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LONG BRANCH, NJ, April 4, 2008 – Monmouth Medical Center has become one of the first hospitals in the United States and the only hospital in New Jersey to offer a new incisionless procedure to reverse weight gain after gastric bypass surgery.
Steven Gorcey, MD, division chief of Gastroenterology at Monmouth Medical Center and Frank Borao, MD, chief of Minimally Invasive Surgery and medical director of Monmouth’s Bariatric Surgery Program, perform the incision-free procedure, coined “ROSE” (Restorative Obesity Surgery, Endolumenal). ROSE reduces the size of a patient’s stomach pouch and stoma to the original post-gastric bypass proportions to help them back onto the path of weight loss.
“Gastric bypass patients work very hard to manage their weight and adjust their lifestyle after surgery,” Dr. Gorcey said. “Sometimes, through no fault of their own or their surgeon, the benefits of the bypass procedure are not permanent.” He added, “To date, revision options have been expensive, difficult to perform and risky for the patient, effectively leaving them without any treatment options. Now, with this new incisionless procedure being offered at Monmouth Medical Center, we have a new and dramatically less invasive way to correct a key cause of weight regain.”
Gastric bypass surgery offers the most effective means possible to lose weight. It is not, however, always a permanent fix. Up to 44 percent of patients who undergo gastric bypass begin to regain weight – and the dangerous co-morbidities associated with it – a few years after their initial operation.
Studies show that post-gastric bypass weight regain sometimes occurs because the stomach pouch and the opening to the small intestine (the stoma) slowly stretch out, allowing the patient to eat more without feeling full. Invasive procedures to restore the anatomy to the original post-surgery proportions have been too complicated and dangerous for most patients, leaving them without any feasible treatment options.
ROSE surgery avoids cutting through scar tissue and instead allows the surgeon to get his tools to the stomach through the mouth and esophagus. Once there, the doctor can reduce the size of the stomach pouch and the opening to the intestine from the inside, without having to cut through previously damaged tissue.
By eliminating skin incisions, this new procedure may provide important advantages to patients including reduced risk of infection and associated complications, less post-operative pain, faster recovery time and no abdominal scars. “We expect the ROSE procedure to give longer lasting results than earlier endoscopic ‘suck and shoot’ revision methods because the sutures are less likely to fall off the lining of the stomach,” Dr. Gorcey said.
Dr. Borao added, “To perform the ROSE procedure, Dr. Gorcey and I use a small, flexible endoscope and a new EndoSurgical Operating System™ (EOS) developed by USGI Medical Inc. The scope and the EOS are inserted through the mouth and into the stomach pouch. The EOS tools are then used to grasp tissue and deploy suture anchors to create multiple, circumferential tissue folds around the stoma, reducing the diameter of the opening to more closely match original post-gastric bypass proportions.” He added, “If needed, additional anchors are then placed in the stomach pouch to reduce its volume capacity. No cuts are made into the patient’s skin during the procedure.”
Brenda Damiano, 47 a registered nurse from Toms River, lost 120 pounds after her gastric bypass weight-loss surgery in 2002. Then, during the past year, some 25 pounds crept back on. She wanted a second chance. Fortunately, she was an excellent candidate for ROSE, and became the first patient to undergo the procedure at Monmouth Medical Center.
Drs. Gorcey and Borao performed the procedure together. “It takes two people, a laparoscopic surgeon and a gastroenterologist,” Dr. Gorcey said. Done under general anesthesia, the ROSE procedure takes about one hour. The patient goes home the same day and no pain aside from a little sore throat that subsides in 24 hours. Most patients can go to work the next day.
The results were immediate. Damiano’s stomach pouch was reduced back to 2 centimeters and she began to feel full right away. She lost about 15 pounds in the first six weeks after the ROSE procedure.
Damiano knows that long-term success is about more than just surgery. She exercises regularly and pays closer attention to her eating – all habits she let slide after the first operation.
“The surgery is just a tool,” she said. “You also need a lifestyle change. “I’ve been given a second chance. If I mess up, shame on me.”
Dr. Gorcey and Dr. Borao said ideal patients for the ROSE procedure are patients who were initially successful losing weight after their gastric bypass and now are regaining weight. After an initial screening, candidates undergo a series of evaluations including nutritional and dietary counseling, a full medical exam and endoscopy to determine if they are good candidates.
More than 15 million people in the United States suffer from severe obesity and the numbers continue to rise. Several serious diseases and conditions are commonly associated with obesity, including Type II diabetes, hypertension, sleep apnea and cardiovascular disease. Surgical treatment of obesity has increased significantly in recent years. Over 200,000 individuals in the United States underwent bariatric surgery 2007, and it is estimated that over 125,000 patients today are candidates waiting for an incisionless revision procedure.
The Bariatric Surgery Program at Monmouth Medical Center makes a long-term commitment to patients’ health and guides them from pre-surgery consultation and testing through surgery, recovery and continuing support. Monmouth Medical Center specializes in laparoscopic weight-loss surgery including adjustable gastric lap banding and Roux-en-y Gastric Bypass.
Dr. Borao is board-certified and fellowship trained in advanced laparoscopic surgery and has been a pioneer in weight loss surgery in New Jersey. As a leader in the field, he has since trained many other surgeons throughout the state in bariatric laparoscopic techniques and has among the lowest complication rates in New Jersey.
For more information on the Bariatric Surgery Program at Monmouth Medical Center or the ROSE procedure, or to schedule a consultation, call 800-339-9053 or visit www.mmcsurgery.com/bariatricsurgery.
CONTACT: Kristine A. Brown
Director of Public Relations
732-557-3902
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