NEWARK — For those looking to get a jump-start on losing weight and returning to their old selves, there’s a new option — the non-surgical ReShape bariatric procedure now offered at Christiana Institute of Advanced Surgery in Newark.
“This is a good option for people with a BMI (body mass index) of 30 to 40 and have a weight-loss goal between 50 and 100 pounds,” said bariatric surgeon Caitlin Halbert of Christiana Institute of Advanced Surgery. “These individuals need to be motivated but may need a jump-start to help them get over that first hump in reaching their goal.”
The procedure is one of three bariatric options candidates for weight-loss procedures have at the practice but unlike the traditional gastric bypass or gastric sleeve procedures, ReShape doesn’t involve permanent alteration of anatomy or going under the knife.
ReShape uses a dual-balloon system to give patients a full feeling around the clock. The deflated balloons are inserted during an out-patient procedure done in the office, not a hospital.
Patients are sedated and the balloons are inserted through the mouth, down the throat and into the stomach where they are filled with 900 millimeters of saline and blue dye.
Recovery time is quick unlike surgery which can keep patients in the hospital for up to three days and leave soreness and discomfort for weeks — many ReShape patients can return to their daily activities almost immediately although there will be a little discomfort while getting used to almost a liter of liquid in the stomach.
“The first couple days, patients may experience some discomfort and if they’re running or jogging — they might be able to feel the balloons move a little bit, but it’s a feeling that becomes less noticeable over time,” Dr. Halbert said.
But the weight and size of the balloons are what leads to the initial weight loss.
A familiar technique
ReShape may sound like a familiar technique, because it is. A similar procedure gained popularity about 20 years ago but there were many complications; most of which resulted from torn or popped balloons.
If the balloon tore or popped, the material would make its way into the digestive track where it would get stuck and surgery would be required to remove it.
But over the past two decades, ReShape has worked out the kinks by using two balloons instead of one, both made with a more durable material than the original. ReShape hasn’t faced any of the complications seen in the technique of the 1990s in trials or completed procedures to date.
“The balloon is filled with saline and blue dye so if there is a tear or break, the patient’s urine will be blue so they’ll know to contact us and the balloons have been designed not to migrate, so if there is a problem, we won’t need to resort to surgery to remove the balloons,” Dr. Halbert said. “We’ll be able to remove them the same way we inserted them.”
And the balloons don’t stay in place forever — they must be removed after a six-month stay.
“Patient selection is very important and they need to anticipate it will come out,” Dr. Halbert said.
So patients with more than 100 pounds to lose and those who know they need that constant reminder of when to stop eating should opt for the more permanent solutions that come from gastric bypass or the sleeve.
But those decisions aren’t made by the patient alone, they’re made through a consultation with a team of doctors where all options are evaluated.
“For the balloon patients, it’s a change because they’ll no longer have that same gauge to tell them when they are full but over the six months they’ve already changed their habits so they just need to continue with those positive changes once the balloons come out.”
And patients are left to their own devices to stay healthy and continue weight loss — patients are set up with a scale that links to their computer, a FitBit to track their physical activity and access to an online portal where they can track their exercise and eating patterns.
“We expect patients to shed about 40 pounds from the procedure and there’s no reason weight loss shouldn’t continue after the balloons are removed,” Dr. Halbert said. “Each patient has different goals and the amount of motivation the patient has will determine if they reach their goals or even exceed them.”
It can be difficult to stay motivated without resources so ReShape patients receive in-person assistance too with monthly consults with a nutritionist at the practice for 12 months. The consultations begin before the procedure is performed so patients can start their new lives with new, healthy habits.
“With bariatric surgery comes a lot of brand new rules like how much you can eat, what you can and cannot eat but with the balloon, patients don’t have these strict rules so they have to show a commitment and take the initiative to change their lives,” Dr. Halbert said.
And although the nutritionist consults eventually come to an end, the patient portal remains open forever so patients can keep track of their progress for years to come.
“I love bariatric and weight loss surgery because I can help people who are motivated and committed to get healthy and go out and play with their kids, go off their diabetes medications and just lead a better life. It’s so rewarding,” Dr. Halbert said.
Christiana Institute of Advanced Surgery has four surgeons who perform weight-loss procedures. Dr. Halbert and her colleague Dr. Isaias Irgau are certified in ReShape and the other two soon will be certified as well.
“We have only done three procedures so far but have been hearing from 20 to 30 interested patients per week for the past two or three weeks,” Dr. Halbert said. “And all the physicians here are all about the procedure and can’t wait to offer it to their patients because it’s a low-risk, high-yield procedure that can really improve people’s lives.”
Patients from Philadelphia to Baltimore to D.C. have shown interest in the practice’s procedure because it’s the only location in this area offering it.
But the current obstacle patients face with ReShape is a financial barrier because the procedure isn’t yet covered by medical insurance, although Dr. Halbert has hopes it soon will be.
“These types of procedures, where patients make an investment in their health are worthwhile and we are hoping that it soon becomes more financially accessible to the patients that are good candidates and can benefit from the procedure,” she said.
Very few people are ineligible for the procedure. It is a good option for individuals older than 18 with a BMI between 30 and 40 looking for assistance in losing about 40 pounds. Ineligible candidates are primarily those who have undergone previous stomach surgery including bariatric surgery.
For more information about ReShape, visit chrias.com or reshapeready.com.