Two recent developments in the weight loss surgery world deserve mention and discussion. A few months ago, a new gastric balloon which can be swallowed down (see picture), checked with an X-ray and inflated with gas inside the stomach became recently available to the UK market. It has yet to gain approval by the Food and Drug Administration in the United States, however preliminary data suggest that this should happen. The reported advantages of this new balloon is the mode of delivery which avoids an endoscopic procedure. Its lighter weight should also decrease the initial awkward symptoms of nausea and vomiting that sometimes cause intolerance with the use of the heavier balloons. Up to three of these balloons can be used at a time for a period of 3 to 4 months. Removal has to be performed by an endoscope and as with the older balloons, weight regain can occur in a significant percentage of users.
The jury is still out regarding long term results, however the method of delivery is beneficial for individuals seeking a quick outpatient intervention.
Gastric plication has gained popularity as more centres offer this procedure, although again as with the balloon above, long term results are unavailable and therefore its use should be restricted to trials. The principle is to apply sutures to the length of the stomach in such a way to invert a layer of tissue and decrease the volume of the stomach as a result (see picture). One or two rows of suture can be used and the operation is reversible which is an appealing quality, in contradistinction to sleeve and bypass procedures. The risks included injury to the stomach wall and failure to lose weight in the long term as no one can predict the degree of gastric stretch.
Again as with all new innovations, one should wait for long term results from well conducted studies before passing judgement. When making a decision to have surgery, one should be minded to view the results of established procedures such as band, sleeve and bypass in comparison to newer interventions.
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