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At the University of Chicago Medicine, we partner with our patients who are struggling with weight and provide them with a non-surgical program that uses endoscopic therapies as a powerful tool to facilitate or enhance weight loss. Though it is not a cure for obesity, when used properly, endoscopy can provide an effective way to achieve sustained weight loss. Patients lose an average of 8 to 20 percent of their total body weight.
As the only program in Chicago currently offering endoscopic sleeve gastroplasty, our Center for the Endoscopic Treatment of Obesity offers patients the latest treatments for nonsurgical weight loss. In addition to performing a wide variety of procedures to best meet our patients' needs, we also offer our patients access to clinical trials, enabling them to benefit from novel treatment solutions not yet widely available on the market.
The partnership we form with our patients goes far beyond performing these procedures. We work with our patients to make healthier choices, providing guidance on dietary and lifestyle changes, and where applicable, the use of nutritional supplements. Our recommendations are tailored to each individual patient.
Lifestyle changes could include regular exercise containing both aerobic and resistance components to maximize a patient's potential. Our dietitians ensure our patients receive adequate protein and nutritional intake to enhance their prolonged success and minimize the risk of developing a nutritional deficiency.
The key to our success is maintaining long-term relationships with our patients. This allows us to identify and treat any issues or concerns before they become more severe and difficult to manage.
Endoscopic therapy uses flexible scopes that are introduced into natural body openings (such as the mouth or throat) without requiring an incision. These endoscopes are often used with both traditional open and minimally invasive procedures to diagnose and treat conditions. This allows patients to heal more quickly, with less pain, so they can return to normal activities faster.
UChicago Medicine has a highly specialized interventional endoscopy program, the Center for Endoscopic Research and Therapeutics (CERT), which ranks among the top in the country as a leader in progressive treatment techniques. The Center for Endoscopic Treatment of Obesity is part of our greater CERT program, bringing that same expertise and innovation to help manage obesity.
There are several options for patients who are considering assistance with weight loss, and it's important to know what procedures are available and what you can expect. Patients who choose to use endoscopic weight loss techniques have several advantages over alternative weight loss options, such as:
Often referred to as the “weight loss balloon,” these durable, saline-filled silicone balloons are temporarily placed in your stomach for six to eight months to promote healthy weight loss. The shape and volume of the stomach balloon (about the size of a grapefruit) takes up approximately one third of the space in your stomach and helps you adapt to smaller portion sizes. With this technology patients can experience up to three times the weight loss of diet and exercise alone.
In order to provide our patients with the most advanced care, UChicago Medicine is participating in clinical trials, including a weight loss balloon trial. Patients who are interested in pursing weight loss balloons should talk to their physicians about qualifying for or getting more information about this clinical trial.
The endoscopic sleeve gastroplasty (also known as an endoscopic stomach sleeve) is a procedure similar to gastric sleeve surgery, but it is non-surgical. The entire procedure is done through the mouth without requiring any incisions. Using this technique, your physician reduces the size and volume of your stomach to much less than its original capacity. Unlike surgical procedures, the endoscopic sleeve is reversible and can be redone if a patient needs their stomach to be resized again. Sleeve gastroplasty offers a safe, effective alternative for patients who are not ideal candidates for surgery or who prefer a non-surgical solution.
With only a few physicians in the country performing the endoscopic sleeve gastroplasty, UChicago Medicine is the only hospital offering this option in the Chicago area. If you and your physician decide this is the right procedure to meet your weight loss goals, you can feel confident that you have partnered with experts who have the skill and experience you can trust.
Aspiration therapy with the AspireAssist is a new FDA-approved weight loss solution that reduces the calories absorbed by the body, allowing you to make progressive, healthy changes to your lifestyle. With AspireAssist, a small tube is placed in your stomach that allows you to aspirate (or evacuate) up to 30 percent of a meal after eating, preventing those calories from being absorbed into the body and resulting in weight loss.
Although bariatric surgery is often a highly effective tool for weight loss, sometimes patients experience weight re-gain. If this occurs, endoscopic bariatric therapies, including endoscopic suturing, are available to help patients by nonsurgically reducing the size of their residual stomach or surgical connection site to assist in losing weight that has been regained.
