Late December 2009, GI Dynamics, a leader in non-surgical, endoscopic treatments for type 2 diabetes and obesity, announced that it has received European CE mark approval for the EndoBarrier, a non-surgical therapy to treat type 2 diabetes and obesity. The CE marking (an acronym for the French “Conformite Europeenne” or European conformity) certifies that a product has met EU requirements for marketing in Europe.

Features and benefits include:

• The EndoBarrier is implanted and removed endoscopically.

• The implantation can be carried out as a day procedure

• The overall metabolic effect that results from the implantation of the device is similar to the complicated Roux-en-Y gastric bypass surgical procedure

• Glycemic control in Type 2 diabetes

• Weight loss

• Procedure is reversible

• Safe alternative to gastric bypass

• Non invasive procedure

• Rapid recovery

• Lower costs

It could be a safe way for those who awaiting surgery to lose weight prior to the surgery.

The EndoBarrier is fundamentally a gastrointestinal impermeable barrier or a gastric sleeve that prevents food from coming in contact with the intestinal wall.

The EndoBarrier Gastric Sleeve is implanted endoscopically through the mouth and is placed in such a way that it lines the first two feet of the small intestine. This helps to prevent easy absorption of food as long as it remains in the sleeve and has huge impact on the person’s intake of nutrients and calories. The digestive enzymes are on the outside of the liner and the food and the digestive juices do not mix until 2 feet downstream in the small intestines.

The EndoBarrier received European CE mark approval for the treatment of type 2 diabetes and obesity in December 2009.

Currently the EndoBarrier is being considered as a prelude to gastric bypass surgery and hence is treated as a temporary fix. But, its future, as a non-surgical alternative to weight loss and diabetes type 2 treatment, is extremely promising.

Clinical trials to date demonstrated a significant weight loss and diabetes improvement achieved with the Endo-Barrier Gastrointestinal Liner.

Undoubtedly we will hear a lot more about this New Obesity Surgery/

Robotics Obesity Surgery is a particularly good option for bariatric patients who choose the gastric bypass procedure. Robotic surgery isn’t commonly available yet, but certainly considered a new technology on the rise.

Robotics is a cutting-edge method of performing surgery using only a few small incisions, or keyholes similar to that used in laparoscopic cases, as ports for instruments that allow access to the heart, lungs and abdomen, while at the same time fine-tuning the technical skills of the surgeon. This surgery is performed in a three dimensional image compared to the two dimensions of laparoscopic surgery. Robotic instrumentation works by mimicking the motions and movements of the surgeons’ hands and fingers. This provides an added element of dexterity for the surgeon. Furthermore, the da Vinci’s wrist action capabilities allow the surgeon to get around corners and in tight spaces for improved precision.

When performing a gastric bypass procedure, the most complicated and important part of the obesity surgery is creating the connection between the stomach and small bowel after creating the gastric pouch. The most common approaches in connecting them are to either staple or to hand sew them together, but the best results to date and the least complications have been demonstrated with the sewing approach. The robot makes hand sewing much easier by increasing the dexterity, precision and vision of the surgeon in the tight space. More and more studies are now showing that not only in bariatrics but also in other surgical specialties complication rates are less in the robotic assisted approach when compared to the standard laparoscopic approaches.

The Gastric Balloon is a non-surgical procedure available for weight loss in many countries. While gastric balloon procedures generally cost less than other weight loss procedures, the FDA has not approved of the procedure in the United States. The balloon is effective in temporarily reducing hunger, controlling food intake, initiating behavioral (lifestyle) change, and achieving target weight loss of 10 to 25kg. This procdure is also called Toga (for transoral gastroplasty)

What is the gastric balloon?
The gastric balloon is a soft, silicone balloon that is inserted into the stomach and filled with sterile saline (salt water). When the balloon is filled (inflated) it stretches the stomach wall producing a feeling of satiety – or flack of hunger.. Additionally, because the gastric balloon fills a significant portion of the stomach, patients use smaller portion sizes, which means fewer calories!

