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First procedure in India

First endoluminal revision of a prior sleeve gastrectomy

First ever endoluminal bariatric procedure to be performed in South Asia
First known endoluminal revision of a prior sleeve gastrectomy

There were two bariatric ‘firsts’ reported at the 3rd Annual Apollo Bariatric Surgery Conference (ABSCON 2012) in Chennai, India, in January 2012. The firsts came from one procedure, as the first ever endoluminal bariatric procedure to be performed in South Asia is also thought to be the first known endoluminal revision of a prior sleeve gastrectomy.

The operation was performed by New York bariatric surgeon, Dr Elliot Goodman, and Dr Rajkumar Palaniappan, Apollo Hospital in Chennai. The operation was shown via video-link to 80 surgeons attending the ABSCON 2012 conference at the Hyatt Regency Hotel in Chennai. “This represents a tremendous milestone for the evolution of GI surgery as it progresses from open to laparoscopic and now incision-free access,” said Dr Goodman.

The patient was a 27-year-old gentleman who had previously undergone a sleeve gastrectomy for obesity in 2011. He had lost approximately 15kgs in weight, but his weight had then stabilised and he had begun to regain weight. He had a history of depression and hypertension and a pre-operative upper GI series showed that he had significant dilatation of his sleeve, particularly in the mid-portion of the remaining stomach.

Utilising the Overstitch platform (Apollo Endosurgery), the team placed six endoluminal sutures along the sleeve gastrectomy staple line. At the completion of the operation, the team performed an endoscopy which showed significant reduction in the size of the gastric reservoir. The procedure lasted about an hour.

“We believe that flexible surgery represents the most exciting innovation in bariatric and gastrointestinal surgery in years and we look forward to offering these incisionless procedures to our patients to help combat obesity and other conditions,” said Dr Prathap C Reddy, Chairman of Apollo Hospitals Group.

After the successful performance of South Asia’s first endoluminal bariatric procedure, the Apollo Hospital bariatric surgery service will soon perform similar procedures on a regular basis. It is anticipated that the first few cases will be performed within the next couple of months. These will include sleeve gastrectomy and gastric bypass revisions for patients who have initially lost weight, but are now regaining weight due to either sleeve or pouch/stoma dilatation. The Apollo Hospital surgeons will also be examining the safety and efficacy of primary endoluminal gastroplasty in patients with a BMI of 30-40 as part of a clinical trial sponsored by Apollo Endosurgery.

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