These balloons are placed into the stomach in a simple, nonsurgical outpatient procedure. During the procedure, a deflated gastric balloon is inserted through your mouth, down the esophagus and into your stomach. A syringe is then used to fill the balloon with a sterile saline solution to about the size of a grapefruit. The entire procedure takes only about 20 to 30 minutes, and typically patients are discharged home after two hours of recovery.
Although the balloons were somewhat recently approved in the United States, gastric balloons have been used for more than 20 years with over 220,000 gastric balloon procedures successfully performed in more than 80 countries. Serious complications are extremely rare, and balloons can be removed at any time.
Weight loss balloons, and all endoscopic therapies, should be considered a tool to help assist with weight loss. Each patient must learn to use the tools effectively to ensure maximum results. Similar to any weight loss endeavor, the number of pounds lost varies from patient to patient, depending on his or her individual body and lifestyle changes. However, on average, patients can expect to lose approximately 20 to 40 pounds.
The weight loss balloon procedure is designed for patients who are obese, having a body mass index (BMI) of greater than 30, who are not ideal candidates for, or do not desire, bariatric surgery. On a case-by-case basis, we can do these procedures on patients who are overweight (BMI of 27 or higher).
While you are asleep, the physician places an endoscope into your mouth, which is advanced down the esophagus and into your stomach. A suturing device is attached to the endoscope and allows the insertion of sutures in a specific pattern to constrict the stomach, resulting in a “sleeve” shape.
This series of sutures is then tightened, constricting the overall usable volume of the stomach. Patients generally go home the same day or the following day after an overnight admission. They are instructed to follow a specific diet for a brief amount of time afterward. Once a patient's stomach volume is restricted, he or she will consume smaller portions of food. In conjunction with diet and exercise, the endoscopic sleeve can result in weight loss ranging from 40 to 60 pounds.
The endoscopic sleeve gastroplasty (ESG) procedure is designed for patients who are obese, having a BMI of greater than 30, who are not ideal candidates for, or do not desire, bariatric surgery.
The ESG is one of the most effective endoscopic procedures for primary weight loss. On average, patients lose 40 to 60 pounds, or nearly 20 percent of their body weight. Recent research has demonstrated that the weight loss achieved with the ESG procedure can last for more than two years. The sleeve also has been demonstrated to improve other medical complications brought on by excess weight, including cholesterol, diabetes and high blood pressure.
The endoscopic sleeve procedure should be considered internal endoscopic surgery. The rate of major complications associated with the endoscopic sleeve is very low (approximately 2 percent), but some patients might experience abdominal pain, nausea, vomiting and constipation and may need to be observed overnight in the hospital to manage symptoms.
After anesthesia puts you to sleep, your physician uses an endoscope to place a thin tube in your stomach that connects the inside of your stomach to a small, discrete button on the outside of your abdomen. After each meal, you connect a small handheld device to the button, which allows you to empty up to 30 percent of your meal into the toilet through this tube. This prevents those calories from being absorbed into the body. But you still retain enough food so the body receives the calories it needs to function.
After eating, patients must wait 20 to 30 minutes before beginning aspiration. Patients can expect aspiration to take between 5 to 10 minutes before the process is complete. The food being emptied from the stomach can be drained directly into the toilet, so patients can perform aspirations in private.
By the end of six months of aspiration therapy, patients lose on average 40 percent of their excess weight.
Some bariatric surgeries reduce the size of the stomach. This helps patients feel full more quickly and eat smaller meals. Over time, the stomach can begin to stretch, enabling the patient to eat more before feeling full and can lead to weight gain.
Endoscopic therapies, such as endoscopic suturing, are nonsurgical procedures for reducing the size of the stomach pouch or sleeve for patients who have gradually stretched the stomach after weight loss surgery. These incisionless procedures place a scope through the mouth and into the stomach once a patient is under anesthesia. Sutures are put in place internally to tightening the stomach or the surgical connection site where it has stretched. This can restore that feeling of fullness and encourage patients to eat smaller meals again
Patients who undergo endoscopic revision of bariatric surgery procedures lose 30 to 40 pounds on average. For maximum results, patients should consider therapy before a significant amount of weight is re-gained. When patients feel loss of restriction, notice an increased tolerance of larger meals, or start regaining weight, it is time to contemplate scheduling a consultation.