A medical-device company and a bariatric surgeon team for weight-loss surgery requiring just one incision.
A medical-device company in North Carolina and bariatric surgeon Dr. Brian B. Quebbemann of Newport Beach, Calif., have teamed up for weight-loss surgery requiring just one incision.
The operation was the first time a surgeon has used a new Spider surgical tool for an increasingly frequent form of bariatric surgery that cuts the stomach down to 20 percent of its normal capacity, Quebbemann said.
The Spider system allows surgeons to operate through the belly button, using a tool containing working arms that unfold inside the patient.
The operation is called “vertical sleeve gastrectomy,” which Quebbemann said is one of the fastest-growing types of bariatric surgery. The procedure is most frequently used to treat severely obese patients, but it is also effective for less obese patients with body-mass index of 30 to 35, he said.
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It’s an alternative to better-known forms of weight-loss surgery — the gastric bypass, in which food is detoured around the stomach, and the Lap-Band, which creates a small pouch at the top of the stomach.
The name “vertical sleeve” describes the shape of the portion of the stomach that remains after the surgery.
Quebbemann, surgical director at The N.E.W. Program weight-loss center in Newport Beach, said the procedure appeals to patients who worry about how a gastric bypass will affect nutrition. It’s also an alternative to Lap-Band surgery for patients who do not want “an artificial device attached to their stomach,” he said.
The Spider system, produced by TransEnterix Inc. of Durham, N.C., was approved by the Food and Drug Administration last year.
Quebbemann said the Spider device made the operation easier:
“Instead of making several incisions to place my surgical instruments, I simply make one small incision, hidden in the patient’s belly button, and insert the Spider. I then expand the internal portion of the device, similar to expanding an umbrella. This allows me to clearly see the anatomy and accurately perform the operation.
“(At the end of the procedure,) I simply close the system, and remove it through the small incision, leaving almost no visible scar.”
The company said the device has previously been used for Lap-Band placement, colon surgery and for kidney and gallbladder removals.
The vertical-sleeve operation was performed at the Advanced Surgical Partners Surgery Center in Costa Mesa.
A vertical-sleeve procedure is not a “quick fix” for obesity, warns the Medline Plus online information service, sponsored by the National Institutes for Health.
“It will greatly change your lifestyle. You must diet and exercise after this surgery. You may have complications from the surgery and poor weight loss if you don’t,” Medline says.
This procedure cannot be reversed. Medline says risks include:
Injury to stomach, intestines, or other organs during surgery.
Leaking from the line where parts of the stomach have been stapled together.
Scarring in the abdomen, which could lead to an obstruction in the bowels.
Inflamed stomach lining, heartburn, or stomach ulcers.
Poor nutrition, “although much less than with gastric bypass surgery.”
Vomiting from eating more than the stomach pouch can hold.
“The final weight loss may not as large as with gastric bypass. However, this may be enough for many patients. Because vertical sleeve gastrectomy is a newer procedure, there is less data about the long-term benefits and risks,” Medline says.