Bluegrass Bariatric Surgical Associates Performs New Incisionless Procedure

LEXINGTON, Ky. — Bluegrass Bariatric Surgical Associates' G. Derek Weiss, MD, FACS, FASMBS, and John Oldham, Jr., MD, FASMBS have become two of the first surgeons in the United States and the only surgeons in Kentucky to offer a new incisionless procedure to reverse weight gain after gastric bypass surgery.

Weiss and Oldham, who operate at five centers across Kentucky, have completed the first 27 procedures starting on March 23, and these first patients have lost an average of 15 pounds.

The incision-free procedure known as "ROSE" (Restorative Obesity Surgery, Endolumenal) reduces the size of a patient's stomach pouch and stoma to the original post-gastric bypass proportions to help them back onto the path of weight loss.

"Gastric bypass patients work very hard to manage their weight and adjust their lifestyle after surgery," Weiss said. "Sometimes, through no fault of their own or their surgeon, the benefits of the bypass procedure are not permanent." He added, "To date, revision options have been expensive, difficult to perform and risky for the patient, effectively leaving them without any treatment options. Now, with this new incisionless procedure being offered at Bluegrass Bariatric, we have a new and dramatically less invasive way to correct a key cause of weight regain."

Gastric bypass surgery offers a very effective means to lose weight. It is not, however, always a permanent fix. Up to 44 percent of patients who undergo gastric bypass begin to regain weight — and the dangerous co-morbidities associated with it — a few years after their initial operation.

Studies show that post-gastric bypass weight regain sometimes occurs because the stomach pouch and the opening to the small intestine (the stoma) slowly stretch out, allowing the patient to eat more without feeling full. Invasive procedures to restore the anatomy to the original post-surgery proportions have been too complicated and dangerous for most patients, leaving them without any feasible treatment options.

"By eliminating skin incisions, this new procedure may provide important advantages to patients including reduced risk of infection and associated complications, less post-operative pain, faster recovery time and no abdominal scars," Oldham said.

To perform the ROSE procedure, Weiss and Oldham use a small, flexible endoscope and a new EndoSurgical Operating System™ (EOS) developed by USGI Medical Inc. The scope and the EOS are inserted through the mouth and into the stomach pouch. The EOS tools are then used to grasp tissue and deploy suture anchors to create multiple, circumferential tissue folds around the stoma, reducing the diameter of the opening to more closely match original post-gastric bypass proportions. If needed, additional anchors are then placed in the stomach pouch to reduce its volume capacity. No cuts are made into the patient's skin during the procedure.

Kristy Devers underwent the ROSE procedure on March 26. The soccer mom has always struggled with her weight. She reached 368 pounds in her 20s and became very worried about her health. She entered a weight loss program and lost 40 pounds, but she could never get past that plateau. Three years after she gave birth to her daughter, Jordan, she decided to undergo gastric bypass.

"I wanted to be around when Jordan grew up," Devers, a Lexington, Ky. resident, said. "My original gastric bypass procedure was the best thing I'd ever done for myself. I lost 99 pounds and really felt great. But then the weight gradually started coming back."

Devers came to Weiss and Oldham in search of a procedure that could help put her back on the path to weight loss. "I was so thrilled to hear that there was an incisionless procedure that could help me," she said. "I left the hospital after the ROSE procedure and only felt a little ache in my shoulder, which went away after I took one pain pill. I immediately felt fuller faster during meals and have already lost 24 pounds."

Ideal patients for the ROSE procedure are patients who were initially successful losing weight after their gastric bypass and now are regaining weight. After an initial screening, candidates undergo a series of evaluations including nutritional and dietary counseling, a full medical exam and endoscopy to determine if they are good candidates.

More than 15 million people in the United States suffer from severe obesity and the numbers continue to rise. Several serious diseases and conditions are commonly associated with obesity, including Type II diabetes, hypertension, sleep apnea and cardiovascular disease. Surgical treatment of obesity has increased significantly in recent years. Over 200,000 individuals in the United States underwent bariatric surgery in 2007, and it is estimated that over 125,000 patients today are candidates waiting for an incisionless revision procedure.

Source: Bluegrass Bariatrics