Good Evening All - I had the RNY done in 2003.  I went in weighing 266 and ended up losing to where I weighed a steady 150 for quite some time over the years.  Here over the past year for some reason I've been able to eat alot and I do admit that my exercise pattern has taken the back burner.  I honestly do not have time my own personal time because I have 3 boys that all play baseball - 2 of them play year round baseball and wouldn't you know it, they are all 3 in different divisions so that means different practices, different locations & different tournaments.

I had been looking into getting a revision done because as of today I weigh right at 200lbs.  So as you can see I'm headed back in the wrong direction.  My Bariatric surgeron, Dr. Erik Wilson performed an EDG on me this past Friday and he recommended the stomaphyx.  I was still groggy from the anesthetic when he was talking to me but I think he said that not many Dr.'s do it but that it is FDA approved and that IF it didn't work we could go ahead and pursue other alternatives.

Now, I'm game for having this done as it is virtually painless and is supposed to help your pouch and stoma back to the original size that it was when the RNY was first performed.

My problem is, I'm not seeing too much out there as far as other people's stories telling of their results in having this procedure done.  Will anyone that has had this procedure reach out to me and tell me your stories?  I'm trying to lose about 50 more pounds to get to where I was when I was happiest most after having my RNY?

Please feel free to share your stories with me - I'd like to know.  The nurse is going to talk with me more about the procedure on Monday and try to get something setup - odds are Cigna will approve it and it will be done as an EDG proceure.

Thanks,
Yvonne

I have seen NOTHING to suggest that Stomaphyx works, other than to pay for the doctor's Mercedes -- and that's probably why you haven't seen anything on the message board.  If it worked, people would be wowwing about it.  It doesn't - and I'm REALLY disappointed to hear Wilson is pushing it.  I thought he might be an upright bariatric surgeon, who was offering the DS as well, but this shakes my trust in him.

And I find it difficult to believe that insurance would cover it, unless he's calling it something else.  Or he's setting you up to want it so badly, you're willing to self-pay.  I say DON'T DO IT.

http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

CIGNA does not cover the following bariatric surgery procedures, because each is considered experimental, investigational or unproven (this list may not be all-inclusive):

• Roux-en-Y gastric bypass combined with simultaneous gastric banding

• biliopancreatic diversion (BPD) without duodenal switch (DS)

• Fobi-Pouch (limiting proximal gastric pouch)

• gastric electrical stimulation (GES) or gastric pacing (e.g., Enterra™ Therapy)

• gastroplasty (stomach stapling)

• intestinal bypass (jejunoileal bypass)

• intragastric balloon

• loop gastric bypass

• mini-gastric bypass

• Natural Orifice Transluminal Endoscopic Surgery™ (NOTES™) (e.g., Restorative obesity surgery, endoluminal [ROSE], StomaphyX™)/endoscopic oral-assisted bariatric surgery procedures

• vagus nerve blocking

• vagus nerve stimulation

Bah, I gave up trying to fix the formatting in the above post.

Here are some other reasons not to do this, from PubMed:

JSLS. 2010 Apr-Jun;14(2):217-20.

Early results of trans-oral endoscopic plication and revision of the gastric pouch and stoma following Roux-en-Y gastric bypass surgery.

Leitman IM, Virk CS, Avgerinos DV, Patel R, Lavarias V, Surick B, Holup JL, Goodman ER, Karpeh MS Jr.

Department of Surgery, 10 Beth Israel Medical Center, 10 Union Square East, 2M, New York, NY 10003, USA. [email protected]

Abstract

OBJECTIVE: A new technique for endoscopic plication and revision of the gastric pouch (EPRGP) for patients who underwent gastric bypass (RGB) surgery was evaluated in patients with severe GERD, dumping syndrome, failure of weight loss, or all of these.

PATIENTS AND METHODS: Patients underwent EPRGP over a 12-month period. The StomaphyX device (Endogastric Solutions, Redmond, WA) was utilized over a standard flexible gastroscope. Patients were kept on a liquid diet for 1 week.

RESULTS: The study included 64 patients with a mean age of 48 years who underwent 67 procedures. EPRGP was performed an average of 5 years after RGB. The mean preoperative BMI was 39.5 kg/m². The primary indications for the procedure were inadequate weight loss, dumping syndrome (42), and GERD (15). The mean follow-up period was 5.8 months (range, 3 to 12). The average operative time was 50 minutes, with a significant reduction with increased operator experience. There were only 2 (3%) intraoperative complications during the early period (equipment failure), which did not result in any morbidity. All symptoms from dumping syndrome or reflux improved, with no further operative-related complications. The mean weight loss was 7.3 kg.

