metabolic Surgery Society noted limited and declining use in the UK, with inferior long-term outcomes vs sleeve.
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Not routinely NHS-funded
Most UK NHS bariatric services do not offer plication. It is a private-sector procedure at a small number of centres.
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Red flags
Severe pain, persistent vomiting preventing fluids, fever, breathlessness or spreading redness after surgery are reasons for same-day help.
Reading your operation note
Your operation note in four parts. Read the last one first.
The note the bariatric surgeon sends you keeps to the same shape whether plication, sleeve or bypass was performed.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and technique chosen
Why plication was agreed rather than a sleeve, bypass or ESG — and the size of bougie used to calibrate the pouch.
- 02 Technique
Sutures, rows and bougie size
The number of rows (usually 2–3), suture material (non-absorbable braided), and the bougie size (typically 32–40 Fr).
- 03 Findings
Anatomy, adhesions and any incidental notes
Notes on the greater omentum, gastric arteries, any adhesions from previous surgery, and hiatal anatomy.
- 04 Impression
Diet stages, follow-up and when to worry
Read this first: liquid to puree to soft to normal timeline, dietitian follow-up dates, and red flags that mean same-day help.
Recognised by major UK insurers
Bariatric cover varies widely by insurer, policy and BMI threshold. Plication is often excluded even where sleeve and bypass are covered — we confirm cover before booking.
Frequently asked
Everything we get asked about laparoscopic plication.
Quick answers on weight loss, regain, reversibility, alternatives and cost.
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What is laparoscopic greater curvature plication?
A bariatric operation that folds in the greater curvature of the stomach with two or three rows of non-absorbable sutures placed over a calibrating bougie. It creates a tube-shaped pouch similar to a sleeve gastrectomy but without cutting or removing any tissue.
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How much weight will I lose after plication?
Typically around 30–40% of excess weight at 12 months, which is meaningfully less than sleeve gastrectomy (55–65%) or bypass. A significant proportion of patients regain much of the loss by three to five years.
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Is plication reversible?
In principle yes — the sutures could be released and the stomach would return to its original shape. In practice reversal is rare and revision is usually to a sleeve or bypass rather than a return to normal anatomy.
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Why is plication less common in the UK now?
The BOMSS 2020 position statement noted limited and declining use because long-term weight loss is inferior to sleeve gastrectomy and complication rates were higher than initially promoted. Most UK bariatric MDTs now recommend sleeve, bypass or ESG.
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How does plication compare with endoscopic sleeve gastroplasty (ESG)?
ESG achieves a similar concept — an invaginated tube-shaped stomach — but is done through the mouth without laparoscopy. It has a growing evidence base including the MERIT trial and is generally preferred if a tissue-preserving option is what you want.
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How much does laparoscopic plication cost privately in the UK?
Roughly £6,000–£9,000 depending on the surgeon, clinic and anaesthetic. Sleeve gastrectomy is £9,000–£14,000 and gastric bypass £11,000–£16,000 in the same clinics.
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What are the alternatives to plication I should consider?
Endoscopic sleeve gastroplasty, sleeve gastrectomy, Roux-en-Y gastric bypass, duodenal switch or SADI-S for very high BMI, gastric band, and gastric balloon as a temporary option. We compare all of these against plication before you commit.
Related treatments
Looking for something else?
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Sleeve gastrectomy
The current UK workhorse of bariatric surgery.
Learn more -
Endoscopic sleeve gastroplasty
The endoscopic cousin of plication — no laparoscopy.
Learn more -
Gastric bypass
Roux-en-Y — superior for T2 diabetes remission.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more