Better Than Gastric Bypass? New Procedure Staples Stomache From Inside

Woman finally conquers her weight thanks to scar-free procedure.

June 2, 2009, 7:00 PM

June 3, 2009 — -- Since puberty, 34-year-old Liliana Gomez-Guerrero had battled her weight. She literally has lost hundreds of pounds during her life only to regain the weight. The mother of three didn't find a permanent weight loss success solution until she tried a new incision-free procedure to deal with her obesity.

So far, she has dropped 40 pounds since doctors surgically shrank the size of her stomach so that she feels fuller sooner.

"I just feel a lot better about myself," she said. "I think the best part is I'm a lot more active with my kids."

"It's nice to be able to play with them instead of watching them on a bench on the side," said Gomez-Guerrero, who dropped 20 pounds in the first month following the procedure.

And as the first patient in the western United States to undergo the experimental procedure, Gomez-Guerrero may help usher in a whole new way to combat obesity.

Gomez-Guerrero had planned to have a laparoscopic band surgery when she heard about the incision-less procedure that was part of the TOGA Pivotal Trial.

While the procedure is new, the concept is a relatively old one -- limit the size of the stomach so the patient will feel full more quickly and on less food. The procedure is meant to elicit the same effects as the open surgery known as a vertical gastroplasty. While this surgery resulted in weight loss for most patients, the extensive nature of the operation caused many doctors to question whether its benefits outweighed its drawbacks in the form of risk and recovery time.

Proponents of the new surgery claim it's less traumatic than gastric bypass or band surgeries.

"I think this is going to revolutionize the way weight loss surgery is performed," said Dr. Kai Nishi, of Cedars-Sinai Medical Center in Los Angeles.

Dr. Edward Phillips of Cedars-Sinai Medical Center said the study still is a preliminary one, designed to assess safety rather than weight loss results.

Gomez-Guerrero has no scars from her Aug. 18 procedure, unlike so many patients that have the gastric band operation. The whole operation just took one hour and 49 minutes.

A flexible camera and device to staple the stomach goes in through the patient's mouth during the surgery.

"This particular device is the first of its kind. It goes through the mouth, into the esophagus, into the stomach, and it allows us to staple the stomach from the inside. There is no need for incisions… All of this is done from within… I think it's pretty darn novel," Phillips said.

"When you fire that stapler it creates a sleeve, if you will, or a smaller gastric pouch," Dr. Nishi said.

The result is a stomach that's about the size of half a hot dog. And although there have been some complications, doctors say overall the procedure is less painful and safer than other alternatives.

"The main advantage obviously is the fact that there are no incisions," Nishi said. "That means that you're reducing some of the risk of laparoscopic surgery."

Gomez-Guerrero said the surgery was relatively painless, except for "minor throat pain."

"I took a week off. But I could have gone back to work the next day," she said.

Gastric Vs. Incision-Less

Gomez-Guerrero is one of nearly 200 people in the nation who've had the procedure and all of them were at least 100 pounds overweight.

"It absolutely works," Nishi said. "We have seen a tremendous amount of weight loss."

And patients can recover in just a couple days versus two weeks or more for gastric bypass surgery.

But the clinical trial's results aren't quite as good as gastric bypass patients'. They had about the same result as the gastric band without the cutting.

One thing no one knows is exactly how much this surgery would cost. Doctors assume the maker of the device used will probably charge about what it costs now for a gastric band procedure, which is about $13,000 to $20,000.

Eventually it would probably be covered by insurance and the hope is to make it an outpatient procedure.

Doctors are excited to see how these patients do after a couple of years since it usually takes longer than a year after a stomach stapling to lose all the weight patient's are going to lose.

Aside from being less invasive, Phillips said that this technique has the added possibility of helping those who are not yet morbidly obese, but who are on their way. These people would not have been able to opt for full-blown surgery, as the benefits that they would reap would not be enough to justify the downsides of surgery.

"This could be available to a huge selection of people earlier, while they are en route to morbid obesity," he said.

As for Gomez-Guerrero, she hopes to slim down to about 160 pounds and be a size nine or 10 because "it's much more comfortable than being a size 20, 24."

Thanks to the surgery Gomez-Guerrero has a healthier outlook on life and wants to celebrate it by doing something she could have never done before.

"I started running and I think I would like to do a marathon," she said. "I truly want to do it."

For more information about the TOGA study, patients or their families may call visit

ABC News' Dan Childs contributed to this story.