How is the balloon implanted?
Placement of the balloon takes approximately 20-to-30 minutes to perform by a team of qualified gastroenterologists. Because the balloon is inserted and removed in a day clinic and does not involve surgery, it is considered to be a minimally invasive procedure.

The doctor passes a special endoscope (camera) through the mouth, down the gullet and directly into the stomach. This is done to ensure no abnormalities are present and it is safe to insert the gastric balloon. Once the physician has determined everything is okay, he or she will pass the deflated gastric balloon into the stomach. To ease discomfort, the doctor might offer a local anesthetic to numb the throat to make it easier to swallow. In some cases, muscle relaxants are also used to sooth throat muscles.

Once the gastric balloon is inside the stomach, it is immediately filled with sterile saline through a small filling tube (catheter) attached to the balloon. Once filled, the doctor removes the catheter by gently pulling on the external end. The balloon has a self-sealing valve and at this point it is floating freely in the stomach. Physicians also add a specially made green dye so that in the event of the balloon leaks or ruptures, the patient’s urine will change color, thereby alerting them to visit the doctor.

Because there is no general anesthesia involved in this weight loss procedure, the patient is observed for a short time, he or she is free to leave the hospital in one or two hours.

Obese patients with diabetes type 2 whom had obesity surgery reversed their diabetes very soon after their obesity surgery.

More surgeons are testing whether obesity surgery helps diabetics who are merely overweight or a tad obese to control their blood sugar.

It has been reported that The Cleveland Clinic is recruiting 150 overweight and obese diabetics. Some will have surgery and their progress will be compared to those who manage their diabetes with medicine. The goal is to see which group can beat their diabetes.

Also seen reported on the wire that the New York-Presbyterian/Weill Cornell Medical Center is looking for 50 diabetics to undergo surgery. Doctors will track if patients’ blood sugar levels normalize after the procedure.

Longterm success of keeping weight off after obesity surgery depends on maintaining the lifestyle you needed to made to lose the weight.

That means continuing improving your body and mind.

Even if you now look and feel great after the weight loss you achieved with obesity surgery, there are always steps you can take, every day, to improve your body and mind to ensure the weight stays off. It takes constant work to improve your life, even when you have achieved already so much.

The stress of modern life can sometimes make it difficult to continue leading a healthy lifestyle. You can continue living healthy by adopting a healthy mindset.

So with that said, we all can use some healthy living tips to ensure that we are the best we can be every day. So here are some healthy living tips to improve your body, mind and long term weight control.

The most essential mental and physical health tip is to enjoy quality sleep. Likely your sleep apnea is gone after the weight loss. Getting enough sleep will boost your health and productivity, and it will rejuvenate your body and mind.

Some people may believe that sleep is overrated, but study after study has shown that those who get at least eight hours of sleep look and feel better than those who don’t.

Don’t be be tempted to skip exercise. Not only does exercise help you look good, but it also helps you feel good. Exercise releases endorphins that make you feel good from top to bottom and stress literally drips off you!

Positive thinking begins when you affirm the positives in your life. You can use the power of positive affirmations to reprogram your mind so you can think in a healthier and more positive way

Use positive affirmations to help remind you of your healthy living goals. Affirmations are short statements that encourage you to sharpen your mind and body while conquering your goals and improving on your weaknesses. Affirmations can help you focus on creating and maintaining the healthy body and mind you desire because it gives you the motivation you need to focus on your most important asset – you!

For example, each morning you could say, “I make positive choices for the best of my body, mind, and soul.” You can use positive affirmations in moments of weakness when you are tempted to fill up on junk food, respond negatively to something, or trade sleep for something less important.

Some other examples of affirmations include, “It is okay for me to take care of myself first,” or, “I am healthy and deserve the benefits of a healthy lifestyle.” You can use these simple positive statements throughout the day to stay motivated and focused. After all, we all need some motivation from time to time.

