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Bon Secours First to Offer Incision-free Procedure to Keep Weight Off

Procedure to Treat Weight Regain after Gastric Bypass Surgery

Richmond Surgical Bariatrics Group at Bon Secours St. Mary’s Hospital is one of the first centers in the U.S. and the only hospital in Virginia to offer a new incision-less procedure to reverse weight gain after gastric bypass surgery. The first procedures were performed earlier this week.

The incision-less procedure, which physicians have coined "ROSE" (Restorative Obesity Surgery, Endolumenal), reduces the size of a patient's stomach pouch and stoma (the opening to the small intestine) to its original post-gastric bypass proportions to help the patient get back on the path to weight loss. An estimated 125,000 patients are candidates waiting for an incision-less revision procedure.

Surgeons Gregory L. Schroder, M.D., F.A.C.S., and Matthew L. Brengman M.D., F.A.C.S., are the physicians performing the procedures at St. Mary’s.

According to Dr. Schroder, 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 gain sometimes occurs because the stomach pouches and the stoma slowly stretch out, allowing the patient to eat more without feeling full.

To date, revision options have been expensive, difficult to perform and risky for the patient because of the scar tissue left from the original operation, effectively leaving them without any treatment options.

“The ROSE procedure offers a dramatically less invasive way to correct a key cause of weight regain," Dr. Brengman said. “By eliminating skin incisions, this new procedure provides important advantages to patients including reduced risk of infection and associated complications, less post-operative pain, faster recovery time and no abdominal scars.”

The ideal patient for the ROSE procedure is a patient who was initially successful in losing weight after their gastric bypass and is now regaining. 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.

"Gastric bypass patients work very hard to manage their weight and adjust their lifestyle after surgery," Dr. Schroder said. "Sometimes, through no fault of their own or their surgeon, the benefits of the bypass procedure start to fade and they begin to regain weight and the problems associated with it."

To perform the ROSE procedure, the surgeons use a small, flexible endoscope and a new EndoSurgical Operating System(TM) (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 tissue folds around the circumference of the stoma, reducing the diameter of the opening to more closely match original post-gastric bypass proportions. 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.

More than 200,000 individuals in the U.S. underwent bariatric surgery 2007. More than 15 million people in the U.S. 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.

Patients wishing to learn more about the ROSE procedure may call the Richmond Surgical Group at 1-800-720-5871.

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