Single-Incision Weight Loss Surgery Now Available
By Michael Lasalandra
Beth Israel Deaconess Medical Center Correspondent
Six years after delivering twins, Elizabeth Rousseau topped out at 309 pounds -- and started thinking about weight-loss surgery. Early this year, the Ashland woman and mother of six did something about it. She underwent minimally-invasive lapband surgery done a new way, leaving her with only one small scar, and that is already receding into her belly button.
Rousseau, who says she has been heavy most of her life, was one of the first patients in New England to undergo “one-port” lapband surgery, meaning only one incision was needed. She had it done by
Dr. Daniel Jones, Chief of the Section of Minimally Invasive Surgery at Beth Israel Deaconess Medical Center.
“When I heard about it, I was excited,” says the 42-year-old former teacher. “I didn’t want four or five scars. I wanted only one scar.”
The lapband operation has been around for years. The idea is to create a small pouch in the upper part of the stomach by placing an adjustable band around it, restricting the amount of food the stomach can hold. As a result, many patients with the band find themselves feeling full after eating much less food than before. Or they simply don’t feel very hungry most of the time.
The surgery generally has been done in a minimally invasive or laparoscopic fashion, but four or five tiny incisions had been needed across the abdomen for insertion of cameras and surgical instruments. Now, the operation can be performed by inserting those devices through just one incision or port -- located at the belly button.
“The trick is having instruments and cameras that bend,” says Dr. Jones, who is among the first in New England to perform the operation this way. “You recreate the same angles you would have if you had made all the incisions at different places.”
Dr. Jones says the “one port” method is not for everybody -- he tried doing it on a patient who weighed 350 pounds but had to revert to the method using several incisions. “We couldn’t get it done that way,” he says.
“But on a lighter patient, we are able to get the safe view we need,” he says.
The advantage is one scar, not several. In Rousseau’s case, that scar is already disappearing into her belly button.
The single incision method may result in less pain, although Dr. Jones says that remains to be seen until the procedure has been done numerous times.
In Rousseau’s case, she was up and walking the next morning. And while she was given pain pills to take home with her, she says she never took any. “I just took Tylenol,” she says.
Before the operation, she was required to lose 15 pounds, getting her down to 294. In the first few weeks after the surgery, she lost 37 more.
“Everything is going great,” she says. “I feel wonderful, energized.”
A few weeks after the operation, she was still eating mostly soft foods like yogurt and cottage cheese, but said she expected to be able to eat most anything at the six-week period.
Rousseau says she recommends the operation for anyone “if they are willing to put the effort into it.”
The pouch created by the band can be inflated or deflated any time after the operation, helping patients to continually lose weight as they reach their goals. This involves injecting saline into a port placed under the skin in the wall of the abdomen. The filling is done at the hospital. This is the same no matter which method of surgery is performed to insert the band.
Dr. Jones concedes the one-incision method is still investigational but predicts it will become more popular over time as new and more flexible instruments come on the market.
“Now that we know we can do it, companies should be meeting the demand for better surgical instruments,” he says.
Either way, the operation usually allows patients to lose 50 to 60 percent of the extra body weight they are carrying, he says. “And as patients lose weight, many get their diabetes or high blood pressure under control,” he says. “Many are able to come off their medications.”
The other method of weight-loss surgery, gastric bypass, is a more extensive operation, involving either stapling the stomach or removing part of it. While is usually done laparoscopically, Dr. Jones says, it is not yet able to be done using just one incision.
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted March 2009
