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Cabell Huntington Hospital offers new option to address weight gain after weight-loss surgery

Dec. 18, 2012 @ 10:40 AM

     Blaine Nease, MD, FACS, director of the Center for Surgical Weight Control at Cabell Huntington Hospital, often tells his patients to view their bariatric surgery as a tool to help them make better lifestyle choices. And at the Center for Surgical Weight Control, there are
numerous tools available to ensure weight-loss success well beyond the surgery itself.
     From ongoing dietary counseling to regular followup appointments, bariatric patients have a lasting support system at the Center for Surgical Weight Control. Now, with the introduction of a minimally invasive revisional procedure called endoscopic gastric suturing, patients have access to another lasting benefit— a second chance.
     “Endoscopic gastric suturing is a treatment option for patients who have undergone weight-loss surgery and have experienced weight regain
after their procedure,” Dr. Nease said. “It is not meant to replace the original surgery; it is not replacing that original tool. It is taking that tool and learning how to use it again or how to use it better.”
     During the first few years after a bariatric procedure, patients may experience a loss in restriction, causing them to feel less full after meals and start to regain weight. Dr. Nease said it is during these early stages of weight regain that patients are most likely to benefit from an endoscopic revisional procedure.
     “This is not for patients who have gained all of their weight back or those who are gaining weight not because of a loss in restriction, but
because of dietary choices like consuming high-calorie drinks,” Dr. Nease said.
     “However, for patients who have put some weight back on and are motivated, revisional surgery can actually take them back to the same restriction they felt after their initial surgery. In fact, we mentally prepare them to go back to that day—they follow the same steps and return to the same diet they followed after their first surgery.”
     Dr. Nease is the first and only surgeon in West Virginia and the Tri-State to offer endoscopic gastric suturing. Using an endoscope, which travels through the mouth and down the esophagus into the stomach, Dr. Nease sutures the opening to the stomach—or, in patients who have had gastric sleeve resection surgery, sutures the stomach itself —to tighten the area back to the size it was after the first weight-loss procedure. It is a low-risk alternative to other revisional surgeries, requiring no incisions and only taking a few hours to complete.
     Dr. Nease said although some patients may still require laparoscopic or more invasive revisional procedures, endoscopic gastric suturing is
the best and most advanced option for patients who are in the beginning stages of weight regain due to restriction loss. It is yet another aspect of his surgical practice that sets the Center for Surgical Weight Control apart.
     “The best bariatric surgical practices are ones that offer a variety of options for weight loss surgery,” Dr. Nease said. “Our mission is to be
a one-stop bariatric surgical practice. If you want an adjustable gastric band and it’s appropriate for you, we can provide it. If you want a gastric bypass or a gastric sleeve, we can provide that. If you need revisional surgery, we have experience in doing that, too. And now, we have experience in offering a more minimally invasive revisional procedure. This is just one more treatment option for our patients. It is another way for us to provide the best care possible.”

     An endoscopic repair eliminates the need for an open or laparoscopic procedure. With traditional abdominal surgery, scarring and adhesions from the initial bypass procedure often make open or laparoscopic revisional surgery very challenging. Abdominal revisional surgery usually takes longer than the original gastric bypass and patients are three times more likely to develop complications.
     With the endoscopic approach, patients reduce their risks compared to major abdominal surgery, have less post-operative pain, recover faster and have no abdominal scars. Typically, patients go home the same day, but each patient’s discharge will vary based on his/her physician’s recommendation. Please discuss your options for enlarged outlet and pouch repair with your physician or surgeon.

     It is anticipated that patients will feel little or no discomfort from the endoscopic procedure. Minor side effects may include nausea, a temporary sore throat, swollen tongue and lip pain from the insertion of the endoscope into the mouth.

     Typically, patients return to their normal routine within 48 hours. Following endoscopic suturing repair, patients should follow the same diet and exercise regimen they did after their initial bypass surgery.

     It depends upon the patient’s insurance plan. For further information, please call the Center for Surgical Weight Control at 1.877.WLS.CENTER.