Our Summary

The research paper discusses a newer method of treating a condition called gastric sleeve stenosis (GSS), which is a narrowing of the stomach that can cause difficulty eating. The traditional treatments for this condition aren’t always successful, so the researchers are studying a different procedure called Gastric Peroral Endoscopic Myotomy (G-POEM).

The study looked back at 13 patients who had GSS and who were treated with G-POEM. The main goal was to see if these patients felt better and could eat properly again without needing more treatment. The majority of the patients (85%) had a specific type of GSS, and nearly a quarter of them also had a leak in their gastric sleeve. Most (77%) had tried other treatments for GSS before.

There were two complications during the procedure, but none of them were serious or changed the course of the procedure. After a follow-up period of about 6 months, 77% of the patients were doing well - they felt better and could eat properly again. Their severity of symptoms also decreased substantially. However, about a quarter of the patients still needed further surgery.

In conclusion, the G-POEM procedure seems to be a safe and feasible treatment for GSS, and it could be a good alternative for patients who don’t want to undergo more invasive surgery.

FAQs

  1. What is gastric peroral endoscopic myotomy (G-POEM) and how does it help in treating gastric sleeve stenosis (GSS)?
  2. What were the early outcomes of using G-POEM for GSS treatment according to the study?
  3. What are the possible complications associated with G-POEM and how many patients required surgical revision after the treatment?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastric sleeve is to consider gastric peroral endoscopic myotomy (G-POEM) as a potential treatment option for gastric sleeve stenosis (GSS). G-POEM has shown promising early outcomes in treating GSS, with a high rate of clinical success and low complication rates. It may be a less invasive alternative to surgical revision for some patients with GSS. It is important to discuss all treatment options with your healthcare provider to determine the best course of action for your individual situation.

Suitable For

Patients who are typically recommended for gastric sleeve surgery include those who are severely obese with a body mass index (BMI) of 40 or higher, or those with a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. Additionally, patients who have tried and failed to lose weight through diet and exercise, and who are committed to making lifestyle changes post-surgery, may also be good candidates for gastric sleeve surgery.

Timeline

Before gastric sleeve:

  • Patient undergoes a thorough evaluation by a healthcare provider to determine if they are a suitable candidate for gastric sleeve surgery.
  • Patient receives counseling on the risks and benefits of the procedure, as well as the lifestyle changes required post-surgery.
  • Patient may undergo pre-operative tests, such as blood work and imaging studies.
  • Patient undergoes gastric sleeve surgery, during which a portion of the stomach is removed to create a smaller stomach pouch.
  • Patient is monitored closely post-surgery for any complications or side effects.

After gastric sleeve:

  • Patient will follow a strict post-operative diet plan, starting with clear liquids and gradually progressing to solid foods.
  • Patient will need to make significant lifestyle changes, including adopting a healthy diet and regular exercise routine.
  • Patient will attend follow-up appointments with their healthcare provider to monitor weight loss progress and address any concerns.
  • Patient may experience side effects such as nausea, vomiting, and dumping syndrome in the immediate post-operative period.
  • Patient will continue to work with a healthcare provider and a dietitian to ensure long-term success with weight loss and maintenance.

Overall, the timeline for a patient before and after gastric sleeve surgery involves thorough evaluation, surgery, post-operative care, lifestyle changes, and long-term follow-up to monitor progress and address any issues that may arise.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with G-POEM for gastric sleeve stenosis?
  2. How long does the G-POEM procedure typically take to perform?
  3. What is the success rate of G-POEM for treating gastric sleeve stenosis?
  4. How soon after the G-POEM procedure can I expect to resume normal eating habits?
  5. Are there any specific dietary guidelines or restrictions I should follow after G-POEM?
  6. Will I need any follow-up appointments or tests after the G-POEM procedure?
  7. Are there any alternative treatments for gastric sleeve stenosis that I should consider?
  8. How experienced is the medical team in performing G-POEM procedures for gastric sleeve stenosis?
  9. What are the potential long-term effects or complications of G-POEM for gastric sleeve stenosis?
  10. How soon can I expect to see improvements in my symptoms after undergoing G-POEM for gastric sleeve stenosis?

Reference

Authors: Zhang LY, Canto MI, Schweitzer MA, Khashab MA, Kumbhari V. Journal: Endoscopy. 2022 Apr;54(4):376-381. doi: 10.1055/a-1544-4923. Epub 2021 Sep 13. PMID: 34225370