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September 10, 2007

StomaphyX: Incisionless Surgery To Correct Weight Gain After Bypass

Stomaphyx_gastric_bypass_2 As the number of obesity cases continues to soar in the United States, the number of bariatric surgeries performed annually for weight loss increases steadily. But surgeons are now beginning to see another wave of patients whose success with the surgery has started to wane.

At Ohio State University Medical Center, surgeons have performed the first incisionless procedure in the United States for weight gain following gastric bypass – which makes it possible to escape the high rate of complications associated with traditional revisional surgery.

The incisionless technique has been approved by the Food and Drug Administration, using principles of revisional surgery to help shrink the size of the stomach. But the technique, “endoluminal tissue approximation,” is accomplished totally with a tube passed through the mouth – and no surgical incisions.

Key advantages of the new device, known as the StomaphyX, include: no incisions or scars; less pain; a lower rate of complications compared to the traditional revisional bariatric surgery; and a much quicker recovery, making it an outpatient procedure, according to Dr. Dean Mikami, a general surgeon at OSU Medical Center. Mikami helped to develop the new device and is the first surgeon in the U.S. to perform the procedure.

A flexible endoscope is passed through the mouth and advanced to the stomach, carrying a fiber-optic camera and a tubular surgical tool. Then tissue of the stomach is pulled by suction into the tubular device. Approximately 12 to 20 “H-shaped staple-like” fasteners are placed strategically in the stomach, to create pleats in the tissue and reduce the size of the stomach’s pouch.

“The incisionless surgery helps to re-create the patient’s smaller stomach, causing early satiety and further weight loss,” said Mikami. “This is currently the only endoscopic or nonsurgical way to reduce the size of the stomach after gastric bypass surgery.” The procedure also results in a smaller opening of the stomach’s pouch; a decrease in the stretch of the stomach, so that it can’t hold as much food; and a slower emptying of the stomach.

A total of 22 “endoluminal revisional bariatric operations” have been performed at Ohio State’s Medical Center since April 2007. All patients are doing well, according to Mikami. The average weight loss has been about 10 pounds at one month; 15 pounds at two months; and 20 pounds at three months.

The first patient in the United States to receive the new procedure was referred to Ohio State and received the incisionless operation on April 12, 2007. She had gained approximately 50 pounds since her gastric bypass. Since the StomaphyX procedure was performed, she has lost 26 pounds, or 38 percent, of her excess body weight.

“It is estimated that over 1 million people in the last 15 years have undergone gastric bypass surgery. About 10 to 15 percent of that group two to 10 years out may need a revisional procedure to reduce the size of their gastric pouch for further weight loss or to treat a post-operative bariatric surgery syndrome such as dumping. You’re looking at close to 200,000 patients who may need this type of follow-up procedure in the U.S. alone,” said Mikami, who has helped to train all of the surgeons in the United States – approximately 25 physicians so far – who have learned the procedure.

“As a bariatric surgeon, I treat a growing number of clinical severe obese patients,” said Mikami. “I know the joys of those patients who are cured of their diabetes and hypertension – and no longer require medication. It’s like they receive a second life. Now, the new device has actually given them a third chance at life – in a much safer way than could be offered in the past.”

The patient population for StomaphyX can range in age from 18 to 70. Mikami describes good candidates as those who have undergone gastric bypass for obesity, have re-gained some of the weight they had lost, are compliant with their diet, continue to exercise regularly, and do not have early satiety during meals. The StomaphyX procedure can give patients a tool to help them achieve their weight-loss goal and keep their obesity-related problems away.

“Incisionless surgery, or natural orifice surgery, is currently at the forefront of surgical procedures,” said Mikami. “This could perhaps also lead to the development of new ways to adjust the stomach, even before weight gain occurs. We are definitely on the leading edge of surgical technology.”  (Source)


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Is this procedure ok for original surgical procedures? I am a candidate for Gastric By-pass but am unsure about having it done.

Enid T Davis

I have gain about 40 pounds I'm so afraid that i can go back to the 280 pounds I use to weight. Please let me know I their is any surgeon in PR who is doing this procedure. Please answer me. If you need any patiient to go under this procedure let me know. My diabetes is in control I realy don't want to go back.
Thank a lot

Steve Martin

My sister is a 320 pound 42-year old with diabetes and she has also been on methadone for pain for years and has been diagnosed recently with pulmonary hyper tension. She also has some mild kidney problems. We all (including her doctors) agree that should she be able to lose 100 pounds that she would be able to have a brand new life, but there is no anesthesiologist in Maine that we know of who will allow her to be put under in order to have standard bariatric surgery. Would this new procedure be something we should pursue?

