Weight Loss Surgery News Blog

Link: http://www.robertorizzi.com/obesity-surgery.htm

A new device called “StomaphyX” gained FDA approval in 2007. The stomach stretches over the years and can gradually undo the benefits of the bariatric surgery. For those who may need a secondary gastric bypass surgery, this new procedure — which uses a device called StomaphyX — is noteworthy.

It is a tiny sewing machine lowered from the mouth to the stomach. Using an endoscope, the doctor can guide the StomaphyX to stitch together folds in the stomach, and again reduce the size of the stomach. There is no official certification for bariatric surgeons.

In 2007, 205,000 obese Americans underwent bariatric bypass surgery. The cost of bariatric surgery is in the $25,000 range with insurance covering none or some of the procedure and after care. Pre and post -care for bariatric patients requires assistance of a nutritionist, physiotherapist, gastroenterologist and psychologist.

Due to potential bleeding, infection, intestinal obstruction, hernias, nutritional deficiency and gallstones, to name a few complications, bariatric surgery can contain real risks. Less invasive alternatives reduces the risks and are being further developed and clinical trials are done in Brazil and other countries

NOTES, natural orifice translumenal endoscopic surgery, eliminates the need for a scalpel and reduces recovery time, as well as patient pain and infection.

A non-surgical option awaiting FDA approval is the Endo-Barrier. This might be of interest for the obese and as well those with diabetes, type 2. This gastrointestinal liner is inserted through the patient’s mouth and into the first two feet of the small intestine. The Endo-Barrier can be removed and may provide a safer alternative with more rapid recovery and lower costs by eliminating hospital stays. The Endo-Barrier prevents food from coming in contact with the wall of the intestine. This may have an effect on the patient’s uptake of both nutrients and calories. It may also have a metabolic effect similar to Roux-en-Y gastric bypass surgery.

Endo VX and Maestro are two devices that can block the vagus nerve to assist in dropping 20 to 30 percent of excess weight. The Maestro, similar to a pacemaker, sends tiny electrical signals to the nerve that regulates digestion in the stomach and pancreatic fluid release. These products are only used in clinical trials, and nine of these products will be available until 2010 id trials are positive.

Link: http://www.robertorizzi.com/obesity-surgery.htm

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

For those patients of Americans who may need a secondary gastric bypass surgery, this new 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.

Only a few doctors are experimenting with the Stomaphyx technique around the country. It was approved in March 2007 by the U.S. Food and Drug Administration, and physicians started training with the Stomaphyx device that fall. Research is being done to see if Stomaphyx can become a primary surgery in the future.

Laparoscopic Roux-en-Y Gastric Bypass Surgery, is the most common and proven successful procedure. All other procedures are not having the same proven results, do not have good track records, are not reversible or do have an higher risk of complications. Surgical procedures such as NOTES and Stomaphyx are still being analyzed and are not commonly performed.

Link: http://www.robertorizzi.com/obesity-surgery.htm

A robotic-assisted gastric bypass surgery was already done in the United States, now one was performed for the first time in Edmonton, Canada.

Bariatric doctors in Edmonton are hopeful that the innovative and less invasive procedure will help attract patients (about one-quarter of Canadian adults are obese), medical talent and resources to the city for this growing and still relatively new area of medicine.

A gastric bypass, a procedure that shrinks the stomach and allows food to bypass part of the small intestine, requires a lot of suturing because of the size of the patient and the area operated on.
Suturing is a key area in which the robot can step in and help.

But the robot can't do everything, such as suction or place clips on bleeding tissue, so at least one surgeon must be in the operating room at all times while another controls the computer console.

A study that recently appeared in the Journal of Robotic Surgery found that robot-assisted surgery significantly lowered the risk of gastrointestinal leaks, a rare but serious complication.

On the downside, robotic-assisted gastric bypass surgery currently takes longer to perform than a conventional procedure.

Also, the technology is not cheap and the operations are more expensive than conventional ones. The robotic equipment (a U.S.-made da Vinci Surgical System) used in Edmonton for gastric bypasses and urological surgeries costs $4-million.

Link: http://www.robertorizzi.com/bmi.htm

The two main causes for obesity are poor nutrition and lack of physical activity.

But a new study suggests genetic factors underlying the different reaction of people to lifestyle and environmental conditions.

Obesity is known to increase the risk of chronic disorders, such as diabetes (type 2).

An international team of scientists with German participation through the Helmholtz Zentrum München identified six new obesity genes.

So far, the scientists have analyzed two million DNA variations in 15 genome-wide association studies with a total of more than 32,000 participants. The hereby identified candidate genes were validated in 14 further studies including 59,000 participants. In addition to the FTO and MC4R genes already known, it was now possible for six more obesity genes to be identified: TMEM18, KCTD15, GNPDA2, SH2B1, MTCH2 and NEGR1.

With the exception of the SH2B1 gene, which plays a role in the leptin signalling and thus in the regulation of appetite, none of the other five genes was hitherto discussed as obesity genes.

Link: http://www.robertorizzi.com

Obese women are at an increased risk of developing ovarian cancer compared with women of normal weight.

The new research indicates that obesity may contribute to the development of ovarian cancer through a hormonal mechanism.

While studies have linked excess body weight to higher risks of certain cancers, little is known about the relationship between body mass index and ovarian cancer risk. Ovarian cancer is the most fatal of gynecologic malignancies, and has a 5-year survival rate of only 37 percent.

The study findings are published in the Feb. 15 issue of the journal Cancer.

Women who've had children and who've used oral contraceptives appear to have a decreased risk of the disease.

For the new study, investigators from the U.S. National Cancer Institute followed almost 95,000 U.S. women, aged 50 to 71, for an average of seven years.

Overall, obese women -- those with a body mass index (BMI) or 30 or above -- had a 26 percent higher chance of developing ovarian cancer than women of normal weight, a figure the researchers said was not statistically significant.
The researchers documented 303 ovarian cancer cases during this time and noted that among women who had never taken hormones after menopause, obesity was associated with an almost 80 percent higher risk of ovarian cancer.

According to the study authors, the findings indicate that obesity may increase ovarian cancer risk through hormonal effects. Specifically, excess fat increases production of estrogen, which may spur the growth of ovarian cancer.