Stomaphyx: Gastric bypass pouch repair

Stomaphyx a novel approach to fixing a gastric bypass pouch that has stretched

San Antonio, TX

Bariatric surgery has been a real boon for patients who need to lose massive amounts of weight. But sometimes, the small pouches created by gastric bypass procedures expand. Now, there’s a new procedure to help fix that problem.
Claudia Sisk, 51, of San Antonio lost more than 80 pounds after her original bypass surgery several years ago, but her pouch began to expand and she started regaining unwanted weight.

“Now I see myself eating a little more than usual so that’s why I went back and asked what else, was there a way they could tighten this pouch and make it smaller,” Sisk said.

“Previously, we would have to go in and operate and make incisions on the skin,” explained Dr. Mickey Seger, a bariatric surgeon. “It’s a very high risk operation. There’s over a 40% chance of having a problem or a complication with a re-do surgery like that.”

At Methodist Specialty and Transplant Hopsital, Sisk had a new procedure called Stompahyx. No cuts in the abdomen. The surgeon uses an endoscope to look down into the pouch, and a special tool to make it smaller.

Here’s how it works. The instrument is guided into the stomach. A vacuum sucks a small piece of tissue into the tube, and then the device injects a fastener into place, creating a fold in the stomach. A series of folds literally closes down the pouch, making it harder for the patient to overeat.

“It’ll dramatically reduce the amount of food she can take before being full,” Seger said. “Whereas now she can eat pretty much a regular-sized meal, we’ll be able to get her satisfied with less than a cup.”

The procedure takes less than an hour. There are no cuts and no scars. Sisk is hopeful this novel approach will be the help she needs to achieve her goal.

“Hopefully, I’ll get under 200,” Sisk stated. “I want to be, you know, 180 to 200.”

There is no big recovery with this procedure. Patients are out of the hospital within 24 hours and back to work almost immediately. The idea is that they’ll start losing weight once again.

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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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Gastric bypass alternative Stomaphyx involves no Incisions, no stitching

Denver, CO

Imagine surgery without incisions. No cutting, no stitching -- all the work is done through the patient's mouth. A doctor at one local hospital says it can mean a quicker recovery with fewer complications.

CBS4's Kathy Walsh went to Presbyterian/St. Luke's Medical Center to follow a woman who had a gastric bypass in 1999. It seemed like any other operation. Doctors and staff worked in a sterile environment on a patient who was closely monitored.

"She lost a fair amount of weight but then started to gain some weight back," Dr. Matthew Metz said.

Her stomach had stretched and she came in for a gastric bypass revision; a procedure called Stomaphyx, making the stomach smaller. But in this surgery there was no cutting, no incisions at all; it was all done through her mouth.

"We actually have a sewing machine that we mount on the end of a scope that goes down the mouth and we're able to re-sew the stomach and the connection to the small intestine without making any incisions in the abdomen," Metz said.

Metz says he is the first in the region to offer the operation.

"Doing this through the mouth enables you to do the procedure much faster," Metz said. "The recovery time is much shorter."

Metz said the potential for bleeding and infection with a traditional revision surgery can be as high as 60 percent. Through the mouth it's just 3 percent. With another incision, a patient can spend 5 days or longer in the hospital, according to Metz.

The woman went home the same day, ready to get back on track managing her weight.

The Stomaphyx device was approved by the Food and Drop Administration in 2007.

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StomaphyX: Gastric bypass surgery without the incision

Miami, FL

Doctors have announced a ground-breaking procedure. It allows them to perform surgery without making an incision, anywhere. CBS4's Dr. Sean Kenniff explains how it works.

Darlene Dillard lost 100 pounds with gastric bypass. But like 1/4 of people who undergo obesity surgery, a few years later she started to gain weight back.

"I had gained about 30 pounds outside of my range of weight," said Dillard.

Instead of operating again, doctors did something drastically different. It's called Stomaphyx--a natural orifice surgery.

"It is going to be a totally different new era of surgery," said Dr. Michel Gagner from Miami's Mount Sinai Medical Center.

He says it really is a surgical revolution -- with no incisions surgical instruments are inserted through natural orifices. In this case: Darlene's mouth, to make her stomach pouch smaller.

CBS4's Dr. Sean Kenniff said natural orifice surgery isn't limited to obesity procedures. Doctors are now perfecting techniques to treat everything from appendicitis to cancer."

"Removal of part of the liver, removal of adrenal, removal of part of the stomach, doing bowel connections," explained Dr. Gagner.

And many other procedures are being performed through the rectum, esophagus and vagina.

" It's just the beginning, it's going to explode in the next five years, you're going to be hearing a lot more about this," said Dr. Gagner.