When you create a healthy mindset by making good choices about food, rest, and positive thinking, you’ll enjoy the new ways you think, feel, and live. You’ll discover that your happier, healthier lifestyle has arrived after your obesity surgery!

For those of you, who are unfamiliar with gastric bypass surgery, allow me to explain. The basic idea of the surgical procedure is to help to treat morbid obesity. Morbid obesity is classified as an excessive accumulation of fatty tissues and excess weight. A lot of people that get obesity surgery only do so because other forms of weight loss have been unsuccessful. Obesity surgery should only be considered by people that have had problems with losing weight their entire life and not people that are just looking for a short term fix. Gastric Bypass is the most common obesity surgery.

People that are interested in gastric bypass surgery should consider many things. Firstly, the price of this type of procedure will depend on your country’s national health plan. A lot of times this procedure will not be covered by your national health plan. This is because this procedure is considered often just for cosmetic purposes. However there are cases (if you are morbis obese) where they may deem the surgery necessary to your health. In these cases you might be able to get a portion or all of the surgery covered by your health plan.

There are many different forms of obesity surgery; they are all pretty much the same butr the process may vary from country to country, or even surgeon to surgeon. The basic idea of obesity surgery is to get you to feel full quicker resulting in eating less food, absorb less and thus eventually losing weight. It is important to note that this surgery isn’t the only thing that contributes to weight loss. After recovering from the surgery it is still necessary to maintain a healthy lifestyle and exercise.

For those of you that are unfamiliar with gastric bypass surgery, the basic idea is actually quite easy to understand. The basic idea of the surgery is to split the stomach into 2 pouches. The upper pouch is the smaller of the two and the lower pouch is larger. Once this procedure is completed the doctors then re-attach the small intestine to both pouches. This procedure, although basic, has proven to be very effective for a lot of people. Perhaps the most important part of the surgery is the recovery. This will be the time you will start to set the bar for your new diet and workout regiment.

If you are interested in learning more about gastric bypass surgery you should do all of the necessary research in order to find out if you are an ideal candidate for this type of procedure. The good news is that there are a lot of resources dedicated to this surgery. There are many other options of weight loss that should be tried before taking part in this procedure. If you have considered all of your other options and are still considering this surgery, you always consult your doctor or medical health professional to get their medical opinion. They will be able to inform you on all of the risks that are commonly associated with this procedure as well as refer you to other professionals that specialize in gastric bypass surgery.

Incision Free Obesity Surgery Update

A clinical trial for Transoral Gastroplasty for the Treatment of Morbid Obesity (TOGA®) started April 15,2008. This study is ongoing, but not recruiting anymore participants.

The TOGA procedure is an incision-free treatment using a set of flexible staplers introduced into the mouth and esophagus to create a sleeve in the stomach (transoral formation of a gastric sleeve). The TOGA sleeve limits the amount of food that can be eaten and gives the patient a feeling of fullness after a small meal.

Primary Outcome Measures:
Participants had over 25% excess weight loss after 12 months.

Secondary Outcome Measures:
Improvement in Co-morbidities; Improvements in other Obesity Measures and in Quality of Life Measures after 12 months.

Final data collection date for primary outcome measure is expected by October 2010.

Researchers in Mexico and Belgium also successfully tested TOGA weight loss over the past year. TOGA patients stayed overnight in a hospital after the procedure, but doctors believe it will eventually be performed on an outpatient basis. Repoprts indicates up to 45% of excess weight loss.

The Toga System for transoral gastroplasty is being developed by Satiety, Inc., a medical device company based in Palo Alto, Calif. The system comprises a set of flexible devices designed to be inserted through the mouth into the stomach to staple the stomach. The company is now conducting clinical trials with the hope of filing for FDA approval in the future.

Since 1954, hundreds of thousands of patients have had Obesity Surgery.

Main reason for obesity surgery is preventing the Health Risk.

