StomphyX: Gastric bypass surgery without a scalpel

East Brunswick, NJ

Imagine having surgery without being cut. No knife piercing through your skin — even if you can't feel it. No ugly, deformative scars. No side effects. It is possible, and Maria McDonald is living proof.

A new type of abdominal surgery — natural orifice translumenal endoscopic surgery — eliminates the need for a scalpel and reduces recovery time, as well as patient pain and infection.

For the 20 percent of Americans who need secondary gastric bypass surgery, this procedure — which uses a device called StomaphyX — is noteworthy because the transoral incisionless insertion has surgeons entering the body through the mouth, not anywhere in the abdomen.

THEN AND NOW:

McDonald thought she was on her way to having the body she always wanted when she underwent Roux-en-Y gastric bypass surgery in 2002. At the time, she weighed 300 pounds and had tried every fad diet.

"I tried the grapefruit diet, the cabbage soup diet, Weight Watchers and Jenny Craig," said McDonald, a social worker from the Somerset section of Franklin. "I just never really was successful at keeping it off."

Gastric bypass helped her lose about 150 pounds, but there were complications — including nausea and indigestion. So when McDonald, 36, found out she needed a second gastric bypass, she was relieved to find out her doctor at Overlook Hospital in Summit was going to use the Stomaphyx technique.

The procedure was much different from her first surgery, which involved a large incision and made her tired for about six months.

"Even though its surgery, it's all through the mouth," Dr. Muhammad Feteiha, director of minimally invasive surgery at Overlook said before the surgery. "So when Maria wakes up, she won't have any incisions. She'll have very minimal pain, and she'll be able to go home."


MYRIAD BENEFITS:

Lack of pain and quick recovery time are not the only benefits of the Stomaphyx procedure. Others include:

# Less risk of infection.

# Shorter surgery time (it takes about 45 minutes).

# Patients can return to work in as little as one day.

If McDonald were to have traditional gastric bypass surgery again, it would involve reopening her incision, removing part of the pouch and small intestine, and then reattaching it, Feteiha said. And she would have to stay in the hospital for seven to 10 days.

LIGHTLY USED:

Only about 150 doctors are using the Stomaphyx technique around the country. It was approved in March 2007 by the U.S. Food and Drug Administration, and physicians starting training with the Stomaphyx device that fall.

To date, about 500 patients have had the surgery, which allows doctors to reshrink the stomach without even using a scalpel. Research is being done to see if Stomaphyx can become a primary surgery in the future, Feteiha said.

BARIATRIC SURGERY:

For patients who are undergoing bariatric surgery for the first time and choosing to have a gastric band, Dr. Ajay Goyal, medical director of the Center for Advanced Bariatric Surgery at Overlook, performs a new technique that requires only two incisions.

Traditionally, the banding procedure requires four or five incisions around the abdomen. When it comes to severe obesity, traditional weight-loss methods — diets, weight-loss pills, exercise programs — do not work for most people.

Bariatric surgery is recognized by the American Heart Association and the American College of Surgeons and endorsed by the National Institutes of Health as a safe way to help people lose weight and minimize or even eliminate diabetes and hypertension, sometimes within months.

The Center for Advanced Bariatric Surgery at Overlook Hospital is available to individuals who are more than 100 pounds overweight and have tried and failed to lose weight, or who suffer from obesity-related health problems such as heart disease, diabetes or sleep apnea, joint disease or infertility.

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