Overweight patients could lose five stone or more in six months thanks to a pioneering procedure that involves shrinking the stomach with stitches. The scalpel-free method involves no incisions, meaning there is no scarring and patients can return to work within days.
As the stomach is about two-thirds to three-quarters smaller after the procedure is carried out, the patients feel fuller quickly and their appetite is reduced. And patients are warned that should they over-indulge, the delicate stitches will break and the stomach will return to its original size.
Because the success of the operation relies in part on the patient exercising psychological control over their urge to eat, it can be more successful than other more invasive methods in the long term, surgeons claim.
Patients who undergo the treatment can return to work within days unlike traditional surgery
Patients are warned if they eat too much the delicate stitches in their stomach will break returning it to its normal size, however on average those undergoing the treatment report weight loss of at least three stone
Studies suggest the majority of patients undergoing the procedure lose and keep off at least 60 per cent of their excess weight – about three stone, on average.
Results are comparable to one of the most drastic and difficult weight-loss operations, the formal sleeve gastrectomy, in which the stomach is cut and stitched in such a way that it becomes a tube. This reduces the volume of the stomach but the operation is irreversible.
In ten per cent of sleeve gastrectomy cases, the stomach stops producing digestive chemicals essential for absorbing Vitamin B12. This leads to anaemia, which causes extreme fatigue, breathlessness and a host of other problems. Patients facing these problems are forced to take vitamin supplements or have injections for life.
With the new operation, known as endoscopic sleeve gastroplasty (ESG), the stomach isn’t cut or removed, so this complication is avoided. Instead, stitches are used to gather a section of the stomach wall together.
Jamie Kelly, one of the surgeons offering the operation on a trial basis to selected private and NHS patients, says: ‘We see up to 70 per cent weight loss in eight out of ten patients, within the first six to nine months. At the two-year mark we find the majority keep it off.’
Other reversible weight-loss procedures include the gastric band, in which an inflatable ring is implanted so that it sits around the stomach, limiting the amount that can be eaten; and inflatable balloons inserted into the stomach that cause the patient to feel full.
‘A gastric band will give between 50 and 60 per cent excess weight loss at two years. The balloon results in about 20 to 30 per cent weight loss but they are typically removed within a year, and more than 90 per cent of patients regain the weight,’ says Mr Kelly.
Like all weight-loss surgery, ESG is ineffective in about 20 per cent of patients. ‘In the case of ESG, if a patient repeatedly overeats, the stitches will break and the stomach returns to a normal size,’ explains Mr Kelly.
‘But the operation helps them control their urge to overeat, so we see a great weight-loss results.’
During the one-hour procedure, which is carried out under general anaesthetic, the surgeon inserts a camera and instruments on long flexible tubes through the mouth and into the stomach. Mechanical devices are used to grab sections of the stomach wall and place stitches through it.
‘The stitching pattern looks a bit like the lacing on a pair of hiking boots. When it’s pulled tight, that area of the stomach compresses and the overall volume is reduced,’ adds Mr Kelly.
Patients are kept in hospital overnight and given anti-nausea drugs. ‘Any nausea and abdominal pain subsides after about 24 hours,’ says Mr Kelly. ‘Patients are often back at work within three or four days.’
Stitches are made of a non-absorbable nylon-based material resistant to stomach acid.
‘Often, patients who come to see me have tried everything to lose weight and had no success. This operation is minimally invasive, and involves little downtime, so no one needs to know they’ve had it done,’ adds Mr Kelly.
Ideally, patients should have a body mass index score of between 30 and 40. Possible complications include abdominal infection, while those suffering from stomach conditions such as ulcers or a hernia may be unsuitable.
But Mr Kelly says: ‘We hope the success of ESG will mean patients approach us at an earlier stage and at a lower weight, before high blood pressure, diabetes and other obesity-related conditions become a problem.’
At present, the operation is available privately at a cost of about £10,000 or as part of an NHS trial.