CONCLUSIONS: This study demonstrates the technical feasibility, safety, and efficacy of EPRGP.

~~~~~
Surg Endosc. 2010 Jan;24(1):223-8. Epub 2009 Jul 25.

Natural orifice surgery: initial US experience utilizing the StomaphyX device to reduce gastric pouches after Roux-en-Y gastric bypass.

Mikami D, Needleman B, Narula V, Durant J, Melvin WS.

The Ohio State University Medical Center for Minimally Invasive Surgery, N717 Doan Hall, Columbus, OH 43210-1228, USA. [email protected]

Abstract

INTRODUCTION: Weight gain after gastric bypass can occur in up to 10% of patients 5 years following and in about 20% of patients 10 years following surgery. The nadir weight is usually reached within the first 2 years after bypass surgery. However, weight may slowly be regained for numerous reasons. This phenomenon has been studied extensively, but there is often no one reason this occurs. Once psychological and dietary reasons have been investigated, revisional surgery may be the only alternative for treatment. Revisional gastric bypass surgery is associated with a much higher morbidity and mortality when compared with a primary gastric bypass procedure.

PATIENTS AND METHODS: Thirty-nine patients underwent endoluminal gastric pouch reduction with the StomaphyX device after informed consent. The StomaphyX device is a sterile, single-use device for use in endoluminal transoral tissue approximation and ligation in the gastrointestinal (GI) tract.

RESULTS: Average age was 47.8 (29-64) years, and 36/39 (92.3%) patients were female. Average body mass index (BMI) and weight prior to the StomaphyX procedure were 39.8 (22.7-63.2) kg/m(2) and 108.0 kg (65.90-172.2 kg). The average preprocedure excess body weight was 51.1 kg. Weight loss
at 2 weeks (n = 39) was 3.8 kg (7.4% excess body weight loss, EBWL),
at 1 month (n = 34) was 5.4 kg (10.6% EBWL),
at 2 months (n = 26) was 6.7 kg (13.1% EBWL),
at 3 months (n = 15) was 6.7 kg (13.1% EBWL),
at 6 months (n = 14) was 8.7 kg (17.0% EBWL), and
at 1 year (n = 6) was 10.0 kg (19.5% EBWL).
No major complications were observed. The minor complications that were seen included a sore throat lasting less than 48 h in 34/39 patients (87.1%) and epigastric pain that lasted for a few days in 30/39 patients (76.9%). Three patients with chronic diarrhea had their symptoms resolved after the procedure. Eight patients with gastroesophageal reflux disease reported improvement in their symptoms post procedure.

CONCLUSIONS: Endoluminal revision of gastric bypass patients with weight gain using the StomaphyX procedure may offer an alternative to open or laparoscopic revisional bariatric surgery.

Wow - you provied a lot of information for me to chew on.....!! I appreciate it - I think the main thing was that my pouch had not stretched too much so he suggested the stomaphyx.  He did say that if I felt it wasn't providing the results I was looking for then we could go ahead and pursue other options.  I really respect Dr.Wilson and trust that he will work with me in whatever I choose.  As you mentioned earlier though, it may not be such a good solution because there's not so much information out there about it.  I'm going to talk with his nurse Connie tomorrow and get more information from her and what the expected weight loss percentage is. 

The main thing that troubles me is how is it that I can eat more now than before and gain the weight if my pouch has not really stretched that much?  Is it possible that my metabolism is really just starting to slow down on me?  I'm pushing 40 in a few months, I don't drink sodas of any sort and in fact the only caffeine I have is a cup of coffee every morning.  For lunch I eat nothing more than a Lean Cuisine or a Marie Callender lunch and for dinner I eat a regular meal.  It just doesn't make sense to me.  NOW on the other hand, I have stopped working out as I mentioned before but if I'm able to squeeze some time in there somewhere will that really make a difference?

Just a lot of food for thought....

Thanks,
Yvonne

Because you no longer have much if any calorie malabsorption, just vitamin and other micronutrient malabsorption, PLUS your body has now been through yet another terribly calorically restrictive diet (the early part of your RNY experience) and downregulated accordingly, so you are fighting age and a further ruined metabolism.

The only way you are going to lose weight now, in all likelihood, is lifelong dieting and extreme exercise, OR a better bariatric surgery with more and more permanent calorie malabsorption like the DS.

That's my opinion.

Sadly, stomaphyx does not work 100% of the time. Read these very boards and you'll see that everyone is the same. They lose about 20# on the post op diet and as soon as they start eating solids they regain that 20#.

Not many doctors do it because it doesn't work. :o(