Incisionless Weight Loss Surgery. a Novel Gastric Restrictive Procedre Using the Transoral Gastroplasty Technique

The standard operations for weight loss surgery in this country are the Roux-en-y gastric bypass and the adjustable gastric band. Both of these operations are performed laparoscopically. Although the incisions used in minimally invasive surgery are small compared to open surgery, they still require cutting of the anterior abdominal wall. We present one of the first cases of an incisionless weight loss procedure performed in the United States. This novel procedure involves performing a gastroplasty via a transoral approach and eliminates the need for abdominal incisions. The gastroplasty results in the creation of a gastric pouch through the use of a sleeve stapler. Following creation of the gastric pouch, a second device is used to create narrowing of the distal aspect of the pouch to generate a restricted outlet. The net result is a restrictive gastric pouch that results in early satiety and weight loss. This procedure is currently being performed under FDA protocol in a multicenter randomized and blinded trial. This procedure has been performed on 93 patients outside of the United States during the past two years in phase 1 and phase 2 trials. There have been no major complications (esophageal or gastric perforation) in these patients. Excess weight loss in this group is approximately 40%. The procedure requires general anesthesia via nasotracheal intubation, and two operating physicians. One physician operates the endoscope, while the other physician operates the sleeve stapler. Average procedure time is 2 hours. The patients are admitted for 23 hours, and undergo an upper GI series on post operative day one prior to discharge. The patient presented in this video did not encounter any post operative complications, and has lost 26% of her excess weight at one month.

Session: Podium Video Presentation

Program Number: V005

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