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Teens Trim Up With Incisionless Surgery

“Sewing Machine” Used to Create Smaller Stomach Pouch, Limiting Food Intake
By
WebMD Health News
Reviewed by Louise Chang, MD

May 20, 2008 -- Using a tiny sewing machine that is advanced down through the mouth and into the stomach, doctors are successfully reducing the size of obese teens' tummies -- and helping them to shed unhealthy pounds.

So far, 12 adolescents aged 14 to 17 have undergone the procedure. Their average weight dropped from 236 pounds before the procedure to 187 pounds six months afterward.

On average, the teens lost 60% of their excess weight in six months, says Roberto Fogel, MD, of the Hospital de Clinicas Caracas in Venezuela. Fogel invented the procedure.

There were no serious complications, and the patients left the hospital a few hours after the 40-minute procedure. One played softball that night, Fogel says.

The findings were presented at Digestive Disease Week 2008 in San Diego.

How It Works

The incisionless technique involves sewing the front and the back of the stomach together. This creates a smaller stomach pouch, thus limiting how much food you can eat.

Also, food moves more slowly from the top of the stomach to the bottom because only a small opening is left between the two.

"Imagine taking a plastic bag and going two-thirds of the way up or one-third of the way down. Then you sew the front to the back wall, but you leave a little opening between the two," says Mark DeLegge, MD.

DeLegge, a professor of medicine at the Digestive Disease Center of the Medical University of South Carolina in Charleston, moderated a news briefing to discuss the findings.

Doctors introduce the surgical instruments through the mouth, down the esophagus, and into the stomach via a guidewire that is placed alongside a long flexible tube called an endoscope.

The procedure is performed while the patient is under general anesthesia.

Small Portions Key

Fogel stresses that patients have to agree to stick to a diet and exercise program after the procedure. Small portions are key.

"If you start eating too much, you can rip the sutures," he says. "But this [procedure] leaves you less hungry and with less space for food, so it's easier to eat less."

The study in teens was conducted in Venezuela. Fogel has also performed the technique on several hundred adult patients in Venezuela and Miami, with equally good results.

Because it doesn't involve surgery, the procedure may be particularly appropriate for teens, DeLegge tells WebMD.

Many doctors are reluctant to operate on "13-, 14-, or 15-year-olds whose digestive systems may not be fully developed. This [procedure] offers a nonsurgical approach, and one that can be reversed if necessary," DeLegge says.

With nearly one in five teens now obese, "it's obvious we have to do something to fight the epidemic," he says. Obesity in childhood and adolescence has been linked to obesity and an increased risk of cardiovascular disease in adulthood.

While further study is needed to confirm the procedure's safety and long-term effectiveness, "this is not pie in the sky stuff. This is real," DeLegge says.

Fogel says that in addition to the health benefits of shedding excess pounds, "these kids have a very nice change in quality of life. They lose 40 or 45 pounds, they feel different. They start going out more. It's a total life change," he says.

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