No Scars: Oral Obesity Surgery

Doctors Testing A New Surgery That Snakes A Tube Down Throat To Snap Staples In Stomach

(CBS/ AP)  Doctors are testing a new kind of obesity surgery without any cuts through the abdomen, snaking a tube as thick as a garden hose down the throat to snap staples into the stomach.

The experimental, scar-free procedure creates a narrow passage that slows the food as it moves from the upper stomach into the lower stomach, helping patients feel full more quickly and eat less.

Doctors say preliminary results from about 200 U.S. patients and 100 in Europe look promising.

And CBS News medical correspondent Dr. Jennifer Ashton agreed: she said on The Early Show Thursday that the procedure sounds hopeful for people suffering with obesity.

After about 18 months, obese European patients have lost an average of about 45 percent of their body weight, said Dr. Gregg Nishi, a surgeon at Cedars-Sinai Medical Center in Los Angeles. He discussed the European and U.S. studies during a Chicago conference this week for digestive disease specialists.

The procedure is only being done in the studies, which recently ended enrollment. Makers of the device used in the operation plan to seek federal approval if the research continues to go as planned.

Ashton, who performed a year of clinical bariatric surgery research in Pittsburgh, Pa., with surgeons who did more than 1000 obesity procedures, said the procedure has significant advantages, including no skin incisions and no surgical pain.

Ashton added that patients will benefit from the short recovery time.

"They can be back to work the next day," she said.

But, she said the absence of long-term data on the surgery, such as long-term weight loss for patients or reduced cases of diabetes, is a drawback.

While the two studies are still under way and only brief details are being released, Nishi said results so far are slightly better than typical results from with conventional stomach stapling.

In the experimental study, risks include perforating the esophagus, as Nishi said happened to a patient at another center, but otherwise, he said, there have been no major complications.

But in Ashton's opinion, the risks are similar to stomach stapling. She explained to Early Show co-anchor Harry Smith that there is the possibility of gastric bypass-leaks in the staple line, general anesthesia risks, staple-line failure due to over-eating, and perforation of the stomach.

Some study patients have lost weight after unknowingly undergoing fake procedures -- sedation and the tube, but no stapling. Results comparing them with the real thing aren't yet available.

Liliana Gomez, an administrative coordinator at Cedars-Sinai, was among the first Americans to have the scarless obesity surgery last year, as a test case for the U.S. study. She had planned on more invasive conventional surgery until learning that doctors at her hospital were studying the scarless stapling technique.

"When I found out it was going to be oral, through your mouth, I was like, 'Wow, that's kind of different,"' she said.

Since her operation in August, Gomez has lost about 40 pounds and dropped from size 22 to size 16.

The 35-year-old mother of three has a long way to go - she's still obese according to body mass index standards. But Gomez says she has cut her meal portions by more than half and still feels full, and is optimistic she'll continue to lose weight.

The new method is part of a medical movement to perform surgery through body openings such as the nose, mouth and vagina instead of making cuts. The idea is to reduce chances of infection and pain, and speed recovery. With no scars, there are cosmetic advantages, too.

Gomez had considered a gastric bypass operation, a more complex kind of stomach stapling, but worried about risks from that surgery. It reduces the stomach to the size of a golf ball and reroutes the digestive tract.

Whether done through one large abdominal incision or several tiny ones, gastric bypass is far more invasive and increases 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 experimental method Gomez had is the oral version of a different kind of stomach surgery, which reduces the size of the stomach with staples but doesn't reroute the digestive system.

Surgery is generally considered a last-resort treatment for obesity, which affects more than 15 million Americans. Still, demand is high. More than 200,000 Americans are expected to have conventional forms of obesity surgery this year, according to the American Society for Metabolic & Bariatric Surgery.

Dr. Scott Shikora, the society's president, called the oral procedure exciting and innovative, but said, "It is too early for us to say this is going to be a breakthrough."

Shikora said many U.S. obesity surgeons prefer the rerouting surgery or flexible bands, and that it remains to be seen whether the oral method has the same drawbacks as more outmoded stapling procedures.

The U.S. study is taking place at 10 centers. Patients will be followed for at least one year, with final results expected in 2010. They are randomly selected to undergo either the operation or a sham procedure.

Nishi said of 25 patients enrolled at his hospital, 17 got the real treatment, with no complications.

"I'm very impressed with it," Nishi said. So far, it looks like "a viable alternative," he said.

