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Incisionless procedure performed to correct weight gain after gastric bypass
Incisionless surgery may help alleviate complications associated with traditional revision surgery.
Surgeons at Ohio State University Medical Center recently successfully performed endoluminal tissue approximation, an incisionless surgery to shrink the size of a patient’s stomach.
“It is estimated that more than 1 million people in the last 15 years have undergone gastric bypass surgery,” said Dean Mikami, MD, assistant professor of surgery in the division of general and gastrointestinal surgery. “About 10% to 15% of that group two to 10 years out may need a revisional procedure to reduce the size of their gastric pouch for further weight loss or to treat a postoperative bariatric syndrome, such as late dumping.”
Bariatric treatment options such as incisionless surgery offer patients a safe way to help resolve comorbidities associated with obesity, including type 2 diabetes and lipid metabolism disorders, Mikami told Endocrine Today.
Endoluminal tissue approximation is FDA approved and involves passing a tube through the mouth rather than making surgical incisions. The procedure creates a slower emptying of the stomach, a decrease in the stretch of the stomach and a smaller opening of the stomach’s pouch.
The device used in the procedure (StomaphyX, EndoGastric Solutions) has advantages over traditional revisional bariatric surgery, including no incisions or scars, less pain and a lower rate of complications. Surgery is an outpatient procedure, according to Mikami.
“The incisionless surgery helps to recreate the patient’s smaller stomach, causing early satiety and further weight loss,” he said in a press release. “This is currently one of only a few endoscopic ways to reduce the size of the stomach after gastric bypass surgery.”
“It’s exciting technology, but it is still preliminary because we need to know the short-, mid- and long-term results,” Kelvin D. Higa, MD, clinical professor of surgery, University of California, San Francisco, and president of the American Society for Metabolic and Bariatric Surgery, told Endocrine Today.
Possible candidates for incisionless surgery include patients who have undergone gastric bypass surgery for obesity, have regained some of the weight they lost and are compliant with their diet and exercise regimen, according to Mikami.
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| Stomach tissue being suctioned into the Stomaphy X device to create a pleat of tissue. Source: EndoGastric Solutions | |
“Incisionless surgery, or natural orifice surgery, is currently at the forefront of surgical procedures,” he said. “This could perhaps lead to the development of new ways to adjust the stomach, even before weight gain occurs.” – by Christen Haigh
Dr. Mikami receives teaching and speaking honorarium from Endogastric Solutions.