Endoscopic Gastroplasty Results in Rapid Weight Loss for Obese Adolescents: Presented at DDW

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Title: Endoscopic Gastroplasty Results in Rapid Weight Loss for Obese Adolescents: Presented at DDW
URL: http://www.pslgroup.com/dg/221C6E.htm
Doctor's Guide
May 22, 2008

By Ed Susman

SAN DIEGO -- May 22, 2008 -- A new minimally-invasive surgical procedure helps adolescents lose weight by suturing the sides of the stomach together, creating a small pouch that makes patients feel full after ingesting small amounts of food, according to research presented here at Digestive Diseases Week 2008 (DDW).

"Endoluminal suturing to treat adolescent obesity is a possible alternative to more invasive surgeries or less effective diet and exercise programs," said Roberto Fogel, MD, Bariatric Research Physician, Mercy Hospital, Miami, Florida, and Chief of Endoscopy, Hospital de Clinicas, Caracas, Venezuela.

"Adolescent bariatric surgery has been met with great controversy due to the comorbidities and immature anatomy of the patient," Dr. Fogel said in a press briefing on May 20. "Endoluminal techniques to treat obesity, such as per-oral suturing, may offer this population a minimally invasive treatment without the risks associated of surgery."

In some of his patients who have been followed for a year, adolescents have lost as much as 80% of their excess body weight, he said.

Dr. Fogel reported on 31 procedures performed in adolescents in Miami. He said that he has performed 300 such procedures at his institution in Venezuela.

The procedure is performed under general anaesthesia. Tubes that are introduced into the digestive tract through the mouth are used to insert and retract the devices that allow him to visualise the suturing together of the stomach walls.

Patients are required to ingest only liquids for the first 2 weeks after surgery and then eat only soft foods before they can return to a normal diet. Because the stomach postsurgery consists of a small pouch and a tube, the patient cannot eat much food before feeling full. The result is rapid weight loss.

"In our patients, we observed an 18% weight loss after the first month, a 38% reduction in excess body weight after 3 months, and a 60% loss of excess body weight after 6 months," Dr. Fogel explained.

Among his 31 paediatric patients in Miami there have been 3 cases of bleeding complications, which resolved without problems. "We have had no stomach perforations," he said.

Dr. Fogel acknowledged that his technique requires further investigation and longer follow-up before it can receive recommendations for widespread use.

[Presentation title: Per-Oral Suturing as a Potential Treatment for Adolescent Obesity - a Pilot Investigation of 12 Patients With 6-Months Follow-Up. Abstract 243]

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