Incisionless StomaphyX™ Technique Makes Revisional Surgery Safer, Easier

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Weight-loss surgery techniques have made great progress since the early days, when as many as 50 percent of patients experienced complications and frequently needed repeat or “revisional” surgery after the initial procedure. But even with the strides that have been made in surgical methods, it’s still true that not all bariatric surgery leads to immediate or long-term success.

An estimated 10 percent of people who have LapBand surgery must undergo revisional procedures within two years, whether because of slippage or leaking of the device or because the patient simply does not have sufficient success losing weight. With the Roux-en-Y gastric bypass, complications can also arise that require further surgery–within 5 years, between 5 and 10 percent of patients need follow-up procedures due to ulcers or because they have failed to achieve the expected weight loss.

It’s obviously important for anyone considering weight-loss surgery to have a realistic understanding that this possibility exists–and also what the current options are for revisional bariatric surgery. And just as the state of the art in primary bariatric surgery is making rapid advances and many if not most bariatric surgeries are now performed in a minimally invasive fashion (i.e., laparoscopically), patients are also benefiting from the development of new techniques for revisional surgery.

One of the most interesting recent breakthroughs in revisional bariatric surgery is the StomaphyX™–an incisionless type of weight loss surgery. Dr. Paul Cirangle of Laparosopic Associates of San Francisco and The Surgical Weight Loss Center of Hawaii, notes that this new procedure “gives a whole new option to lose the excess weight not achieved or regained since the first weight loss surgery.”

The StomaphyX™ is a device that is inserted through the esophagus down as far as the stomach pouch, where it is used to fasten folds of tissue together to further reduce the size of the stomach pouch. It can be used for those who have had gastric bypass, vertical sleeve gastrectomy, or a duodenal switch operation but have developed an expanded pouch or other complications leading to unsatisfactory weight loss. According to Dr. Cirangle, "The early results of this procedure are promising, showing 15-20% estimated weight loss."

While the surgery is performed under regular general anesthetic, it takes only about 30 minutes and patients do not require an overnight hospital stay. Dr. Cirangle reports that with StomaphyX, "Patients don't have to worry about the complications of the more invasive revisional surgery, such as incisional herniation, infection, adhesions and scarring." Many can return to work or their other normal activities the day after their surgery.

The procedure is still relatively uncommon. Dr. Cirangle’s practice was the first one in the San Franciso area to introduce the StomaphyX procedure, which was developed by EndoGastric Solutions™ and approved by the U.S. Food and Drug Administration in 2007.

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