A Durban doctor has become the first to perform an endoscopic weight loss procedure in private practice in KwaZulu-Natal.
Specialist surgeon Dr Kessendhra Naidoo, practising at Netcare uMhlanga and Gateway Private Hospital, has done two such procedures recently.
The procedure is “entirely endoscopic”. A silicone Orbera balloon, inflated with saline, is inserted into the stomach which effectively reduces its size, resulting in a smaller intake of food.
Endoscopy, according to the Encyclopaedia Britannica online, was the medical examination of the interior of the body, usually through a natural body opening, by the insertion of a flexible, lighted optical shaft or open tube.
Naidoo said: “These (procedures) are the first in private practice in KZN. A handful of cases have been done so far in Johannesburg and Pretoria. A similar balloon was trialled at Inkosi Albert Luthuli Hospital a year or so ago.”
He said his first patient had lost 3.5kg in three weeks.
“The second patient was only just completed a few days ago so I am looking forward to assessing this patient’s response. Both patients were class 1 obesity (BMI of 30.0 to 34.9).”
Its use was advocated for those with a body mass index (BMI) of between 30 and 40.
The BMI is calculated by dividing the weight of the patient by his/her height squared.
Naidoo said: “The procedure takes approximately 30 to 40 minutes. The balloon is inserted and inflated with saline to the desired size. This can be anywhere from 400ml to 700ml. It is non-surgical. The balloon is removed in six months or sooner if necessary.”
The procedure was gaining popularity worldwide, with more than 220 000 procedures having been completed globally so far.
The biggest concern, said Naidoo, would be intestinal obstruction which could occur if the balloon inadvertently leaked and deflated which would allow migration.
“This is very unusual. When we do this procedure we inject a blue dye into the saline so should it leak then the patient’s secretions would be discoloured blue and this would be a red flag for them to see their specialist urgently.”
Another very rare risk, he said, would be gastric erosion from pressure.
“The side-effects include nausea, vomiting, abdominal cramps and back pain. These usually settle in a week or two. Some patients have persistent symptoms and may require removal sooner.”
Naidoo said the balloon had been brought into the country by First Medical company and it cost about R18 000 each.
“The rest of the cost will be hospital, anaesthetic and surgeon fees as well as allied services required for weight management. The average cost in the US is between $6 000 and $7 000 (between R80 000 and R93 000).”
Naidoo emphasised that the balloon was certainly not a replacement for surgery.
“It is advocated for failed medical therapy and can be used as a bridge to bariatric surgery.”
“Weight loss achieved with the balloon is three times more than with diet and exercise alone,” Naidoo said.