|
They are selling a new device from Europe called a "StomaPhyx" which is
supposed to be a non invasive way of making your pouch smaller if you have
gained weight. It sounds great (but then so do used cars!)
First of all, you have to understand how the surgeons use the word "non
invasive" and how WE humans use it. Totally different:
Surgeons: non invasive means less incision or no incision
Us humans: non invasive means less cutting, complications, pain etc. To us
the incision isn't that big a deal but to the surgeons, an incision means
more follow up and they can't be doing surgery when they are following up
so that means a possible loss of income.
So apparently what they do with the StomaPhyx is they stick this long tube
with some machinery attached, down your throat and esophagus into your
pouch. Then they put gas into the pouch so they can work with it.
And then they make a type of pleat or two and hold it in place with
something similar to one of those plastic thingies they use to put price
tags on. That may sound nice but my first thought it, it could make
a hole in the pouch in the longer term and might not be a very good idea.
(Remember how the "buttoneer" put buttons on?)
You can watch something similar to a stomaphyx in action by clicking
here or on the picture.
This is NOT non invasive. The stomaphyx is a surgical instrument which
goes through the mouth and through the esohagus to allow access to the
pouch.
That means they can't really see very well what they are doing... They're
assuming that the repairs are going to be SO easy they don't HAVE to see
well. But they won't know for sure until they've done a bunch of patients
- a BIG bunch....
And on the way down, they can easily nick the esophagus or the pouch and
cause other problems. (The stomaphyx has some edges which could damage
something)
The reason they are hard selling this thing is because
there is a high regain rate on Gastric bypass and revisions are the only
way they know of maybe fixing that. And also because they want to
test it. On YOU.
This is a revision just like any other revision with the same risks of
similar revisions done lap and open.
The stomaphyx is BRAND NEW. I know no patients who have even HAD it (one I
know, is signed up for it but they aren't exactly lining up yet - this one
patient is desperate... desperation is a BAD TIME To make a decision
because generally, you don't make good ones).
It's NEVER a good idea to be the first in line... it takes them anywhere
from 5-10 years to work out the bugs. That's a long time.
But let's look at revisions in general:
Stoma fixes and pouch fixes (which the stomaphyx does). You get an average
of a 30 lb weight loss. That's why most doctors DO NOT recommend these
kind of fixes. And also, if they MAKE the hole between the pouch and gut
smaller you could get all kind of problems like it getting scar tissue and
closing up completely and then you cannot even swallow spit.
I've seen people revised to intestinal bypasses who only got a 30 lb
weight loss.
Or there is the other thing with an intestinal bypass - (which is what a
distal RNY IS) that they get short term complications and cannot eat.
Then, they lose a lot of weight but they are so sick they don't even
notice it.
Does insurance cover? I don't know but insurance usually takes a long time
to respond to something new (probably to see the complication rate and
success rate).
People tend to regain after any weight loss because the body produces
hormones to make you gain because in some of us, once a higher weight has
been achieved, our bodies fight to get back up there because they
apparently think with all the famine around (how they interpret our
dieting or greatly lessened eating) that we need more fat on us.
The reason people are not hungry after their gastric bypasses is NOT
because of the pouch filling up fast but because of the fact that it takes
about a year to heal because they really cut things up and switch things
around inside and so people get (what surgeons call) "surgically induced
anorexia" that is they lose their appetites. After a revision, you
might lose your appetite for a few weeks or so but after that your
appetite will be right back, worse than it was.
What doctors generally advise since the success rate with any type of
revision is so miserable and the risks are very high, is to join a group
diet plan like Weight Watchers or Jenny Craig. The bypass becomes a tool
to even out the field a bit but I won't kid you, it's still a lot of work.
The other possibility - is to not try and lose weight but instead live a
healthy lifestyle of good food choices and daily exercise to just become
or remain healthy.
If you have regained some weight that is actually a good sign that your
body has adapted to the surgical changes... surgeons expect in a healthy
bypass patient that they will regain 50 percent of what they originally
lost so the surgeons do list those who regain as much as 50 percent of
what they lost as a success. (although they don't say that at seminars
because people really aren't interested in health anyway).
The healthiest bypass patients I know are NOT those who kept the weight
off (only a small percentage) but those who DID have the rebound gain...
|