A new experimental obesity surgery promises to reduce the size of the stomach without any major surgery.
Instead of accessing the stomach through the abdomen, doctors insert a flexible tube the diameter of a garden hose down the throat. The tube is equipped with a camera and a device to allow surgeons to staple the stomach smaller.
All of the work is done from within so there are no stitches or scars and the operation takes less than two hours.
The procedure turns the stomach into a narrow tube, slowing the food as it moves from the stomach and helping patients feel full more quickly and therefore eat less.
So far, the procedure has been tested on only 200 U.S. patients and 100 in Europe. But the results look promising, doctors reported at the Digestive Disease Week conference in Chicago this week.
Data on 29 of the patients in Europe and Mexico showed that before the procedure, they weighed an average of 130 pounds over their ideal body weight, reported Dr. Gregg Nishi, a surgeon at Cedars-Sinai Medical Center in Los Angeles.
The 27 subjects who stayed in the study for six months lost almost 40 per cent of their excess body weight, and nine patients who reached the 12-month interval lost almost 50 per cent of their excess weight.
"I think this is going to revolutionize the way weight loss surgery is performed," said Nishi.
The "transoral gastroplasty" procedure does carry risks, including perforating the esophagus. Nishi said that has happened once, but he said there have been no other major complications. Patients generally report throat pain after the procedure but have a quick recovery.
Patients will be followed for at least another year, with final results expected in 2010, said Dr. Edward Phillips, Chief of General Surgery at Cedars-Sinai, who also worked on the study.
"If this non-surgical procedure provides results that are comparable to those of conventional weight loss surgeries, it may provide a good option for patients who need to lose a significant amount of weight but do not wish to have surgery," said Phillips.
Patients in the study were randomly selected to undergo either the operation or a "sham" procedure, which involved sedation and the tube, but no stapling. Nishi noted that some study patients who unknowingly underwent the fake procedures also lost weight. Data comparing the "placebo" surgery against the real surgery were not yet available.
The surgery differs from gastric bypass, which is a more complex kind of surgery that makes the stomach smaller by creating a small pouch at the top of the stomach using surgical staples or a plastic band. The smaller stomach is then connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine.
Gastric bypass is far more invasive than this experimental procedure and can increase chances for malnutrition because it repositions how the stomach attaches to the intestines to restrict calorie absorption.
Another popular weight-loss surgery option involves putting an adjustable band around the top part of the stomach to create a small pouch.
The American Society for Metabolic & Bariatric Surgery president, Dr. Scott Shikora called the oral procedure exciting, but added, "It is too early for us to say this is going to be a breakthrough."
