STOMAPHYX

Does anyone know anything about this (less biased than a press release by the manufacturer) - are any surgeons in CT performing this procedure? REDMOND, Wash., Jan. 8 /PRNewswire/ -- EndoGastric Solutions, Inc., the world leader in endoluminal intragastric surgery, announces the successful reduction of the stomach pouch size after gastric bypass for obesity, using StomaphyX(TM), a new endoluminal surgical device. In December 2006, five StomaphyX(TM) pouch reduction procedures were successfully performed by Dr. Jacques Himpens and Professor Michel Cremer at Sint-Blasius Hospital in Dendermonde, Belgium. Immediately after the procedure, x-rays showed close to a 50% reduction in pouch size and a substantial change in pouch shape in all patients. All patients experienced the onset of satiety and a significant change in their eating patterns, reported that their stomachs felt similar to the four to five week period after the original surgery, and began to lose excess weight. "For the first time, we have been able to achieve similar near term results as we would hope to achieve with a laparoscopic gastric redo-procedure but through a fully trans-oral procedure," said Dr. Jacques Himpens who has performed over 600 gastric redo-procedures and more than 6,000 bariatric procedures, making him one of the most experienced bariatric surgeons in the world. "We demonstrated that this procedure is possible, less invasive, and so far after three weeks, effective," said Dr. Himpens. "All five of my patients have lost weight, significantly altered their eating habits, and have benefited from the incisionless aspects of this procedure. I also believe that the reconstructed pouches will hold for them in the near term." "The StomaphyX procedure can be performed in as little as 15 to 20 minutes," continued Dr. Himpens. "Because the procedure is performed transorally, patients are able to return to their normal routines much faster than if they underwent open or laparoscopic surgery. I know that one patient was able to return to her job as a hairdresser the next day. This was especially important to her because she did not want to miss a single appointment during the busy holiday rush." According to Himpens, failure to maintain adequate weight loss after gastric bypass has been reported to be as high as 25-30% as many procedures start to fail three years after surgery. In these cases, surgical redo- procedures are often required. "This breakthrough procedure is important for the future of both bariatric surgery and gastroenterology since we are dealing with an extremely fragile patient population who often cannot undergo a second or third surgical procedure," said Professor Michel Cremer. "When these patients return for a follow up visit and have regained their weight, they are devastated from a psychological standpoint and, until now, they were faced with the prospect of yet another serious surgery or the risk of becoming morbidly obese again. StomaphyX has the potential to reach many of these patients and provide a minimally invasive alternative that carries far fewer risks than traditional approaches but with similar results to bariatric surgery." "Revision bariatric procedures are difficult, time consuming and are associated with high complication rates," according to Dr. Kelvin Higa, President-Elect, American Society for Bariatric Surgery. With more than 170,000 bariatric procedures estimated to be performed in the US in 2007, the number of patients requiring a secondary operation will grow as well. "The need for a less invasive, safer, possibly endoluminal solution to this problem is of great benefit to our patients. This technology has the potential to develop into primary bariatric solutions as well," according to Dr. Higa.

I haven't heard of anyone in CT performing the stomaphyx procedure, although surgeons at Brighams and Women's Hospital in Boston are pioneering a comparable, endoscopic procedure for revisions.

You do lots of research Steve...  Question.... Is it standard... common... that we RNYr's will need "revisions" in the future? Sounds like a niave question of somebody who has only begun to research. But some of this current conversation is making me wonder. Any comments? T.

