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Endoscopic Bariatric Surgery

Until recently, if you wanted to combat obesity, your only options were lifestyle modification and bariatric surgery. But, a lot of individuals don't want to undergo surgery due to fear or anxiety about the risks involved. Or in some cases, they don't meet the surgical requirements. Today, fortunately, you have another option to help fill in the gap between lifestyle changes and surgery - endoscopic bariatric procedures.

Minimally invasive bariatric endoscopy procedures are ideal if you don't qualify for bariatric surgery or if you’re looking for a non-surgical approach to weight loss. These procedures are often done the same day on an outpatient basis. Unlike bariatric surgery, you also don't need a referral for bariatric endoscopy at our Anderson, SC, weight loss clinic. Just keep in mind that bariatric endoscopy is not covered by insurance.

What are Endoscopic Bariatric Procedures?

Similar to bariatric surgeries (i.e. sleeve gastrectomy, Roux-en-Y gastric bypass, and adjustable gastric banding), bariatric endoscopy helps to reduce stomach volume or alters part of your digestive tract to reduce how many calories your body can absorb or ingest. The goal of this procedure is to help the body lose weight.

During endoscopic bariatric procedures, the endoscopist uses a flexible, small scope to insert a suturing device through the mouth and into the stomach. Once in the stomach, the endoscopist will suture the stomach to make it smaller in size. Because this procedure is minimally invasive, it reduces your risk of complications.

The surgeon can perform endoscopic bariatric therapy as a primary therapy where it's your first-line weight loss treatment or as a secondary therapy where it's used as a follow-up to another previous surgical procedure that didn’t result in weight loss. Typically, endoscopic bariatric procedures are performed on an outpatient basis, where you can return to your regular activities within a few days of your procedure.

Who Should Consider Endoscopic Bariatric Procedures?

Bariatric endoscopy procedures are ideal for anyone struggling with weight loss who doesn’t qualify for weight loss surgery or who doesn’t want to undergo a surgical procedure. It’s also used for patients who’ve previously undergone weight loss surgery but who are no longer seeing weight loss results or have regained weight.

Endoscopic bariatric therapy is generally approved for anyone with a body mass index between 30 and 40. In addition to the BMI qualifications, other candidates for bariatric endoscopy are those who have or are at a greater risk of having weight-related health conditions, like type 2 diabetes, high blood pressure, and heart disease. 

Types of Endoscopic Bariatric Procedures

There are various types of endoscopic bariatric procedures, all using the same method of inserting a tube containing a camera and suturing device through the mouth and into the stomach.

Intragastric Balloon

Intragastric balloon placement, also known as gastric balloon placement, is a type of weight-loss procedure involving the placement of a balloon that is filled with a saline solution into your stomach. It is intended to help you lose weight by making you feel fuller quicker and limiting the amount of food you eat. It's an option if you're concerned about your weight and exercise and diet isn't working for you.

Similar to other procedures for weight loss, an intragastric balloon requires you to commit to a healthier lifestyle. You'll have to make lifelong healthy diet changes and exercise regularly to ensure you achieve long-term success from this procedure.

How the Intragastric Balloon Works

The doctor inserts the intragastric balloon and a small camera through a thin tube that enters the mouth to reach the stomach. Doctors use the camera to position the balloon and fill it with a saline solution. It's an outpatient procedure taking around 30 minutes.

It's a reversible procedure; the balloon is supposed to be left in place for a certain time period—typically 6 months— and then endoscopically removed after.

Risks of Intragastric Balloon Placement

While this endoscopic bariatric procedure isn't considered major surgery, there could still be side effects and potential risks. Some side effects are more likely to occur than others since it takes your body time to adjust to the balloon's presence. Common side effects might include:

  • Nausea
  • Vomiting
  • Abdominal pain

While it's not likely, there could be risks of balloon deflation. The balloon’s saline is a blue tint that acts as an indicator. If your urine is green or blue, you should call your doctor right away.

Those who had previous gastric surgery or have a hiatal hernia don't qualify for the gastric balloon placement. It's also not great for individuals who have acid reflux because it could worsen symptoms.

Results of Intragastric Balloon Placement

After your intragastric balloon procedure, you’ll stay on a liquid diet for at least a week. You’ll then eat soft foods up until week 3, at which time you’ll start eating regular food again.

