Mar - Apr 2016

A Cure for Obesity? New Surgical Techniques Offer Hope for the Future

By Ryan Moon, MD


Twenty or thirty years ago we were just starting to hear a buzz about many of the most common weight loss surgeries being performed today. And you probably didn’t think you’d see so many people having them done—even a handful of celebrities and retired athletes. So what innovations will the next decade bring? Will there be a cure for obesity? Probably not. But when we look out to the horizon to see what’s next, we see that the future is looking bright—and very healthy.


Although the evolution of bariatric surgery can be linked to the continuous efforts of research, and the refinement of surgical products and techniques, a large part of the surgical “picture” can be attributed to the efforts of many surgeons to push the metabolic aspects of surgical weight loss to the forefront. For example, the American Society of Metabolic and Bariatric Surgery (ASMBS), founded in 1983, serves as a governing body for all bariatric surgeons, and aims to “advance the art and science of metabolic and bariatric surgery by improving the quality and safety of care and treatment of people with obesity and related diseases”.


Many years ago, bariatric surgeries were much more invasive—not to mention more likely to have complications. Recently, surgeons have turned to laparoscopic robotic surgery to improve surgical outcomes. The use of laparoscopic robotic surgery has been dramatically increasing over the past several years. Initially introduced into the urologic and gynecologic fields, the use of robotic surgery has recently seen a steady rise in the bariatric arena as well. One area of interest has always been the single-site robotic approach, where the surgeon performs the entire surgery through a single, small incision near the umbilicus. Effort continues to be pursued in helping to make the robotic instruments and equipment more applicable to the morbidly obese population.


The latest device approved by the FDA early this year is an implantable gastric stimulation device that uses small electrodes to stimulate the stomach. The device helps to control hunger and fullness by blocking the vagus nerve, which extends from your brain to your stomach. This procedure does not alter the stomach or intestines like many of the current bariatric surgical procedures.


Finally, an intra-gastric balloon is placed endoscopically and is thought to provide an early satiety by its mere space-occupying qualities. This technique is improved outside of the United States and currently being reviewed by the FDA.