Stomaphyx

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StomaphyX - Gastric Bypass Revision

StomaphyX is an incision-free procedure that reduces the stomach volume to help gastric bypass patients get back on track with weight loss.

The StomaphyX device creates folds of tissue that resemble a pleat, which are then fastened together with staples, making the stomach pouch smaller.

StomaphyX is a new and innovative revision procedure for individuals who have had Roux-en-Y gastric bypass surgery and have regained weight due to a stretched stomach pouch or enlarged stomach outlet. Approved by the US FDA in 2007, the StomaphyX procedure reduces the stomach pouch and stomach outlet (stoma) to the original gastric bypass size without traditional surgery or incisions and with minimal recovery time. It is not performed as a primary method of weight loss surgery, but as a type of revisional bariatric surgery for gastric bypass patients.

Why is the StomaphyX procedure performed?

Although gastric bypass surgery is successful in achieving an average of 60 to 80% excess weight loss, some patients start to regain weight a few years after surgery. The stomach pouch and stoma can gradually stretch over time as the body’s digestive system becomes accustomed to the changes and the patient returns to unhealthy eating patterns. The StomaphyX procedure reduces the stomach pouch and stoma to a size similar to the original gastric bypass surgery, once again limiting food intake and slowing the emptying of the stomach into the small intestine. This results in earlier satiety (feeling of fullness) and more weight loss. Without having to undergo additional traditional surgery, StomaphyX helps gastric bypass patients eat less and lose more weight.

How do I know if my stomach pouch or stoma has stretched?

If you and your doctor suspect that your stomach pouch or stoma may have stretched, there is a simple procedure known as an upper endoscopy that can be performed to find out for certain. This quick and easy procedure is performed by a Gastroenterologist (scope doctor) who uses a small scope with a video camera to measure the stomach pouch and stoma. For the procedure you will be lightly sedated, then the doctor will guide the scope down through the mouth and into the stomach pouch to take measurements. Before undergoing the endoscopy procedure, it is important for the Gastroenterologist to talk to your Bariatric Surgeon and find out exactly what measurements need to be taken.

How is the StomaphyX procedure performed?

First, the patient is put under anesthesia. Then, the bariatric surgeon gently guides the StomaphyX device through the mouth and into the stomach pouch inside a long, thin tube and performs the procedure using endoscopic visualization (miniature light source and camera). Once inside the stomach pouch, sections of stomach tissue are suctioned into a small opening in the StomaphyX device which creates folds of tissue that resemble a pleat. The folds of tissue are then fastened together with little blue staples to hold them in place, making the pouch

Vacuum suction pulls the stomach wall in, using a series of fasteners that cinch up the stomach walls, the maximum volume of the stomach decreases and caloric intake falls with it.

smaller. The amount of folds required depends on a patient's anatomy, but usually a patient needs multiple folds. Then the opening between the stomach pouch and small intestine is sutured together to return it to the appropriate size.

How long does the StomaphyX procedure take?

The StomaphyX device creates folds of tissue that resemble a pleat, which are then fastened together with staples, making the stomach pouch smaller.

The StomaphyX procedure takes approximately 20-60 minutes, depending on the size of the stomach pouch and how much revision needs to be done. Most time the procedure is performed on an outpatient basis.

How long is the recovery period?

The recovery period is very minimal following the StomaphyX procedure. Most patients can return to work as early as the next day. As the procedure is done through the mouth, there are no incisions and no visible scars. In order to allow the pleats to bond to each other, patients are put on a liquid diet for two weeks.

Benefits of the StomaphyX procedure include:

• Overall risks are much lower than with traditional surgery
• Does not require abdominal or internal surgical incisions
• Since there are no visible incisions, there are no visible scars
• Reduces risk of infection from surgical incisions
• Reduces size of stomach pouch, which limits food intake
• Reduces enlarged stoma, which slows passage of food into the small intestine and causes earlier satiety
• Can usually be performed on an outpatient basis
• Quick recovery (1 day vs. two to eight weeks for revision surgery)
• Virtually painless
• Adjustable and/or revisable
• Preserves future treatment options
• Adaptable to different anatomies
• Lower mortality rate (1 in 10,000) than with gastric bypass revision (1 in 100)

Risks of StomaphyX procedure include:

• No long-term studies because the procedure is new, but bariatric surgeons say it poses little to no risk to patients, as long as the surgeon is properly trained in using the device
• Two main risks are bleeding and perforation, which should be minimal if the procedure is performed by an experienced surgeon who knows how to do endoscopy and how to use the device

Cost of StomaphyX

The cost of the StomaphyX procedure is roughly $9,500 to $10,500. This is less than half the cost of a full revision surgery.