Generally, patients who have undergone weight loss surgery are said to be successful if they were able to lose 50% or more of their extra body weight and will be able to maintain that condition for the next five years or so.

Like any major surgery, obesity surgery involves the potential for complications. But being Obese is also a risk. In two recent studies, researchers report that bariatric surgery can help obese people live longer. The two studies, published in the New England Journal of Medicine (NEJM 2007; 357:741, and NEJM 2007; 357:753), indicates that study has shown that gastric bypass surgery reduced all-cause mortality by 40% and bariatric surgery of any type reduced mortality 29%!

What are the general complications with abdominal surgery?

1. Infections related to the incisions. Can be treated with short term use of antibiotics.

2. Hemorrhage. Transfusions may be needed, and re-operation is sometimes necessary.

3. Hernia is an abnormal opening, either within the abdomen, or through the abdominal wall muscles.The risk of abdominal wall hernia is markedly decreased in laparoscopic surgery.

4. Bowel onstruction.Abdominal surgery always results in some scarring of the bowel, called adhesions.Usually an operation is necessary, to correct this problem.

5. Venous thromboembolism. Commonly, blood thinners are administered before surgery, to reduce the probability of this type of complication.

What are the general complications with abdominal surgery?

1. Anastamotic leakage. An anastamosis is a surgical connection, between the stomach and bowel, or between two parts of the bowel. The surgeon attempts to create a water-tight connection, by connecting the two organs with either staples or sutures, either of which actually makes a hole in the bowel wall.Leakage of an anastamosis can occur in about 2% of gastric bypass procedures, usually at the stomach-bowel connection.The use of a “fistula” for 30 days might give healing without need of re-surgery.

2. Anastamotic stricture. As the anastamosis heals, it forms scar tissue, which naturally tends to shrink (“contract”) over time, making the opening smaller. The solution is a procedure called gastroendoscopy, and stretching of the connection by inflating a balloon inside it.

3. Cholecystectomy. One other risk factor of the Gastric Bypass surgery is related to rapid weight reduction, not the surgery itself. Any rapid weight reduction, regardless of the method used to lose weight, can lead to the increased formation of gallstones and possible gallbladder attack.

4. Nutritional deficiencies. Those will require nutritional supplements.

Obeity Surgery is the most effective treatment for morbid obesity, and can markedly improve health and lifestyle.

When it comes to determining if obesity surgery is right for you, there are a number of factors that you will need to take into consideration. One of those factors is your current BMI (Body Mass Index). If you need to calculate your BMI, please go to: BMI Calculator.

The option of surgical treatment is only open to patients who are severe obese, well informed, motivated, and understand the surgical procedures. The patient should be able to participate in treatment and long term follow-up. A decision to elect surgical treatment requires an assessment of the risk and benefit in each case.

There are strict guidelines for bariatric surgeons to obide with. Additional health insurance programs might add other qualifications.

Morbid obese patients, those with a body mass index over 40, health is at serious risk and do qualify.

Patients whose BMI exceeds 40 are potential candidates for surgery if they strongly desire substantial weight loss, because morbid obesity severely impairs the quality of their lives. They must clearly and realistically understand how their lives may change after surgery.

Patients who has a BMI between 35 and 40 and a medical condition (obesity-related health problems such as hypertension, diabetes, dyslipidemias, sleep apnea, coronary insufficiency, gastroes-ophageal reflux disease, depression, knee or hip osteoarthritis and other related conditions) that would be improved by losing weight might qualify as well.

In all cases patients must has made serious and prolonged attempts to lose weight by other means under appropriate medical supervision.

As with all surgical procedures, obesity surgery has risks and complications depending on the chosen procedure. When the latest, advanced techniques are available through a highly qualified surgical team, utilizing a first class renowned hospital which offers full support, the rate of complications and mortality are extremely low.

Risk and efficacy of operations for obesity must be understood in the context that severe obesity is a chronic, frequently progressive, life threatening disease. Obesity itself is a great health risk.