x Abu Dhabi, UAEWednesday 17 January 2018

UAE doctors warn new incisionless procedure is still under trial

Doctors warn against noninvasive obesity procedure because trials are not complete.

Dr Faisal Al Badri, head of general surgery at Rashed Hospital, says the incisionless treatment is not reversible. Pawan Singh / The National
Dr Faisal Al Badri, head of general surgery at Rashed Hospital, says the incisionless treatment is not reversible. Pawan Singh / The National

Doctors have warned that a new incisionless procedure promising weight loss is still under trial.

The technique, primary obesity surgery endoluminal (Pose), is an outpatient procedure performed under general anaesthesia and involves stitching the stomach where the hunger receptors are located.

Dr Tarek Saleh, a consultant gastroenterologist at Medcare Hospital in Dubai, is the first doctor in the UAE to offer the procedure and has so far treated 20 patients.

"It is a good option for people who want to lose some weight without resorting to more invasive, laparoscopic bariatric procedures that require longer recovery time," Dr Saleh said.

During the procedure, a tube is inserted orally and lands in the spongy part of the stomach that stretches out to accommodate large meals.

This portion of the stomach is also responsible for the secretion of hunger hormones that can lead to overeating, Dr Saleh said.

Surgical tools are moved through the tube and used to grasp the stomach tissue and deploy suture anchors to create tissue folds in the stomach wall, reducing its capacity by up to 25 per cent.

The process usually takes about an hour and costs Dh45,000.

The procedure works best for patients who need to lose 10 to 30 kilograms with a body mass index of between 30 and 40.

Patients must not be diabetic or have a history of being treated with insulin.

Past bariatric procedures would also rule out a candidate.

But doctors warn the procedure, which is yet to be approved by the US Food and Drug Administration (FDA), is still in its experimental phase.

"This is not a widely practised procedure. It is still under trial," said Dr Faruq Badiuddin, a specialist general surgeon in laparoscopic gastrointestinal and obesity surgery at Mediclinic Dubai.

"We do not routinely recommend this because we do not know the long-term results.

We tell patients very clearly, look this is an experimental procedure. If you want to take your chances, please go ahead but do it in a place where someone who is experienced is doing it."

The surgery is irreversible and once the stomach is stitched no other bariatric procedure can be performed on the patient, which is a concern for physicians.

"The doctor should tell the patient if the weight didn't go down, I don't know what to do," said Dr Faisal Badri, head of general surgery at Rashid Hospital. "The surgeon can't do anything after clipping of the stomach.

"When you do plication [folding] of the stomach from inside, surgically I cannot cut the stomach because of the clips."

Although the method is yet to be approved by the FDA, the instruments used for the procedure have been cleared.

Possible complications associated with Pose are bleeding and infection that can result from perforation of the gastric wall.

Since clinical trials began in 2007, no deaths have been reported and there is a complication rate of less than 1.4 per cent.