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New Weight Loss Surgery...Gastric Plication Surgery

New Weight Loss Surgery Appears Safe and Effective

One of the newest and most promising weight loss procedures is gastric plication surgery. The operation compares favorably to existing more-invasive bariatric procedures, offering patients minimal risk and quick recovery while producing similar weight loss results.

Like other bariatric operations, the procedure promotes weight loss by reducing stomach capacity to cause early satiety and limit calorie intake. Unlike other bariatric procedures, gastric plication does not involve stapling, cutting or removing stomach tissue or require a medical implant.

Based on preliminary results, gastric plication surgery for severe obesity appears to be a safe and effective weight loss procedure. The only downside at this time appears to be the lack of long-term data. This issue is the focus of several ongoing clinical trials. Interested patients may want to see if they qualify for one of the studies examining this promising new procedure.

Ongoing Clinical Trials

Laparoscopic Gastric Plication Operation for Patients With Severe or Morbid Obesity – This study (ClinicalTrials.gov identifier: NCT01207609) states that it is not yet recruiting participants, but lists a start date of December 2010 and an estimated completion date of December 2013. It is sponsored by Jaime Ponce, MD at Hamilton Medical Center in Dalton, Georgia.

Surgical Intervention in Bariatric Patients: Excess Weight Loss in the Morbidly Obese Following Gastric Plication – This study (ClinicalTrials.gov identifier: NCT01077193) states that it is currently recruiting participants at Ohio State University Medical Center, with a start date of November 2009 and an estimated completion date of August 2013. It is sponsored by Ethicon Endo-Surgery.

What is Gastric Plication Surgery?

Gastric Plication Surgery (GPS) is a “gastric sleeve” that resembles Sleeve Gastrectomy but does not involve stomach resection (permanent removal of stomach tissue with a stapling device) to reduce stomach capacity. Rather, the stomach capacity is reduced by folding the stomach in on itself and then stitching it together.

Benefits of Gastric Plication Surgery:

• Involves no stapling, cutting, or removal of tissue
• Weight loss results comparable to existing bariatric procedures
• Performed laparoscopically
• Does not cause malabsorption (like gastric bypass surgery)
• Does not require a medical implant (like gastric banding)
• Does not involve cutting away and removing a portion of the stomach (like sleeve gastrectomy)
• Procedure is easily reversed
• Offers minimal risk and quick recovery
• Currently the lowest cost weight loss procedure available

Outside of clinical trials, Gastric Plication Surgery, also known as Gastric Imbrication, Total Vertical Sleeve Plication, and Laparoscopic Greater Curvature Plication, is being performed by only a few doctors in the United States at this time, including: Dr. Brad Watkins at Cincinnati Weight Loss Center, Daniel Cottam, MD at Surgical Weight Loss Centre of Utah, and Sunil Sharma, MD at the University of Florida.

While short-term results to date have been promising for gastric plication surgery, ongoing clinical trials and the accumulation of data over time will give us a clearer picture of what to expect in the long-term. With further development and continued positive results, gastric plication surgery may be more widely available in the next few years.

Is Weight Loss Surgery Safe?

Weight-loss surgery (bariatric surgery) done by experts is getting safer, according to a study reported in the July 30 issue of the New England Journal of Medicine.

Bariatric surgery is very effective. Not only do people shed many pounds of fat, but they also decrease their risk ofdiabetes and heart disease. Their risk of death over time is about one-third lower than for very obese people who don't have surgery.

Your reluctance to have surgery is shared by many other patients. The three main reasons have been the risk of severe complications during and after surgery, long term health problems and cost.

The new study offers some reassurance about safety. Deaths and serious problems occurred during and shortly after surgery at rates similar to those of other major operations.

In addition, the study highlights which patients are most likely to get into serious trouble during and right after surgery. The patients at highest risk:

--Are extremely obese, with a body mass index of 55 or greater

--Have a history of blood clots in the legs and/or lungs

--Function poorly in everyday life. This group may be unable to walk even short distances or do daily activities without help.

Sleep apnea also increases the short-term risk of surgery. But obesity can cause sleep apnea. So this is a reason for obese people to consider the surgery.

In the past, some people had problems getting enough nutrition after the surgery. Some developed osteoporosis, or thin bones. These longer-term problems can now be prevented.

Cost is a complex issue. Surgery certainly is more costly than other weight loss techniques in the short run. More procedures would greatly increase costs in our already unaffordable health system. But in the longer term, this may actually lead to major cost savings.