Satiety Inc., a California company that created the medical devices used in the technique, is paying for the research. Nishi said he has no financial ties to the company.

At Washington University School of Medicine in St. Louis, where the first U.S. procedure was done last summer, about 30 patients have undergone the treatment. Side effects have been minimal, including sore throats, nausea and some abdominal pain lasting less than a week, said Dr. J. Christopher Eagon. He said weight loss results from his center aren't yet available.

[funslideds]

I've known one individual personally, who had bariatric surgery.

They have had no end of health problems, secondary to the surgery, since.

Personally, I'd rather be overweight than have bariatric surgery.

[ass_u_me]

Posted by drivelphobe at 5:28 PM : Jun 4, 2009

What are you basing "majority" on? Do you have some sort of survey. As far as I know, there isn't any data on that. If so, please enlighten us.

Are brain illnesses relevant in weight? Mental illness, perhaps?

Recently, there is some evidence that being overweight, to a degree, is preferable to weighing less.

http://news.bbc.co.uk/1/hi/health/4468001.stm

[ass_u_me]

cr-ap. I had crafted a post and it 'disappeared' into cyberspace.

[ass_u_me]

ass_u_me..

Majority was in my original post and you missed it.

Anyway, if you don't care that is fine. I care because of the massive burden obese people put on our health care system, both in benefit payout and increase in insurance premiums. I consider obesity, in the majority of cases, to be self imposed. Millions of claims are made each year for disability benefits, workmens comp and medical benefits. Unfortunately, millions are paid out due to pre-mature death as well. It is just a waste.

Gotta go now. It's time for a run and a few hours in the gym.
Posted by drivelphobe at 5:28 PM : Jun 4, 2009
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some issues with your posts ...

A) how do you know that the "minority" of overweight individuals do not have an "injury or disease"?

Is mental illness a disease? Most people would say so. Is mental illness a disease of the brain, again, most people would agree. A good example is Anorexia. Most people would agree the Anorexia is a "brain disease". Is it a health concern, in general? Absolutely. Would you fault an individual with Anorexia for not having the Willpower to eat more? To exercise Less?

B) Weight may not have as much to do with health as you think (to a point). Recently, there has been the realization that being "a little overweight" is healthier than being underweight
(http://news.bbc.co.uk/1/hi/health/4468001.stm).

[drivelphobe]

ass_u_me..

Majority was in my original post and you missed it.

Anyway, if you don't care that is fine. I care because of the massive burden obese people put on our health care system, both in benefit payout and increase in insurance premiums. I consider obesity, in the majority of cases, to be self imposed. Millions of claims are made each year for disability benefits, workmens comp and medical benefits. Unfortunately, millions are paid out due to pre-mature death as well. It is just a waste.

Gotta go now. It's time for a run and a few hours in the gym.

[ass_u_me]

Unless I am injured or become seriously ill, I will always remain as fit as possible for my age. I am in great shape and put people thirty years my junior to shame. Any one realizes that age takes it toll. Is this something you just realized?
Posted by drivelphobe at 4:46 PM : Jun 4, 2009
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nope. don't see "majority" there.

[ass_u_me]

ass_u_me..

You didn't read my post thoroughly. There are those with medical conditions that prevent maintaining a healthy body. My gripe is with those who refuse to even try to keep the pounds off.
Posted by drivelphobe at 4:58 PM : Jun 4, 2009
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Fine. Here's my gripe with you.

When you speak of an obese person who you don't know (of) personally, you have NO way of knowing WHY they are that way. Judging overweight people is simply that, judging. It's just discrimination based upon assumptions.

Even if someone is overweight because they "eat too much", so what. I'm sure you have your 'vices'. I really don't care what they are if they don't harm anyone.

[drivelphobe]

ass_u_me..

Did you read the word, "majority"? The minority are those who have the medical issues.

[drivelphobe]

ass_u_me..

You didn't read my post thoroughly. There are those with medical conditions that prevent maintaining a healthy body. My gripe is with those who refuse to even try to keep the pounds off.

[drivelphobe]

Meg,

Good to hear from you. Your post was impressive and I'm glad you were funnin" with me. I too am health conscious, as is ass_u_me appears to be. You are correct that good health and exercise helps improve one's resistance to injury and illness. I am happy to hear you survived the bout with cancer. It can strike anyone at anytime. Genetics is a great part of health, but it also take some degree of motivation to persist.

I am pretty tough on people who could so easily be fit but just won't get on the bandwagon. Very frustrating.

Have a great day and stay healthy.