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Bluegrass Bariatric Surgical Associates Performs New Incisionless Procedure to Treat Weight Regain After Gastric Bypass

Wednesday, August 6, 2008 General News J E 4
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LEXINGTON, Ky., Aug. 5 Bluegrass Bariatric SurgicalAssociates' G. Derek Weiss, MD, FACS, FASMBS and John Oldham, Jr., MD, FASMBShave become two of the first surgeons in the United States and the onlysurgeons in Kentucky to offer a new incisionless procedure to reverse weightgain after gastric bypass surgery.

Drs. Weiss and Oldham, who operate at five centers across Kentucky, havecompleted the first 27 procedures starting on March 23, 2008 and these firstpatients 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 theoriginal post-gastric bypass proportions to help them back onto the path ofweight loss.

"Gastric bypass patients work very hard to manage their weight and adjusttheir lifestyle after surgery," Dr. Weiss said. "Sometimes, through no faultof their own or their surgeon, the benefits of the bypass procedure are notpermanent." He added, "To date, revision options have been expensive,difficult to perform and risky for the patient, effectively leaving themwithout any treatment options. Now, with this new incisionless procedure beingoffered at Bluegrass Bariatric, we have a new and dramatically less invasiveway to correct a key cause of weight regain."

Gastric bypass surgery offers a very effective means to lose weight. It isnot, however, always a permanent fix. Up to 44 percent of patients who undergogastric bypass begin to regain weight -- and the dangerous co-morbiditiesassociated with it -- a few years after their initial operation.

Studies show that post-gastric bypass weight regain sometimes occursbecause 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-surgeryproportions have been too complicated and dangerous for most patients, leavingthem without any feasible treatment options.

"By eliminating skin incisions, this new procedure may provide importantadvantages to patients including reduced risk of infection and associatedcomplications, less post-operative pain, faster recovery time and no abdominalscars," Dr. Oldham said.

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

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

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

Devers came to Dr. Weiss and Dr. Oldham in search of a procedure thatcould help put her back on the path to weight loss. "I was so thrilled to hearthat there was an incisionless procedure that could help me," she said. "Ileft the hospital after the ROSE procedure and only felt a little ache in myshoulder, which went aw
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