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New, Minimally-Invasive Surgery for the Morbidly Obese

Three studies presented at the 71st Annual Scientific Meeting of the American College of Gastroenterology demonstrated that transoral endoscopic surgical// techniques – entering the abdomen through oral cavities such as the nose and mouth – can be successful in both bovine and human patients. Further, patients who underwent endoscopic-guided transoral gastroplasty for morbid obesity showed signs of initial weight loss.

Transoral gastroplasty restricts or limits the expansion of the stomach when eating so patients feel full when they eat a small portion of food. Unlike other procedures to restrict the stomach, this is done with an endoscope through the mouth without any skin incisions. Transoral gastroplasty represents an emerging category of endoscopic surgery using natural orifices for minimally invasive procedures.

Twelve patients with morbid obesity were enrolled in the pilot study to test the feasibility and initial safety of the procedure. Transoral gastroplasty was performed under general anesthesia using a flexible transoral stapling device. Patients were then put on a diet and asked to begin an exercise program.

Study leader Steven Edmundowicz, M.D. of the Washington University School of Medicine noticed considerable weight loss ranging from 12 to 28 pounds in all patients one month after surgery. The pilot study showed no serious adverse effects. Minor side effects included pharyngeal pain, vomiting, and temporal mandibular dysfunction, a disorder of the jaw that results from positioning the patient with a wide-open mouth for a prolonged period of time.

“This pilot study demonstrated that the device could be used in humans without major complications,” said Dr. Edmundowicz. “The future of transoral gastroplasty will be defined by well-designed clinical studies to demonstrate the efficacy of this procedure in generating short-and-long-term weight loss in morbidly obese patients.”

Dr. Edmundowic
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