For carefully selected people, bariatric surgery can be consider if you have a body mass index (BMI) of 40 or greater or have certain medical conditions (such as high blood pressure, diabetes, heart disease or sleep apnea) and a BMI of 35 or greater.

They also must have made serious attempts at weight loss with non-surgical approaches, as you have done.

Blubber....A Funny Word!

Description

Whale blubber.

Lipid-rich, collagen fiber–laced blubber comprises the hypodermis and covers the whole body, except for parts of the appendages, strongly attached to the musculature and skeleton by highly organized, fan-shaped networks of tendons and ligaments. It can comprise up to 50% of the body mass of some marine mammals during some points in their lives and can range from a couple of inches thick in dolphins and smaller whales, to more than a foot thick in some bigger whales, such as Right and Bowhead Whales. However, this is not indicative of larger whales' ability to retain heat better, as the thickness of a whale's blubber does not significantly affect heat loss. More indicative of a whale's ability to retain heat is the water and lipid concentration in blubber, as water reduces heat retaining capacities, and lipid increases them.

Function

Blubber serves several different functions. It is the primary location of fat on some mammals, and is essential for storing energy. It is particularly important for species which feed and breed in different parts of the ocean. During these periods the species are operating on a fat-based metabolism. Recent research also shows that blubber may save further energy for marine mammals such as dolphins in that it adds bounce to a dolphin's swim.

Blubber is, however, different from other forms of adipose tissue in its extra thickness, which allows it to serve as an efficient thermal insulator, making blubber essential for thermoregulation. Blubber is also more vascularized, or rich in blood vessels, than other adipose tissue.

Blubber has advantages over fur (as in sea otters) in the respect that although fur can retain heat by holding pockets of air, the air pockets will be expelled under pressure (while diving). Blubber, however, does not compress under pressure. It is effective enough that some whales can dwell in temperatures as low as 40 °F (4 °C). While diving in cold water, blood vessels covering the blubber constrict and decrease blood flow, thus increasing blubber's efficiency as an insulator.

Blubber can also aid in buoyancy, and acts to streamline the body because the highly organized, complex collagenous network supports the non-circular cross sections characteristic of cetaceans.

Research into the thermal conductivity of the common bottlenose dolphin's blubber reveals that its thickness and lipid content vary greatly amongst individuals and across life history categories. However, blubber from emaciated dolphins is a much poorer insulator than that from non-pregnant adults, which in turn have a higher heat conductivity than blubber from pregnant females and pre-adults.

Human influences

Uses

Muktuk (the Inuit/Eskimo word for blubber) formed an important part of the traditional diets of the Inuit and other northernly peoples because of its high energy value. Seal blubber has large amounts of Vitamin E, selenium, and other antioxidants, which may reduce the effect of the free radicals formed within the body's cells. Damage caused to cells by free radicals are a theorized contributor to some diseases. Whale blubber, which tastes like Arrowroot biscuits, has similar properties. The positive effects of consuming blubber can be seen in Greenland; in Uummannaq for example, a hunting district with 3,000 residents, no deaths due to cardiovascular diseases occurred in the 1970s. However, emigrants to Denmark have contracted the same diseases as the rest of the population. The average 70-year-old Inuit with a traditional diet of whale and seal has arteries as elastic as that of a 20-year-old Danish resident.

One of the major reasons for the whaling trade was the collection of whale blubber. This was rendered down into oil in try pots or later, in vats on factory ships. The oil could be then used in the manufacture of soap, leather, and cosmetics. Whale oil was also used in candles as wax, and in oil lamps as fuel.
Blue Whales can yield blubber harvests of up to 50 tons.

Health

Recent research has identified that blubber from whales and seals contains both Omega-3 fatty acids and Vitamin D. Without the Vitamin D, for example, the Inuit and other natives of the Arctic would likely suffer from rickets. There is evidence that the blubber and other fats in the Northern diet also provide the calories needed to replace the lack of carbohydrates found in the diets of cultures in the rest of the world.

Toxicity

Recent studies suggest that blubber contains naturally occurring PCBs, carcinogens which damage the human nervous, immune and reproductive systems.^[14][15] The source of PCB concentrations is unknown. Since toothed whales typically place high on the food chain, they likely consume large amounts of industrial pollutants (bioaccumulation). Even baleen whales, by merit of the huge amount of food they consume, are bound to have toxic chemicals stored in their bodies. Recent studies have found high levels of mercury in the blubber of seals of the Canadian Arctic.