The intragastric balloon could make you feel fuller quicker than you would normally when you eat, which frequently means you won't eat as much. This could be because the balloon slows the time down that it takes for emptying your stomach. Or, it could also be due to hormone level changes that control your appetite.

You can anticipate a loss of around 7% to 15% of your body weight during the first six months following the placement of your intragastric balloon. Total excess weight loss will typically range from 30% to 47%. How much weight you lose will also depend on your ability to change your lifestyle habits which includes exercise and your diet.

Endoscopic Sleeve Gastroplasty

This is a minimally invasive procedure for weight loss. During endoscopic sleeve gastroplasty, doctors suture the stomach to make it smaller. 

How Endoscopic Sleeve Gastroplasty Works

For this procedure, the doctor uses a flexible tube with an attached camera and an endoscope (endoscopic suturing device). They insert the endoscope down the throat and into the stomach. The camera lets the doctor see inside your stomach and operate without having to make incisions in your abdomen.

The doctor uses the endoscope to place sutures in your stomach. These sutures will change your stomach's structure and leave it shaped like a tube, which restricts how much food you can eat because it causes you to feel fuller quicker.

Endoscopic sleeve gastroplasty results in substantial weight loss. It limits how much you're able to eat, which is how it helps you lose weight. It's a minimally invasive procedure and reduces your risk of surgery complications. It also allows you to return to your daily activities quickly.

Endoscopic sleeve gastroplasty is performed as an outpatient procedure, taking under two hours to complete. For the procedure, general anesthesia is used so you'll be unconscious. After your endoscopic sleeve gastroplasty, you will have a liquid diet for at least 14 days, before moving on to semi-solid foods, and a regular diet thereafter.

Like with other types of procedures for weight loss, endoscopic sleeve gastroplasty requires you to commit to a healthier lifestyle. You have to make permanent healthy diet and exercise changes to ensure this procedure's long-term success.

Risks of Endoscopic Sleeve Gastroplasty

Endoscopic sleeve gastroplasty, so far, has been shown to be safe. Nausea and pain might occur for a few days following your procedure. You can usually manage these symptoms with medication. Most individuals feel better after several days.

Results of Endoscopic Sleeve Gastroplasty

Like with other weight loss programs, you must commit to physical activity, nutrition, and emotional health as it will play a huge role in the amount of weight you lose. Usually, if you finish the entire program and follow all guidelines, you could expect to lose around 12% to 20% of your weight in a year.

Aspiration Therapy

Aspiration therapy is another solution for weight loss for individuals suffering from obesity. It's a tube port, nonsurgical, weight loss solution, which allows you to effectively and safely remove food from your stomach after you eat. It's reversible and nonsurgical and is an easy approach that will allow you to control your own weight loss.

How Aspiration Therapy Works

During aspiration therapy, the doctor inserts a small tube into your stomach during an easy 15-minute procedure. This tube attaches to a button on your skin's surface. Around half-hour after every meal (up to three times daily), you'll open the button and connect it to a hand-held device that will facilitate the emptying of the contents of your stomach into the toilet. This is how the device limits how many calories your body processes. 

Individuals can typically go home within a couple of hours after their procedure and get back to regular activities within a couple of days.

With this procedure, no foods or drinks are off-limits, although with the help of your health care team, you'll slowly learn to eat healthier. There's also no need to limit your activities after the device is installed. 

With consistent monitoring by your doctor and a team of health care experts, aspiration therapy provides a long-term, weight loss option. However, the device can be removed any time during a 10-minute, outpatient procedure.

Risks of Aspiration Therapy

Any side effects with aspiration therapy are typically minor and few. Since your gastrointestinal anatomy isn't changed, you don't experience the side effects you'd experience with more invasive weight loss procedures.

Aspiration therapy complications are similar to the complications you'd see with standard PEG tube placement. Some complications you might experience are:

  • Abdominal pain
  • Nausea
  • Vomiting
  • Peristomal bacterial infections
  • Peristomal inflammation

Serious adverse events are rare but could include severe abdominal pain and peritonitis, which requires intravenous antibiotics.

Results of Aspiration Therapy

In the first month, a lot of individuals see quick weight loss. The target weight loss is around one to two pounds each week, but weight loss can be even quicker during the first several weeks. A study showed that successful, U.S. patients who regularly used the device and made lifestyle changes gradually, lost more than 100 pounds in their first year.