With Darlene's weight loss, her medical problems disappeared.

"There was borderline diabetes, borderline hypertension," explained Darlene. "I had stress fractures of my feet."

And she hopes the new no-incision surgery will keep the pounds, and those problems away.

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Stompaphyx gastric bypass revision

Miami Beach, FL

A quarter of a million obese Americans undergo gastric bypass surgery for weight loss every year, but 20 percent of those surgeries will fail with time, doctors said.

That's what happened to Darlene Dillard, who regained 30 pounds after losing 100.

"My gastric bypass started failing five to six years out of the surgery," she said. "Increased appetite, the urge to eat constantly."

So, Dillard became the first South Florida patient to have Stomaphyx, a natural orifice surgery performed without any incisions.

"There's a suction apparatus that sucks the inside of the pouch, then we fire this double T fastener," said Dr. Michel Gagner of Mount Sinai Medical Center.

The suction creates folds that reduce the stomach size. In Dillard's case, doctors said they had to use 18 T fasteners around her stomach.

"I do have some discomfort in the lower chest area," Dillard said. "Not pain, just discomfort."

Dillard's doctors said they worry about bleeding from inside from the fasteners.

"They can create a little amount of bleeding," Gagner said.

Dillard said 24 hours after the procedure she was ready to go home.

Stomaphyx is for patients who have regained weight after bariatric surgery.

"It's going to be more for the 100 pounds or less of weight loss," Gagner said. "Because it is a restrictive operation. It restricts the volume in the inside of the stomach."

Mount Sinai Medical Center is one of only two hospitals using Stomaphyx for gastric bypass revision.

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StomaphyX: New procedure for gastric bypass surgery patients

Los Angeles, CA

A new procedure could help gastric bypass surgery patients who may need a second surgery.

The device is called stomaphyx and only a handful of surgeons are trained to use it.

It's inserted through the mouth to do corrective surgery in order to shrink the stomach again.

The good news, doctors don't have to cut the patient open, but there's a catch.

"We can fix the stomach, but if they don't fix their lifestyle and if they don't get involved in the support groups and follow ups with the surgeon then the stomach won't work the way they want it to work," said Dr. Julie Ellner, Alvardo Surgical Weight Loss Director.

Doctors recommend repeated follow-up visits, and a committment to exercise and nutritional programs.

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Mercy Medical in Rockville Center leads StomaphyX bariatric surgery project

Rockville Center, NY

Dr. Shawn Garber, chief of bariatric surgery at Mercy Medical Center in Rockville Centre, and a hospital team have been training surgeons from across the country in a noninvasive procedure that reduces stomach size in patients who have had previous weight-loss surgery.

Mercy is one of just three hospitals nationwide -- the others are in Ohio and Florida -- selected by EndoGastric Solutions of Redmond, Wash., to train surgeons how to use its StomaphyX device to perform stomach surgery without making an incision. In addition to Garber, Dr. Spencer Holover also performs the StomaphyX procedure.

The device is inserted into the mouth and through the esophagus to the stomach, where it can tighten existing pouches formed by previous gastric bypass surgery. During bypass, surgeons make a pouch out of a small portion of the stomach, and food is directed to it. The pouch's small size makes patients feel full sooner, helping them to eat less and lose weight. More >>

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StomaphyX: Incisionless Gastric Bypass Surgery Revision

NEW YORK (Reuters Health) - When weight loss stalls or other problems arise years after gastric bypass, the surgery can be successfully revised with an incisionless, from-the-inside approach, researchers from Ohio State University in Columbus report.

The technique, involves the use of a device called StomaphyX, which has been approved by the US Food and Drug Administration. The device is inserted with an endoscope via the mouth into the stomach, where suction pulls the stomach walls against the device. Staple-like fasteners are then deployed to create pleats in the walls, effectively reducing the size of the stomach.

"The incisionless surgery helps to recreate the patient's smaller stomach, causing early satiety and further weight loss," Dr. Dean Mikami, a surgeon involved in the development of StomaphyX and the first to perform the operation in the US, said in a statement. "This is currently the only endoscopic or nonsurgical way to reduce the size of the stomach after gastric bypass surgery."

Since April, a total of 22 such gastric bypass revisions have been performed at OSU. On average, patients dropped 10 pounds after 1 month, 15 pounds after 2 months, and 20 pounds after 3 months.

According to Mikami, between 10 and 15 percent of patients who undergo gastric bypass surgery will require a revision 2 to 15 years later.

Good candidates for treatment with StomaphyX, Mikami said, include those who have regained some of their weight after gastric bypass surgery and are compliant with their diet, exercise regularly, and do not experience early satiety during meals.

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