WLS Help (wlshelp.com) is a website dedicated to providing the most current information available on weight loss procedures, including surgeries. Recently, the website listed its five most promising weight loss procedures in the fight against obesity. These five procedures include:
- Sleeve Gastrectomy
- EndoBarrierTM Gastrointestinal Liner
- Pose, and
- Gastric Plication Surgery
1. EndoBarrierTM Gastrointestinal Liner
This is the only procedure that is surgery free. During this procedure, a Teflon-like material is placed at the inner side of the small intestines to serve as a barrier between the food ingested and a portion of the digestive tract where food gets absorbed.
The gastrointestinal liner, or GI sleeve, was approved for use in Europe back in December of 2009, and is in the final stages of clinical development in the U.S. This procedure was developed by GI Dynamics.
The benefits of EndoBarrierTM Gastrointestinal Liner are that there are no incisions such as those needed for surgery, in no way does it alter the anatomy of the digestive system, and the device can be removed after the period of treatment.
Sleeve Gastrectomy, TOGA, POSE, and Gastric Plication Surgery are all new surgery procedures for those seeking options for weight loss.
2. Sleeve Gastrectomy
Sleeve gastrectomy (or gastric sleeve) is a relatively new and promising surgery in which the stomach is reduced in size. This is a purely restrictive procedure with no malabsorptive component. The absorption of the food proceeds normally but the amount of food that a person can consume is significantly restricted. As a result of the partial resection of the stomach, gastric sleeve almost eliminates the production of ghrelin, the hunger hormone that is produced by cells in the stomach wall. This hormone stimulates the brain, telling the body that it wants to eat.
In the past, gastric sleeve was performed as part of the more complicated “sleeve gastrectomy with duodenal switch”, a procedure that apart from reducing the size of the stomach it also dramatically restricted the ability of the intestines to absorb the ingested food. Sleeve gastrectomy with duodenal switch targeted severely obese people.
Although there has been much success with sleeve gastrectomy procedure in the short term, the long term success rate has yet to be decided.
TOGA, which is an acronym for Trans-Oral Gastroplasty, is performed through the mouth of the patient. It requires the surgeon to staple sections of the stomach together to make it smaller. Reducing the size of the stomach reduces the amount of food a person can take in, and makes the patient feel fuller much faster. The advantage of TOGA over other weight loss surgery procedures is that it is less invasive.
The TOGA System from Satiety, Inc. is not yet available in the U.S., although investigational tests in FDA trials have so far been positive.
The newest weight loss option is the POSE (Primary Obesity Surgery, Endolumenal) which reduces the size of the stomach pouch of a patient that has undergone gastric bypass surgery. Dilation of the pouch in gastric bypass patients is a common case and leads to overeating. POSE aims at reducing the size of the dilated pouch, thus restricting the amount of food that can be ingested.
POSE is done without any external incisions. A surgeon uses special tools to make special anchors to hold tissues of the stomach together. These tools are manufactured by USGI Medical, and claim that they work for up to two years. This procedure is currently being tested in clinical trials. The procedure is meant to decrease the size of the stomach, as well as the amount of food it can take in, resulting in weight loss.
5. Gastric Plication Surgery
Gastric Plication Surgery (GPS) is a lot like the vertical sleeve gastrectomy, but does not use staples or reduction of the stomach via resective operations. The GPS system folds the stomach on top of itself, to reduce the amount of space, prompting the patient to reduce the size of meals they are eating. It does this by stitching the stomach together after it is folded on itself. Currently there is no long term data on patients after having this done. As of now, this is the cheapest surgical weight loss procedure available.