Lucy White

I had gastric bypass surgery in 1999. I lost weight quickly with exercise. Now, I am slowly gaining all of it back and have put back on 130 pounds. I still have vomiting if I eat too much or too fast, but I have no trouble eating snack foods.

Is there a surgeon in Arkansas who does this, and if so, what is the cost? I'm sure my insurance would not be responsible for it.

Thank you.



I too had the surgery in 1992. I kept it off long enought to have 2 children. I in the last 5 years have put almost all of it back on. IN my research thus far, the closes I can find is in Houston or Austin, TX.

Please advise anyone-- Need someone in Arkansas!


Steffany R

I have found several doctors at this URL...
http://www.obesityhelp.com/forums/rny/a,doclisting/type,StomaphyX/ There is one in Little Rock, but not sure how close that might be for you.


I had a gastic bypas in 2000, gained 30 pounds back and had 2 stomaphyx procedures with Dr Eric Schlessnger in Phoenix. I paid out of pocket and neither surgery worked. i have gained even more weight. if anyone else had it done and it didn't work please tell me.

toni londow

i had gastric stappling in 2002. just recently gain all the weight back. is there any procedure to fix the gastric stappling.


I also have had bypass surgery and have gained the weight back so I am looking for a surgeon in the Buffalo New York area or the Rochester New York area that will do the new procedure stomaphynx. Please help me


Had gastric by-pass surgery 8 years ago. Six months after my surgery, my doctor retired and was told by the hospital that they had no one to follow me. So I have been on my own basically ever since doing research and asking my GP questions. I have been slowly regaining weight. My Type II diabetes was the reason for the surgery and is still controlled but do not want those problems to return. I have arthritis and my weight gain is hindering my exercising. Is there anyone in Virginia that performs the stomaphyx.


I had gastric bypass 08-2002 and lost 100 lbs. I have now gained back 25 lbs. and I'm very interested in stomaphyx. I need to lose 40 lbs altogether. Does anyone know if this is covered by insurance and how hard is getting the insurance to okay it? I still have high blood pressure and feel with another 40 lbs. weight loss I might be able to get off of meds.
Had surgery in Ft Collins, Colorado.


I had GB back in 2004 and have gained about 35-40 lbs. Now I am fighting lower back stenosis degenerated disc problems, hight blood pressure,osteroarthritis (had two knees replaced) and was wondering if insurance will pay for stomaphyx?


Can anyone tell me approxamatly how much this procedure costs? Does insurance cover any? Do you have to be refered by Dr? Thank you


i had gb in 2004 and have never gotton down to my ideal weight. and am now putting weight back on.need someone to help in pa


I to had gastric bypass about 2 yrs ago and have gained of my weight back. I work in an ER dept. and it is really hard to eat healthy food there! I ask my doctor who done my rny and he recommended this stomaphyx and I got all ready for it and when it came time for the surgery my insurance would not pay...they say it is experimental...dont ask me how but they do!!! I appealed it several times to the highest I could go and needless to say I still didnt get to have the surgery.... So if anyone knows where I can get this done at a resonable rate please let me know. Heck anyone that has had this done please let me know if it works...before I pay cash to have it done! Thanks and god bless all!!

Tina Moyer

If anyone knows, is there physician in PA thats does the stomaphyx procedures?


Is there a doctor in Idaho Boise area that perform this surgery? Approx how much does it cost?


Does insurance pay for this procedure. I had gastric bypass in the 80's. Started gaining my weight back in 2000. Lot's of changes in my life. Now I'm almost back to my orignal weight before the surgery. I spoke to a center in NJ. They told me the procedure in the clinic would 11,500.00 if in hospital it would be much higher. I live in DE. Has anyone had experience in DE or close to DE with this procedure? Thank You


Does anyone know of a doctor in Kentucky who does the Stomaphyx Procedure


The STOMAPHYX is not what I was hoping for,one month ago I had it done and to me it was a waste of money and time! I am hungry and DO NOT have the restriction I had with my gastric bypass and the constapation is terrible! I set myself up for failure! GOOD LUCK MAYBE IT WILL WORK FOR YOU IT ISN'T FOR ME!!

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