Car salesman Ben Jones, 31, from Newport, South Wales, is one of the first patients to benefit.
At his heaviest, the married father of one weighted 23st and had a BMI score of 43.
He was on high doses of blood-pressure medication and his blood-sugar levels were in the pre-diabetic range. Numerous diets failed to help. Ben underwent ESG surgery at the Spire Southampton Hospital with Mr Kelly last November, and today weighs 18st. He no longer needs medication, and his blood-sugar levels are normal.
‘After the operation, I felt very groggy, but not sick,’ he says. ‘But the next day I felt fine, and I didn’t need anything more than paracetamol to control the pain. I had to stick to a liquid diet for 30 days, which was the hardest part, and then move on to soft foods, like mashed bananas.
‘Now I can eat what I like but my appetite is massively reduced.
‘Surgery has given me a new lease of life. I’m more than happy, and I have a few fat friends who want the operation now.’
10 reasons why you can’t stop hiccupping
1 YOU’RE TAKING PILLS THAT TRIGGER THEM
Medication can affect the nerves in the diaphragm, the muscle under the lungs that aids breathing; hiccups are an automatic reflex caused by a sudden contraction of the diaphragm. Drugs known to trigger them include sedatives such as diazepam, levodopa (for Parkinson’s disease), steroids and some antibiotics and painkillers. Speak to your GP about altering your dose.
2 YOU’RE EATING YOUR MEAL TOO FAST…
Any movement that extends the diaphragm upwards, or increases the amount of air or fluid in the stomach, such as eating too quickly, could stimulate the vagus nerve (running through the oesophagus to the stomach), causing the involuntary spasm that triggers hiccups. Try distracting the nerves by drinking ‘upside down’ – hold the far edge of a glass filled with water against your upper lip. Bend your head forward and keep your upper lip touching the outer tip of the glass. Pour the water slowly into your mouth so it runs over your upper palate.
3 …OR MUNCHING ON COLD POTATOES
When potatoes are cooked and then cooled, they contain more resistant starch, which is harder to digest. This can create a lot of gas, irritating the diaphragm. Stick to eating them hot or just slowly and in small quantities.
4 BLAME THAT ACID REFLUX
Digestive acid can escape and travel towards the oesophagus, irritating the nerves there, leading to hiccups. Silicic acid gel from the pharmacy may help calm the digestive tract.
5 YOU’VE HAD A STRESSFUL DAY
Stress, anxiety and excitement causes us to breathe faster, which puts pressure on the diaphragm. Take a moment to reset your breathing by inhaling for as long as you possibly can. This increases the amount of carbon dioxide in the blood, which inhibits spasms.
6 TAKE EXTRA CARE ON A COLD DAY
Sudden temperature changes – such as those brought on by stepping outside on a cold day – can cause hiccups.
7 IT’S A GALLBLADDER OR HEART PROBLEM…
Hiccups may be caused by chronic irritation of the nerves or tissue in the diaphragm, stomach or oesophagus. This may be an indication of a serious conditions such as gallbladder infection, heart inflammation or a brain condition. If hiccups persist after 48 hours, see your GP.
8 …OR IT COULD BE A SIGN OF KIDNEY DISEASE
Malfunctioning kidneys are unable to filter out harmful substances such as urea (a compound of protein). When high levels of urea accumulate in the blood, they can irritate the phrenic nerve, inducing spasms. See your GP if hiccups persist.
9 CONGRATULATIONS, YOU’RE PREGNANT
Two-thirds of pregnant women experience frequent bouts of hiccups. This is due to excess release of the hormone progesterone that slows down digestion and the position of the foetus puts pressure on the diaphragm. Applying peppermint oil to the back of the neck can stimulate the nervous system.
10 AND WHY BABIES ARE PRONE TO HICCUP MORE
Babies tend to swallow an excessive amount of air, making them more prone to hiccups. Put your baby in a more upright position when feeding them.