Reversing Weight Gain Following Gastric Bypass Surgery

Patients who have regained weight after gastric bypass surgery now have access to an incisionless procedure that appears highly effective at reversing weight gain, according to a new study.

Researchers at the University of California, San Diego (UCSD, USA) conducted a six-month follow-up of a registry of 116 patients enrolled who underwent Restorative Obesity Surgery, Endolumenal (ROSE). For the purposes of the registry, excess body weight was defined as anything over a body mass index (BMI) rating of 55. The registry data showed that 88% (96) of the patients stopped regaining weight after ROSE. Overall, these patients lost an average 18% of their excess weight six months after the procedure. Patients who were most successful losing weight after their original gastric bypass had the best results following the ROSE procedure; this subset of patients dropped 29% of their excess weight during the six months after ROSE. One of the patient in the study lost 30 kg, or 84% of her excess weight, during that six-month period. The study was presented at the annual meeting of the American Society of Metabolic and Bariatric Surgeons (ASMBS), held during July 2009 in Grapevine (TX, USA).

"We believe this registry represents the largest collection of data showing the effectiveness, safety and durability of the ROSE procedure,” said study presenter Santiago Horgan, M.D, a professor of surgery and director of the Center for the Treatment of Obesity at UCSD. "There are not many options to repair a failing gastric bypass. Invasive procedures to restore the anatomy are complicated and risky for most patients. In comparison, there were no significant complications associated with ROSE and most of the patients lost clinically relevant amounts of weight.”

Up to 50% of patients who undergo gastric bypass surgery begin to regain weight after two years; this often occurs because the stomach pouch and the stoma connecting the stomach to the small intestine slowly stretch, allowing the patient to eat more without feeling full, necessitating ROSE. The procedure avoids cutting through scar tissue, and involves inserting a small, flexible endoscope and several specially crafted tools through the mouth, down the esophagus, and into the stomach pouch; once there, the doctor can reduce the size of the stomach pouch and the opening to the intestine from the inside, without having to cut through previously damaged tissue. The tools, developed by USGI Medical (San Clemente, CA, USA), are used to grasp, fold, and stitch tissue to reduce both the diameter of the stomach opening and the volume of the stomach pouch.

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University of California, San Diego
USGI Medical