Advertisement

Surgical Endoscopy

, Volume 27, Issue 9, pp 3417–3420 | Cite as

Gastric pouch reduction using StomaphyX™ in post Roux-en-Y gastric bypass patients does not result in sustained weight loss: a retrospective analysis

  • Vinay Goyal
  • Spencer Holover
  • Shawn Garber
Endoluminal Surgery

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.

Keywords

Bariatric Obesity Endoscopy 

Notes

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.

References

  1. 1.
    Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, FAhrbach K et al (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737PubMedCrossRefGoogle Scholar
  2. 2.
    Christou NV, Look D, Maclean LD (2006) Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg 244:734–740PubMedCrossRefGoogle Scholar
  3. 3.
    Mullady DK, Lautz DB, Thompson CC (2009) Treatment of weight regain after gastric bypass surgery when using a new endoscopic platform: initial experience and early outcomes (with video). Gastrointest Endosc 70:440–444PubMedCrossRefGoogle Scholar
  4. 4.
    Carrodeguas L, Szomstein S, Soto F, Whipple O, Simpfendorfer C, Gonzalvo JP et al (2005) Management of gastrogastric fistulas after divided Roux-en-Y gastric bypass surgery for morbid obesity: analysis of 1,292 consecutive patients and review of literature. Surg Obes Relat Dis 1:467–474PubMedCrossRefGoogle Scholar
  5. 5.
    Gumbs AA, Pomp A, Gagner M (2007) Revisional bariatric surgery for inadequate weight loss. Obes Surg 17:1137–1145PubMedCrossRefGoogle Scholar
  6. 6.
    Benotti PN, Forse RA (1996) Safety and long-term efficacy of revisional surgery in severe obesity. Am J Surg 172:232–235PubMedCrossRefGoogle Scholar
  7. 7.
    Mikami D, Needleman B, Narula V, Durant J, Melvin WS (2010) Natural orifice surgery: initial US experience utilizing the StomaphyX device to reduce gastric pouches after Roux-en-Y gastric bypass. Surg Endosc 24:223–228PubMedCrossRefGoogle Scholar
  8. 8.
    Jones KB Jr (2005) Revisional bariatric surgery—potentially safe and effective. Surg Obes Relat Dis 1:599–603PubMedCrossRefGoogle Scholar
  9. 9.
    Leitman IM, Virk CS, Avgerinos DV, Patel R, Lavarias V, Surick B et al (2010) Early results of trans-oral endoscopic plication and revision of the gastric pouch and stoma following Roux-en-Y gastric bypass surgery. JSLS 14:217–220PubMedCrossRefGoogle Scholar
  10. 10.
    Ong’uti SK, Ortega G, Onwugbufor MT, Ivey GD, Fullum TM, Tran DD (2013) Effective weight loss management with endoscopic gastric plication using StomaphyX device: is it achievable? Surg Obes Relat Dis 9(1):113–117PubMedCrossRefGoogle Scholar
  11. 11.
    Schweitzer M (2004) Endoscopic intraluminal suture plication of the gastric pouch and stoma in postoperative Roux-en-Y gastric bypass patients. J Laparoendosc Adv Surg Tech A 14:223–226PubMedGoogle Scholar
  12. 12.
    Coakley BA, Deveney CW, Spight DH, Thompson SK, Le D, Jobe BA et al (2008) Revisional bariatric surgery for failed restrictive procedures. Surg Obes Relat Dis 4:581–586PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Bronx Lebanon Hospital CenterBronxUSA
  2. 2.New York Bariatric GroupNew Hyde ParkUSA

Personalised recommendations