The New Zealander made only one unenforced switch, bringing in Rhys Webb for Gareth Davies at scrum-half.
Sam Warburton, Alun Wyn Jones and Alex Cuthbert miss out with injuries.
"We wanted to give the players a chance to sort of put behind us a disappointing first half from last week," said Gatland.
Flanker Justin Tipuric, second row Luke Charteris and Hallam Amos are drafted in to the team in place of the injured players.
Dan Lydiate will captain the side in the absence of Warburton and regular stand-in Jones.
Gatland said he had shown faith in players who had performed well in earlier matches, a fact he acknowledged was hard on hooker Ken Owens who makes his fourth appearance on the bench in this Six Nations championship.
"He's unlucky, really unlucky," he added.
"We felt that [hooker] Scott Baldwin has gone pretty well throughout the campaign.
"Ken has been brilliant for us coming off the bench and I know that's a tag he doesn't want to keep, but he is unlucky not to get a start."
Scarlets hooker Owens had made 38 appearances for Wales, but started in only eight of those games.
Wales go into the match against Italy knowing a win will secure second place in the championship for the first time since it was expended to include six countries.
Lydiate will lead Wales for the first time in a Test match, having previously led them in a midweek match against EP Kings on the summer tour of South Africa in 2014.
He said it was a "personal honour for me and my family" and added his captaincy style was unsophisticated.
"I wouldn't ask someone to do something that I wouldn't do myself, so I'll throw myself in front of a bus so that's what I expect everyone else to do," he said.
"There are plenty of leaders and a wealth of experience in the team."
Wales coach Warren Gatland resisted making more changes to his team against Italy to give his men a chance to make up for their poor start at Twickenham.