TOGa Procedure Offers Weight Loss Surgery Without Incisions

An innovative weight loss surgery procedure that does not require incisions may offer a new treatment option for patients considering conventional bariatric surgeries, such as the gastric bypass, gastric sleeve or Lap-Band.

The new procedure is called TOGa — but this TOGa has nothing to do with Roman attire or Animal House hijinks. It’s a new gastric sleeve technique that requires no surgery at all.

“Transoral gastroplasty” – or TOGa – is actually an experimental procedure that uses a surgical insert – called the TOGa device, manufactured by a California-based company, Satiety, Inc.

The TOGa is a combination surgical stapler, suction unit, clamp, and tissue-spreading retractor. What makes TOGa special is its size: small enough to be inserted into the patient’s stomach via the mouth and esophagus. This eliminates the need to cut open the abdomen.

In a TOGa procedure, the patient is placed under general anesthesia; then the surgeon threads the TOGa unit through the patient’s mouth and into the stomach, along with an endoscope.

The TOGa’s retractor is deployed, which spreads the stomach open from within. The surgeon applies suction, pinching a section of stomach tissue together into a short tube, then uses the TOGa to staple this tube closed, forming a gastric sleeve within the stomach itself. This acts as a pouch, catching food as it enters the patient’s stomach and giving the feeling of fullness after a small meal.

The result: substantial weight loss with less risk.

A year-long study of the TOGa procedure conducted outside the U.S. found that patients lost an average of almost 40 percent of their excess weight within one year of the operation – slower than with gastric bypass or Lap-Band, but with far fewer complications.

The first U.S. transoral gastroplasty procedure was performed by doctors of the Washington University School of Medicine in St. Louis last July, and a new study is being conducted in America by NewYork-Presbyterian Hospital and Columbia University Medical Center.

Doctors associated with the new study say that if proven safe and effective, TOGa will provide patients with the benefits similar to those of current weight loss surgery techniques, but with less pain, shorter recovery times, shortened hospital stays and a far lower chance of infection, scarring or other complications. The results of the study should be available later this year.

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