20% of stomach removed via mouth in US

Doctors who performed a stomach reduction through a patient's mouth say it's the first time this type of surgery has been done in the United States.

During the weight-loss procedure - called a sleeve gastrectomy - surgeons at the University of California, San Diego, School of Medicine removed 20% of the patient's stomach. The smaller stomach is thought to increase the patient's feeling of fullness and reduce food consumption. A patient generally loses two to four pounds a week after the surgery.

The operation, which involved laparoscopic surgery, required five small incisions in the abdomen to allow cameras and other instruments to enter the abdomen. Surgeons also removed a small portion of tissue through the abdomen and inserted staples to close the stomach.

"The number of options for minimally invasive weight-loss surgery is rapidly evolving. Our goal is to offer patients a customised long-term solution for losing weight with as few scars as possible, and if desired, no medical devices," Dr Santiago Horgan, chief of minimally invasive surgery and director of the UCSD Centre for the Treatment of Obesity, said in a university news release.

"By removing 80% of the stomach through the mouth we minimised trauma to the abdomen. The absence of a large open incision reduced the risk of hernia, and greatly diminished pain for the patient. We are getting closer to weight-loss surgery with no scars," Horgan said.

Second surgery sometimes needed

In 2009, a committee of experts with American Society for Metabolic and Bariatric Surgery issued a position statement on sleeve gastrectomy, published in Surgery for Obesity and Related Diseases.

The ASMBS has accepted the procedure as an approved bariatric surgery "primarily because of its potential value as a first-stage operation for high-risk patients," the committee wrote.

However, they say "unanswered questions" remain - including whether many patients undergoing sleeve gastrectomy might later need to undergo a second weight-loss surgery.

"A deficiency of long-term follow-up data remains in the published surgical reports to confirm the effectiveness of sleeve gastrectomy as a stand-alone intervention at [or beyond] five years," the group wrote. (August 2010)

(Copyright © 2010 HealthDay. All rights reserved.)

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