Endoscopic Gastric Bypass Repair @ BWH,Boston, Ma....

on 9/11/07 5:14 pm - WA
As you can see in other threads, I had Stomaphyx. I believe Stomaphyx and this procedure you are talking about are similar, but not exactly the same. When the doctor put the tube down my throat, he made my stoma smaller by pleating it and putting in plastic fasteners to keep it pleated until the scar tissue forms and makes the pleats permanent (in about 1 month) Then he pulled the tube out about 1-2 inches and pleated again. So not only is my stoma smaller, but the pouch is smaller also. The other procedures whose name escape me, just make the stoma smaller. Now, this is not better or worse, just which do you need...smaller stoma (or outlet from pouch)...or smaller pouch and outlet? These are options depending on where your need is, stretched stoma or stretched pouch. My RNY was 15 years old and stretched. Good luck. It is so great to see more options becomin available.
on 9/11/07 10:13 pm - Lynn, MA
Wow,  thanks for your posting!!  Your posting is very well written and makes it  things clearer to ME now.  At this point I don't know what has stretched but it sounds like the procedure you had done will be very sucessful for you with regards to weight control. Making the Stoma and the pouch smaller sounds good.............Now I just have one question did you have to pay out of your pocket to have this done? Did you insurance cover this?
Cheryl J.
on 9/12/07 11:17 pm, edited 9/12/07 11:24 pm
Revision on 08/15/11 with
Sorry, but I have to let you know you are giving mis-information about the "other procedure" which is called the EROS procedure for short.  You can look at the photos below so you will know exactly what is happening. In the illustrations below, you will see that first the doctor makes the stoma smaller, and second reduces the pouch with sutures.  This is the same technique as the Stomaphyx with using a different tool.  I have seen both tools.  The Stomaphyx has a straight-edged on the bottom so it cannot take up the stoma like the EROS can.  Drs using the Stomaphyx makes the Stoma smaller by putting pleats of tissue over the Stoma to make a smaller canal.  The EROS tool has a barrel at the end, and so it is easier to grab the tissue from the Stoma and make pleats around it.  You can see from the photos below.  My mother is having the StomaPhyx this Tuesday, and Im having the EROS Oct. 1st.  I will let you know the difference in results. Thanks. EndoSurgical Operating System EROS Stoma Restoration EROS Pouch Reduction 
(deactivated member)
on 9/12/07 11:29 pm
Cheryl J.
on 9/12/07 11:38 pm, edited 9/12/07 11:54 pm
Revision on 08/15/11 with
If the 10 hospitals that are doing the study include Dr. Bessler @ NY Presbyterian, Mt. Sinai Hospital in NYC, Brigham by Dr. Thompson in Mass., Dr. Bard who started the study, the Dr. in Chicago (cannot remember his name) etc.....they are supposed to reduce the pouch as well. Please read the info below from one of the links in regards to the study, thanks: "Weight regained after gastric bypass surgery may be caused by an enlarged pouch and/or stretching of the stoma, the opening between the stomach pouch and small intestine. The EROS Procedure is a new surgical option to treat weight regain in post-gastric bypass patients. The procedure uses FDA-cleared endoscopic instruments to decrease pouch and stoma size and recreate a restriction to encourage weight loss. It does not require surgical incisions. In the procedure, an endoscopic suturing device is introduced through the mouth. Sutures are placed in the stomach pouch and stoma to reduce their size which slows the exit of food from the stomach pouch, enabling patients to better restrict food intake and reverse their weight re-gain. The EROS procedure is expected to provide important advantages over surgery, including, minimal post-operative pain, fast recovery time, and no scarring." It does both, it reduces the stoma and the pouch.
(deactivated member)
on 9/13/07 12:00 am

I hope you're right.  I'd love to have both the pouch and the stoma done.  I was trying to get into the study for EROS being done at NY Presbyterian but I don't think my pouch is long enough.  It needs to be at least 4 cm for their tools.  When I called the Cleveland Clinic they said that the pouch only needs to be at least 1 cm for their tools.  I'm wondering why the discrepancy?  The only hospitals I remember that sounded familiar on the list were Vanderbilt in TN, The Cleveland Clinic, and Brigham and Women's.  She rattled them off quickly. 

Cheryl J.
on 9/13/07 12:26 am
Revision on 08/15/11 with
"When I called the Cleveland Clinic they said that the pouch only needs to be at least 1 cm for their tools." This doesn't make sense for any revision surgery. If your pouch is only 1 cm, you would not need a revision.  Are you sure you have the correct information for what they are doing?  My pouch is 5cm, and my mother is 6cm which is normal for a stretched pouch. Just a little concerned, thanks!
(deactivated member)
on 9/13/07 1:16 am
I went into see a surgeon for a possible revision because I can eat a lot in one sitting (as much as my husband almost) and then I'm hungry again 2 hours later.  I had an upper GI last Friday and according to the doc my pouch is "normal" (I don't have measurements yet) and my stoma is "enlarged."    He said my pouch is emptying too quickly and that's why I'm hungry all the time and my pouch won't stay full.  That's all I know at this point.  Today at 2pm I have an upper endoscopy that will give me specifics and see if I qualify for the study, anatomically at least.  The way this study is being presented is for post gastric bypass patients with enlarged stoma, but I'll ask more questions today to see if they reduce the pouch too in some cases and if this is the same study being done at Mt Sinai and Columbia
Cheryl J.
on 9/13/07 1:24 am
Revision on 08/15/11 with
Oh okay. Yes ask if this is the same as the EROS because if it is the pouch is reduced also.  I wonder what they meant by "normal" size pouch.  My pouch is 5cm long and Dr. Garber said that my previous RNY surgeon is known for doing large pouches and stomas, or large stomas.  Dr. Bessler at Columbia reviewed my endoscopy report and said by the looks of it, I am a candidate for the procedure.  My pouch is 5cm and my stoma is 4-5cm wide. You will be fine today, take care.
on 9/13/07 5:04 am - Port St. Lucie, FL
I had the surgery 1 year ago with Dr. Thompson in Boston, I lost 40 pounds but he also said i needed to have my pouch done, they did not do the pouch then.  I am thinking of the stomaphyx now, the Bard Endocinch does not staple like the stomaphyx, it stitches.  My stitches only lasted about 7 months, right back to where I started from. He didn't have the clinical trial then, you had to pay.  I would say that staples last much longer than stitches.  You just need to decide which is best for you and really study everything.  If I knew then what I know now I would have had DS
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