Monmouth, NJ ROSE UPDATE

8 Patients done to date.  All went well with no post op pain. The last 5 went home same day.  All are losing serious weight. The bariatric Center was flooded with calls on the USGI message board. They are trying to get back to people as fast as possible but they are presently understaffed.  The 20 allotted registry slots are just about filled. Only after the first twenty are completed will they know if any more registry slots will be made available. That will be sometime mid june.  They hope that their positive data will help sway some insurance companies to pay, especially since stomaphyx clearly is not effective by itself. And sclerotherapy of the stoma is unproven at this time. BTW, it was because of the proliferation of stomaphyx and before that endocinch, that the insurance companies (mainly medicare and blue cross) decided not to cover endoscopic revision.The ROSE is turning out to be THE definitive revision technique for RNY. Dr Borao feels that anyone would be crazy to have a surgical revision if they qualify for a ROSE. Why risk more adhesions and wound infections. The Docs are trying to work out a deal so patients can get financed if insurance doesnt cover, after the registry is closed.If you are having trouble getting through the lines to the MMC Bariatric center (which is hospital based) you can try calling Monmouth Gastroenterology (732-389-5004) to schedule with Dr Gorcey.

Interesting data...did your surgeon tell you this or did you read this someplace?  Please share your resource... (especially since stomaphyx clearly is not effective by itself. And sclerotherapy of the stoma is unproven at this time. BTW, it was because of the proliferation of stomaphyx and before that endocinch, that the insurance companies (mainly medicare and blue cross) decided not to cover endoscopic revision.The ROSE is turning out to be THE definitive revision technique for RNY.)

I work VERY close with Dr Gorcey and Dr Borao. This information is coming directly from them.

USGI did a  lot of resear*****oming up with their tissue anchors. They examined over 150 different types, working mostly with pig stomachs (which closely resemble human)  they found that ONLY if the anchors penetrated the muscularis/serosal layers (the deeper layer) of the stomach did they get LASTING results. All mucosal placed anchors eventually fell off and did not result in gastric remodeling. STOMAPHYX was doomed for failure from the start because you cannot consistantly get muscular/serosal layer with suction. This is clear from other procedures that use similar suction such as rubber banding for esophageal varices. The bands stay about 2 weeks before sloughing off. the mucosal  layer of the stomach renews itself every 10 days to 2 weeks. i hope this helps

Playing the devils advocate here... So tell me how the ROSE procedure is different.   How can you be certain that the ROSE procedure will be successful since it is still in clinical trial phase?   I totally respect clinical researchers because they are so passionate about their research but until there are published statistics how can you say "The ROSE is turning out to be THE definitive revision technique for RNY".   Do you have a url or the publication title from USGI for the findings as you stated above?  I would love to read a bit more on this. Thanks,

 

even though the actual registry is not complete, there is already some longer term follow up thats not published. Dr Thompson at brigham for women  had performed about 50 prior to the registry. The whole idea of the registry is to collect data for ultimate publication. The reason i used the term "turning out to be" and not "is" is because all present USGI plication data that went into the development of their anchors shows not only that the anchors stay in place and overgrow with mucosa, but that when there is serosal approximation (which can only be achieved by deep muscularis/serosal plication) there is lasting gastric wall remodeling. Actual surgical devices that are passed through the  TRANSPORT along with an endoscope for visualization only, are used to perform these plications. the surgeons have complete control over the degree of  tissue approximation and the tension on the anchors. In this respect, ROSE is the ONLY TRUE endoSURGICAL procedure. endocinch, stomaphyx, and sclerotherapy are merely endoscopic procedures.  You are correct though, that LONGTERM endoscopic followup  in a controlled fashion is neededt to confirm lasting results. this is where the registry comes in which requires endosopy at 3 and 9 months.Then there will be more to read.

Hi!  I am THRILLED that you are so up on procedures!  I presently live in CT but will be moving to Arizona in June.  I called Monmouth but was informed that I am to "thin" and  will also not able to  be considered for the study because I have already had a StomaphyX procedure that did not work from the first day (performed by Dr. Sean Garber).  Do you know of any place or any one in AZ that will be doing this procedure?  I am not huge, but DON'T want to get there just to get an operation, if you know what I mean! Please write to me at [email protected] if you can, and I am extremely grateful for any help you can offer me. Beth

I would recommend making an appt with Dr Gorcey to discuss options. His number is 7323895004. The only sites in the ROSE registry are portland, sandiego, cincinati, kentucky,virginia,and monmouth. .

Hi all; I had my consultation with the monmouth bariatric yesterday and met with Dr.Gorsey for my consult and then he performed my endoscopy..Dr. Gorsey is one cool guy.He is very upbeat and a big proponent of the Rose. He is working hard to get more people approved for this procedure..As Littleguy mentioned above,the bariatric center at monmouth has been inundated with new patients and are working hard to get things moving.Everyone was very nice. I had my consult with the dietician and a history and then went over to the monmouth gastro for the endo.I am a candidate and hope to hear soon about a surgical date.I did not meet Dr.Borao yesterday,but Dr. Gorcey and Dr. Borao must be an awesome team from how Dr. Gorcey is so on board about this program.They do the surgery together.. Thanks again littleguy......  PatsyAmsterdam

HI PATSY. I AM HOPING FOR THEM TO CALL ME. I SPOKE TO SOMEONE THIS PAST MONDAY AND SHE SAID I WILL BE CALLED SOON. I HAD E-MAILE THEM 2 WEEKS AGO ABOUT GETTING IN THE CLINICAL TRIAL.  DOES YOUR STOMACH HAVE TO BE STRECTHED OUT DO QUALIFY? ARE THERE ANY COSTS FOR THE PROCEDURE?    THANKS DANA