New bariatric surgery technique can help people lose weight less invasively

It can improve life expectancy, resolve Type 2 diabetes, and cut risk of coronary disease in half.

Bariatric surgery is helping a lot of people take control of their weight and their lives.

However, re-routing organs to achieve that goal can be scary for those considering operations.

Now, a new technique that has the potential to be undone is giving patients a less invasive option.

Ryan is full of energy, and because of her weight, his mom could not keep up.

Tracey Bartholow, who had gastric plication, says, "I didn't want to sit on the sidelines and just watch him go through life. I wanted to enjoy it with him."

Of all her options, she decided to take part in a case study for gastric plication.

Dr. Stacy Brethauer, a bariatric surgeon, says, "We're not removing anything. We're simply in-folding the stomach on itself."

The stomach's sutured and becomes tubular.

Its volume is reduced by 80%, so patients can eat less and still feel full. The operation's less invasive than gastric bypass, or a gastric sleeve procedure. Those involve removing a part of the stomach or re-routing the intestines

"We've seen, overall, less risk with this procedure than we have with some of the other procedures that we do."

While still investigational, it could be used to augment a lap-band, a removable device to aid weight-loss. There is also a possibility that gastric plication could be undone.

"We think that it's going to be feasible to restore the anatomy, so that you can convert it to another procedure if you needed to."

Dr. Brethauer says gastric plication can help get rid of 50 to 55 percent of excess weight. That is more than the lap band, but it is less than the gastric sleeve or bypass, and if your body mass index is over 50, this may not be right for you.

"So, most people who want to lose somewhere between 50 and 100 pounds are going to do quite well with this operation."

Tracey is thrilled with her results.

As she continues to keep her weight down, she is able to keep up with Ryan.

"I'm now in the game with him, and that's exactly where I wanted to be."

Gastric plication patients are out of the hospital in one to two days.

Because it is still investigational, right now, insurance does not cover it.

It can cost between $15,000 and $22,000.

Tracey tells us she paid more than $18,000.

Dr. Brethauer tells us it is only available in a handful of centers across the United States right now.

RESEARCH SUMMARY

WHAT IS BARIATRIC SURGERY? Bariatric surgery alters the digestive system to help people with severe weight-related health problems lose weight. Bariatric refers to the causes, prevention and treatment of obesity. Bariatric surgery, or weight loss surgery, works in three basic ways:

1) Restricting how much food your stomach can hold at any time
2) Preventing your digestive system from absorbing all the nutrition in the food you eat.
3) A combination of these two ways. In general, doctors operate on people who have been unable to achieve lasting weight loss with lifestyle changes and medications aimed at weight loss. Types of bariatric surgery include.

* Gastric banding and gastroplasty ("stomach stapling"): restrictive procedures that decrease the stomach size from about six cups to one.
* Malabsorptive procedures: block food absorption (ex: gastric bypass).
* "Roux-en-Y" gastric bypass: combines both approaches and is the most common weight loss surgery in the U.S. It reduces the size of the stomach and prevents the absorption of calories in the small intestine. (www.webmd.com)

RISKS: For bariatric surgery, the risk of dying is less than 1% and serious complications are rare. Possible complications include: pouch stretching back to stomach's original size, vomiting from eating more than the stomach pouch can hold, the band disintegrating, band and staples falling apart-reversing the procedure, stomach contents leaking into the abdomen, gallstones from excess weight loss, nutritional deficiencies and health problems. Another possible side effect is "dumping syndrome," which occurs after gastric bypass when stomach contents move too rapidly through the small intestine. Symptoms include nausea, sweating, faintness, weakness after eating sweets and diarrhea. (www.webmd.com)

GASTRIC PLICATION: Gastric Plication is the newest weight-loss procedure to be introduced. Some are promoting it as "the most exciting advancement in weight loss surgery since adjustable gastric banding."

Basically, the procedure can best be understood as a version of the more popular gastric sleeve or gastrectomy surgery, where a sleeve is created by suturing rather than removing stomach tissue, thus preserving its natural nutrient absorption capabilities. There is no cutting, stapling, or removal of the stomach or intestines during the Gastric Plication. The Gastric Plication may potentially be reversed or converted to another procedure if needed. The procedure is minimally invasive and takes approximately one to two hours to complete. (www.gastricplication.org, weightloss.clevelandclinic.org)


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