 |
| Image courtesy:Aspire Bariatrics |
One more
gadget added to the armamentarium of obesity treatment device as FDA approves The AspireAssist device[1].
This device uses a surgically placed tube in the stomach to drain about 30% of
the content after every meal. AspireAssist, is created by Segway inventor Dean
Kamen and a team of bariatricians and was patented in 2013[2].
It is not a
short term procedure and is not indicated in patients who are moderately obese.
Its main indication is in patients aged 22 and older, with BMI between 35-55
and who have failed to achieve and maintain weight through non-surgical
procedure.
The short
OPD procedure consists of endoscopically placing a tube in the stomach through
a small incision in the abdomen. A small disc shaped port valve is connected to
the tube and it lies outside the abdominal skin flushed with the body. The patient
is taught to drain the content of the stomach 20-30 minutes after a meal into
toilet. For optimal weight loss the patients should drain the contents atleast
3 times daily[3].
AspireAssist
is in use in parts of Europe since late 2011. In a trial of 111 study
participants who received AspireAssist and lifestyle modification vs 60 control
participants who only received lifestyle modification, AspireAssist patients
lost 3 times the body weight by simple lifestyle modification only.
All the
patients are monitored closely as it requires shortening of the tube as patients
lose weight and abdominal girth. Frequent electrolyte checkup and nutritional supplement
are required, along with dietary and life style modification. The patient is
also taught the hygiene of the abdominal port.
Side effects
of the tube include diarrhea, indigestion, nausea and vomiting.
The risks
associated with AspireAssist include risk of the surgical procedure and risk
associated with the abdominal port. Surgical risk includes sore throat, pain,
abdominal bloating, indigestion, bleeding, infection, nausea, vomiting,
sedation-related breathing problems, inflammation of the lining of the abdomen,
sores on the inside of the stomach, pneumonia, unintended puncture of the
stomach or intestinal wall and death.
A number of
complications associated with the abdominal port requires removal of the tube
and closing the port. Patient may present with abdominal discomfort or pain,
irritation, hardening or inflammation of the skin around the site where the
tube is placed, leakage, bleeding and/or infection around the site where the
tube is placed and device migration into the stomach wall.
Contraindication
to AspireAssist includes diagnosed bulimia, diagnosed binge eating disorder,
night eating syndrome, certain types of previous abdominal surgery, pregnancy
or lactation, inflammatory bowel disease or stomach ulcers. Certain systemic
conditions like uncontrolled hypertension, serious pulmonary or cardiovascular
disease, coagulation disorders, chronic abdominal pain also places the
patients at high risk for abdominal surgery.
No comments:
Post a Comment