Other Surgical Options for Failed Roux-en-Y Gastric Bypass

• Revision surgery to restore the original gastric bypass anatomy
• Conversion to Vertical Sleeve Gastrectomy (Gastric Sleeve)
• Conversion to Duodenal Switch
• Conversion to Bilio-Pancreatic Diversion (Scopinaro-type)
• Adjustable Gastric Banding (LAP-BAND or REALIZE Band)
• Gastric bypass revision with the ROSE Procedure

Patient Criteria for StomaphyX

The StomaphyX procedure is designed for gastric bypass patients who never achieved adequate weight loss or regained weight after their initial weight loss.

Eventually the StomaphyX procedure will become available for individuals with "virgin" stomachs. Although it is not yet possible to perform StomaphyX as a primary method of weight loss surgery, it is only a matter of time before the medical community develops an instrument that can reach the curves of a normal stomach.

StomaphyX Results

The StomaphyX procedure offers gastric bypass patients a safer alternative than previously available for gastric bypass revision. Without having to undergo another traditional surgical procedure, gastric bypass patients can have their stretched stomach pouch or stoma reduced to an appropriate size. The overall results of StomaphyX are earlier satiety and increased weight loss.

StomaphyX Video:

Bariatrics The branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.

Roux-en-Y Gastric Bypass A type of gastric bypass procedure which combines restrictive and malabsorption techniques - meaning, it reduces the amount of food a patient can comfortably eat (restriction), and also reduces the amount of calories that can be digested in the small intestine (malabsorption). This combination of bariatric methods leads to greater weight loss and the roux-en-y procedure is seen as one of the best ways to treat clinically severe obesity. See WLS Videos for animated surgery technique.

Surgical Staples Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds. Stapling is much faster than suturing by hand, and also more accurate and consistent. In bariatric surgery, staples are primarily used because staple lines are less likely to leak blood, air or bowel contents. In skin closure, dermal adhesives (skin glues) are also an increasingly common alternative. The technique of stapling for surgery is said to have been influenced by the Roman use of ants for wound closure.

Satiety The feeling of satisfaction or fullness with the intake of food.

Stoma Opening to stomach created by stapling or placing an adjustable band around the upper part of the stomach during surgery.

Endoscopy Endoscopy is a minimally invasive medical procedure that is used to assess the interior surfaces of an organ by inserting a tube (generally a medical instrument known as an endoscope) into the body. Many endoscopic procedures are considered to be relatively painless and, at worst, associated with mild discomfort. Eliminating incisions means less risk than traditional open or laparoscopic surgery, minimal post operative pain, fast recovery time and no scarring. The Restorative Obesity Surgery, Endolumenal Procedure better known as The ROSE Procedure is performed endoscopically, as is the StomaphyX gastric bypass revision. Patients generally report minimal or no pain after the procedures and many of them return to work and normal activities the next day.

Pouch Most bariatric surgeries restricts the amount of food a patient can eat by reducing the size of the stomach by gastric banding, stapling or removal. What results is known as the gastric pouch.

StomaphyX StomaphyX is an incision-free procedure that reduces the stomach volume to help gastric bypass patients get back on track with weight loss. Approved by the US FDA in 2007, the StomaphyX procedure reduces the stomach pouch and stomach outlet (stoma) to the original gastric bypass size without traditional surgery or incisions and with minimal recovery time. It is not performed as a primary method of weight loss surgery, but as a type of revisional bariatric surgery for gastric bypass patients. See our in-depth StomaphyX procedure article, including animation video, in the forums.