Wednesday, December 22, 2010

New stomach shrinking procedure helps patients lose weight

A new experimental stomach shrinking procedure is helping obese patients lose weight, without bands, staples, or implants.
Reporter: Maureen McFadden

A new experimental stomach shrinking procedure is helping obese patients lose weight, without bands, staples or implants.

Every year, Americans spend $30 billion a year on diets, weight loss products and other weight loss services. Now, more than 200,000 people a year are going even further than pills or diets, and turning to surgery.

Teresa Flowers, a 54-year-old lifelong dieter, has tried numerous diets which all have failed. With a job that keeps her sitting eight hours a day, Flowers was ready to try something big.

"It's very frustrating to be obese and feel like your back is up against a wall and there's basically no hope,” says Flowers.

She became one of the first patients in the U.S. to undergo a new experimental weight loss surgery called gastric imbrication.

Gastric imbrication is a procedure that shrinks the volume of the stomach by 90-percent by folding and stitching it into a small, narrow tube.

Sunil Sharma, a doctor at the University of Florida’s Weight Loss Surgery Institute, says, “That translates into easy filling of the stomach, but eating less quantity of food."

"The fact that my stomach is only ten-percent the size that it was, it makes me make a conscious effort to not eat, and to eat wisely,” says Flowers.

The minimally invasive procedure is performed through several small incisions in the abdomen, or one cut through the belly button.

A pilot study in India on 30 patients showed participants losing 40-percent of their excess weight within the first year after surgery, all along with quicker recovery and fewer complications.

Two weeks after having the surgery, Teresa Flowers already had lost 23 pounds.

“I started at 313. I'd love to be down to about a hundred fifty pounds,” says Flowers.

Although at least two U.S. studies are now underway, gastric imbrication is still considered experimental and is not covered by insurance.

However, Sharma says that because it is less invasive than other bariatric procedures as well as not requiring the removal of any stomach tissue, the cost is much lower.

Gastric imbrication costing $12,500, compared to as much as $16,000 for lap band surgery and $19,000 for gastric bypass.

The process can be adjusted or even reversed as a result of the non-dissolvable sutures used in the procedure.

REPORT: MB #3228

BACKGROUND: There are a number of stomach-shrinking procedures that offer surgical solutions to bariatric complications. The most common is the Roux-en-Y Gastric Bypass procedure, wherein the patient's stomach size can be decreased by surgically segmenting it into two parts, using surgical stables or a plastic band. The top part is formed into a small, golf ball sized pouch, which is then connected to a section of the small intestine, bypassing about five feet of intestine before reconnecting. The small pouch allows the patient to feel full after consuming only one to two ounces of food, and the bypassed intestine prevents the patient from absorbing additional calories. The next procedure is called Gastric-Band Surgery, where an inflated, silicone band is wrapped and tightened around the upper area of the stomach to create a pouch which only allows about an ounce of food to enter. Saline is used to inflate the band, and is fed into a plastic tube, which is attached to the band. During Gastric Sleeve Surgery, anywhere from 60-75% of the stomach is actually removed, leaving a sleeve-shaped formation which can receive and break down food. Also known as a gastrectomy, or "Sleeve gastrectomy," this procedure naturally limits caloric intake. (SOURCE: University of Florida Weight Loss Institute and

GASTRIC IMBRICATION: Also called Gastric Plication Surgery, this reversible procedure is accomplished without removing any portions of the stomach, re-routing the small intestine, or using any stapling or cutting. During this procedure, the bulging portion of the stomach is folded onto its other half, and held in place with non-absorptive sutures. The stomach's size is therefore decreased to a gastric sleeve proportion, but without using any of the potentially harmful, foreign objects to do so. Unlike Gastric Bypass, Gastric Imbrication does pose the risk of malabsorption, and is in fact considered to be a low-risk and low-cost procedure with a quick recovery. The procedure is certainly promising, but there are no long-term results reported at this point. (SOURCE: University of Florida Weight Loss Institute, Weight Loss Surgery News)

OBESITY STATISTICS: An August, 2010 obesity reports called "Vital Signs: State-Specific Obesity Prevalence Among Adults -- United States, 2009," found that in 2007, no state had met the 2001 Surgeon General-issued obesity goals, published as the Call to Action to Prevent and Decrease Overweight and Obesity. These goals aimed to reduce the presence of obesity amongst American adults to only 15%. The overall self-reported figure was in fact 26.7%, varying over many characteristics. The highest numbers were found in adults aged 50-59, 31.1%, 60-69, 30.9%, non-Hispanic blacks, 36.8%, (non-Hispanic black women in particular, 41.9%), Hispanics, 30.7% and Midwestern and Southern residents, 28.2% and 28.4% respectively. In all, men measured at 22.9% and women at 18.6%, with the largest group of them being found in the group without a high school degree and the smallest in the group with a college degree.

Sunil K. Sharma, MD
University of Florida
Weight Loss Institute
(904) 633 -0834


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