Excess stomach removed via mouth in first ever novel weight-loss surgery

Surgeons at the University of California, San Diego School of Medicine have achieved what is believed to be the nation's first stomach reduction via the mouth. The novel weight loss procedure, known as a sleeve gastrectomy, reduces the stomach to 20 percent of its original size. The smaller stomach leads to less caloric intake and increased feelings of fullness. This is the first time in the U.S. that the excess stomach has been removed through the mouth rather than a large open incision.

''The number of options for minimally invasive weight loss surgery is rapidly evolving,'' said Santiago Horgan, MD, chief of minimally invasive surgery and director for the UCSD Center for the Treatment of Obesity. ''Our goal is to offer patients a customized long-term solution for losing weight with as few scars as possible, and if desired, no medical devices.''

The one hour procedure is described as a hybrid laparoscopic and natural orifice translumenal endoscopic surgery (NOTES.) Five small incisions were made in the abdomen to accomplish the task of partially removing then closing the stomach. The small ports allowed for cameras and instruments to enter the abdomen and for staples to be deployed to safely close the stomach. Patients lose approximately 2-4 pounds per week following surgery.

''By removing 80 percent of the stomach through the mouth we minimized trauma to the abdomen,'' said Horgan, director of the UCSD Center for the Future of Surgery. ''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.''

The Center for the Treatment of Obesity performs a wide range of procedures from gastric banding and gastric bypass to sleeve gastrectomy and scarless options for reducing the size of the stomach to ''tune up'' a gastric bypass. All patients are treated by a multidisciplinary team of experts which includes nurses, psychologists, support groups and nutritional and fitness counselors.

Horgan has performed more than 100 NOTES procedures. The Center for the Future of Surgery team was the first in the U.S. to perform an oral appendix removal and was the first in the U.S. to perform an oral gallbladder removal as part of the nation's first multicenter clinical trial to compare NOTES to laparoscopy.

Patients interested in learning more about new weight loss options, or attending a free seminar with the UCSD Center for the Treatment of Obesity may call 800-926-UCSD.