I guess the "need" for revision - or extra help beyond the original bariatric surgery to assure sustaining weight loss, T. - is subjective.  The root of your question seems to me to be about weight regain...is it inevitable that we will regain any or all of our weight that was lost as a result of surgery? I am 3.5 years post-gastric bypass surgery; I am maintaining my weight loss, I have not yet regained any of the 214 lbs. lost.  I do not believe it is inevitable that we are destined to regain the weight. Having said that, however, I absolutely believe that the only way to keep the weight off is a daily and vigilent commitment to behavioral AND psychological change - physical activity, hard and often; making healthy eating choices every day for the rest of my life; and, for me this is every bit as important: living a passionate and full life that embraces the philosophy of knowing what I'm made of and then giving it away...in other words, if I can get out of my "puny" self-centered, self-absorbed thinking and instead make it a priority to connect to people and be of service to my community and my world, I simply won't have time to obssess about food.  This is the path I have chosen after living most of my life as a super morbidly obese person. Today, I am living life in a normal sized body, and I will go down kicking and screaming before I give that up. So, it is NOT inevitable that we will regain the weight. It IS, however, a daily struggle and to sustain the weight loss will require hard, hard effort for the rest of our lives. The surgery is only a tool - it is not a magic pill, it is not our happily-ever-after. Maybe not what folks want to hear but this is my truth, my reality. Be well, all. Maureen

Thank you for your input. To date I have not gained my weight back. To date, I am vigilant abou****ching what goes into my body... as well as regular exercise. I can see that my question did not go to Steve. I will directly address that to him.

Hello  Thank you for input but I never heard that product. So far.... I am still wearing size 8, still exercise 5 times a week, watch what i am eating and stay away from CARBS ( I was former Carb Queen). I still have fear in my back of my head is REGAIN so keep exercise five days help me peace of ,my mind and keep touch with friends as support group to support and talk. Wihtout using tools, we will go back to old bad habits. Keep post for update about this product. Take care ! Kathy K

Gosh, I hope I didn't offend you - anything I said in my email only directly relates to me; I am referring to my own self-centeredness, my own tendency towards feeling sorry for myself, my own "puny" thinking - I reread what I wrote and realized it could be totally misunderstood - so sorry if it came across as harsh.  Towanda, I am seeing a lot of regain for folks 3 years out or more. Obviously, its an area of concern and I certainly welcome the opportunity to discuss it.  If I offended anyone, I am genuinely very, very sorry.  I can sometimes come across as harsh when in fact I'm only trying to be of help. Hope you accept my apology! Maureen

Maureen: Thanks for the clarification. I wholeheartedly believe we are better off  working as a team of sorts to make our individual journeys more successful. And discussing the pitfalls that at one time or another we all find ourselves facing is better than sweeping it under the rug. So I say we keep discussing all issues that come up. To clarify from my point of view... I was asking the question more as a "hmmm" about how the pouch lasts over years of use (without abuse)... rather than some sort of inevitable "must happen" regain. I see that my part in all of this is the largest part once the surgery is done. Dealing with the way one chooses/has chosen/chooses (for in my world it is a daily conscious chose of intent) can be a slippery sliding road without support. And I suppose there could be a whole other discussion similar to Plastics... Yes? No? Right? So... let us carry on with the knowledge that all we want is the very best for each other. That is what I like about the CT forum. We keep on keeping on. T.

I have never seen any studies on the actual breakdown of revisions caused by mechanical failures of the original surgery (such as were fairly common before patients' pouches and remnant stomaches were transected) versus those that are caused by patients' overeating and stretching the pouch.   My anecdotal experience is that many of us do have a slight bounce up after hitting our record low weights-- some have trouble stopping the bounce or fall into some bad habits (and I fall into this category) which can be rationalized as long as we stay within some range that we feel is "normal" or "o.k." for us.  The difficulty, and why I think many of us look into the possiblity of a revision, is figuring out if we are not backsliding into that old mindset where we tried to content ourselves if we only regained a few pounds after a failed diet.  And, of course, there are always those few (and I do think they form an absolute minority) who want to blame any weight gain on a mechanical failure (as opposed to sugar free oreos) and who look to a revision as a cure-all. But, I do think that for those of us who have found more struggles as we progress, and who work hard to maintain their "normal" sized bodies, there is always some intrigue with a revision-- with the possiblity that an option exists were we to stumble that would return us to the mindset and hopefullness that filled those first few months of quick and steady weight loss. 

Well said, Steve, thanks for this. I suppose this is precisely why I posted the question Stomaphyx (I'm just realizing what the phonetic meaning of the word is--Good Lord!) in the first place.  I'll be the first in line under the sign that reads: "Terrified of Gaining the Weight Back" - be well, all. Maureen