Bariatric surgery is major surgery, and many people who might benefit from it don't get it because it is a scary prospect. But obesity also carries risks, and South Texans experience obesity at rates above the national average. To make bariatric interventions accessible to more people, UT Health San Antonio offers procedures that reduce risk while still delivering benefits, no scalpel required.
Dr. Matheus Franco is a gastroenterologist and director of endoscopy at the UT Health San Antonio Multispecialty and Research Hospital, and he performs non-surgical bariatric procedures with an endoscope — a slim, flexible tube equipped with a light, a camera, and a suturing device. He threads the tube through a patient's esophagus and into the stomach, where he can perform the same procedures surgeons do, but without cutting into a patient from the outside. "It's less invasive. No external incisions.
Endoscopic bariatric procedures also take less time than bariatric surgeries, making what Franco called "adverse events" less likely. They are performed on an outpatient basis, so a patient can get back to their daily routine within a few days. That includes most jobs, Franco said, as well as exercise, which improves short and long-term outcomes. "After three days, we can restart the patient on light activities like walking and jogging," Franco said.
The results of non-surgical bariatric interventions are comparable to surgical procedures. "At one year after the endoscopic procedure, the total body weight loss reported is around 17 to 20%," he explained, "And the surgical procedures are around 20 to 25%." If you're doing a cost-benefit analysis based on risk, Franco said, those are pretty encouraging numbers. He added that those who have higher weight loss goals can add a GLP-1 medication to their treatment plan and likely see even greater weight loss. Everyone's plan is different, he said, and decisions are made collaboratively. "It's a multidisciplinary team involving dietitians, behavioral health, and everybody together to help the patient figure out what is the best way. We want to provide personalized care for everyone."
Science & Medicine is a collaboration between TPR and The University of Texas Health Science Center at San Antonio, about how scientific discovery in San Antonio advances the way medicine is practiced everywhere.
