Abstract
Background
Gastric bypass is the “gold standard” procedure of bariatric surgery. However, 20.4–34.9 % of these patients may fail to achieve or maintain the weight loss on long-term follow-up and may require additional procedures. StomaphyX™ has been promoted for weight reduction in such patients.
Objectives
To study whether endoluminal reduction of gastric pouch and stoma using StomaphyX™ results in sustained weight loss in patients who regain weight after gastric bypass.
Methods
Retrospective chart review was performed on 59 postgastric bypass patients who underwent revision of gastric pouch using StomaphyX™ from 2007 to 2008. Postprocedure weight at 1 week, 1 month, and 6 months follow-up as well as weight at the time of the review was recorded for each patient.
Results
Average weight loss and excess body weight loss (EBWL) were 2.6 ± 2.3 kg and 7.3 ± 7.1 % (n = 42) at 1 week, 3.7 ± 2.9 kg and 11.6 ± 12.1 % (n = 31) at 1 month, and 3.8 ± 4.5 kg and 11.5 ± 17.9 % (n = 10) at 6 months respectively. At the time of review, the average follow-up was 41 months, average weight loss was 1.7 ± 9.7 kg, and EBWL was 4.3 ± 29.8 % (n = 53). Endoscopy in 12 patients at average 18 months follow-up showed no sustained reduction in pouch and stoma size.
Conclusions
StomaphyX™ results in weight loss that is not sustained on long-term follow-up. Pouch and stoma tend to regain their preprocedure size on follow-up. StomaphyX™ cannot be recommended as a weight loss strategy in postgastric bypass patients who regain weight.
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Disclosures
Vinay Goyal has no conflict of interest or financial ties to disclose. Spencer Holover is a shareholder in EndoGastric Solutions and is a consultant to Covidien. Shawn Garber is a shareholder in EndoGastric Solutions and a consultant to Covidien, Ethicon, and Allergan.
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Goyal, V., Holover, S. & Garber, S. Gastric pouch reduction using StomaphyX™ in post Roux-en-Y gastric bypass patients does not result in sustained weight loss: a retrospective analysis. Surg Endosc 27, 3417–3420 (2013). https://doi.org/10.1007/s00464-013-2905-8
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DOI: https://doi.org/10.1007/s00464-013-2905-8