Secondary Endoscopic Bariatric Therapy

Endoscopic bariatric therapy is often done as a corrective or secondary procedure to resolve adverse issues from a past bariatric surgical procedure. Individuals who experience adverse issues following gastric bypass, adjustable gastric banding, or sleeve gastrectomy or those who've regained weight following a gastric bypass surgery could receive a secondary endoscopic bariatric therapy treatment. Secondary endoscopic bariatric therapy can apply any of the specific therapies detailed above.

How Secondary Endoscopic Bariatric Therapy Works

Suturing is used in an endoscopic revision for people who've regained weight after a past gastric sleeve or gastric bypass surgery.

Research has shown sustained weight loss can be hard for some patients of bariatric surgery, including people who experience initial success. Most people reach their maximum weight loss around one year to three years after their weight loss surgery. The research shows patients, on average, after 10 years, regain around 30% of their weight. This is where secondary endoscopic bariatric therapy is used to help keep weight off throughout the lifetime of the patient.

During endoscopic bariatric therapy, the doctor inserts the endoscope through your mouth while you're under supervised anesthesia and assesses your intestines and stomach. If the stomach and/or pouch has been stretched, they can place sutures to decrease the opening and pouch size. This results in a retightened structure that initiates renewed satiety feelings to curb your intake of food.

This procedure will require you to fast overnight before your surgery with no bowel preparation. Usually, it's an outpatient procedure that lasts about an hour, but it might require you to stay overnight to treat nausea or pain.

To optimize your chance of successfully losing weight, you'll receive a consultation with a dietitian before your surgery and also follow-up counseling following your procedure. You'll be consulted about the type of diet you'll need to follow after your surgery to:

  • Facilitate weight loss
  • Avoid complications
  • Maintain long-term weight loss

You'll have a follow-up appointment with your doctor a month after your procedure.

How Much Do Endoscopic Bariatric Procedures Cost?

The cost of endoscopic bariatric procedures varies depending on the surgery type and length of stay in the hospital. Typically, patients can expect to pay anywhere from $7,000 to $14,000, although that number is dependent on the individual’s needs. For those who are looking for bariatric endoscopy in Anderson, AnMed Health will review the cost with each patient so they know what to expect financially.

As of yet, endoscopic bariatric procedures are not covered by all insurance, patients who decide to undergo the non-surgical weight loss options are often referred to financial counselors to review the associated costs.

There's more to the cost of endoscopic bariatric procedures than just the procedures themselves, however. There are things like pre-op classes, weight loss seminars, materials, follow-up appointments, and support post-procedure that are all necessary for your success at weight loss and maintaining healthy weight loss.

If you're having AnMed Health perform your procedure, the materials, classes, and seminars are included in your procedure costs. Whatever is not included and needs to be paid out-of-pocket, AnMed Health works with their patients to help them find the best payment options available, including financial counseling services.

Endoscopic Bariatric Procedures vs Bariatric Surgery

While both endoscopic bariatric procedures and bariatric surgery offer similar weight loss solutions, there are key differences in the approach and overall patient experience.

Preparation Time

Unlike bariatric weight loss surgery, where it can take months to prep and a few days to recover, endoscopic bariatric procedures are typically one-day procedures. While you won't experience the dramatic weight loss that you would with surgery, the bariatric endoscopy usually only takes a few hours.

Financial Options

As mentioned, not all insurances cover endoscopic bariatric procedures. Yet, if certain requirements are met, some insurance will cover bariatric surgery. So for some, bariatric surgery may be more affordable with the help of insurance.

Risks

Endoscopic bariatric procedures are an ideal solution that are less invasive than surgical procedures and, therefore, carry fewer risks and side effects than bariatric surgery.

Bariatric Endoscopy in Anderson

At AnMed Health’s Weight Loss Clinic in Anderson, SC, you’ll find a team of dedicated endoscopists that are experienced with both surgical and nonsurgical weight loss solutions. During an initial consultation, we’ll review your weight loss goals and together decide what the best weight loss procedure is for you. When you choose AnMed Health as your weight loss care provider, you’ll get the support of a dedicated medical team that will help you throughout your entire weight loss journey.

 Contact us today to schedule your endoscopic bariatric procedure appointment.