Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue.
On a recent Wednesday, Karleen Perez lay unconscious on an operating table in Upper Manhattan while her surgeons and two consultants from a medical device company peered at an overhead monitor that displayed images from inside her digestive tract.
The surgeons, Dr. Marc Bessler and Dr. Daniel Davis, had just stapled her stomach to form a thumb-sized tube that would hold only a small amount of food. The operation resembled others done for weight loss, with one huge difference. In Ms. Perez’s case, there was no cutting. Instead, the surgeons had passed the stapler down her throat and stapled her stomach from the inside.
Inspecting their handiwork, Dr. Bessler said, “I don’t think you’ll get much better than that.” The operation, meant to make people feel full after eating very little, is strictly experimental. Only a few patients have tried it in this country, as part of a study paid for by Satiety Inc., which makes the staplers and hopes the Food and Drug Administration will approve them.
Ms. Perez, a 25-year-old graduate student in social work, was the second patient at NewYork-Presbyterian Hospital/Columbia to enter the study. Satiety employees advised her surgeons throughout the operation.
The procedure is part of a trend to make surgery less painful and invasive, to minimize risks and speed recovery. Many operations that once required big incisions are now performed through small slits, with cameras inserted to let surgeons see what they are doing on video screens.
Ms. Perez’s doctors took the next step: using a natural opening to avoid cutting through the abdominal wall. Dr. Bessler and other surgeons have used similar techniques to remove the appendix through the mouth, and the gallbladder through the vagina.
In Mexico and Europe over the past two to three years, 98 patients have had the new weight-loss surgery, named Toga (for transoral gastroplasty). On average, those who have passed the one-year mark have lost about 40 percent of their excess weight. Only time will tell whether they will be able to avoid gaining it back.
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