VBLOC therapy and Gastric plication

These emerging surgeries are new-comers so their track record is short compared with gastric banding and gastric sleeve surgery.

VBLOC refers to a new technical device for weight loss surgery. It is a programable electronic device that is implanted in the abdomen around the vagal trunks near the gastro-oesphageal junction. It induces an intra-abdominal sub-diapraghmatic intermittent vagal block via a radio-frequency system. This signalling results in improved satiety, reduced calorie intake, weight loss, reduced hunger and improvements in obesity related co-morbidities such as diabetes mellitus and hypertension. The effectiveness of the device appears to be greater when the device is operating more than 12 hours a day compared with just a few hours a day.

 

The Maestro(R) Rechargeable System by EnterMedics Inc is the VBLOC device that is now included on the Australian Register of Therapeutic Goods but it is not commercially available in the United States.

 

The VBLOC therapy device under-went rigorous trials before it recently gained approval.

 

This device is still in its infancy and not many surgeons have adopted it yet.

 

Gastric plication is a new procedure that is gaining popularity in the United States because it is relatively cheap to perform. Residents in the USA have very expensive health system and without insurance or company cover, any surgery or checkups at the doctor (for blood tests or band adjustments) is expensive to self-fund. They do not have access to something like our Medicare program for band adjustment or gap payments.

 

A handful of Australian surgeons are exploring gastric plication but a very big drawback about this procedure is that there appears to be no standardised surgical method yet. A Queensland surgeon revealed that one of the better indicators for surgical success is that the person complains of bad nausea and appetite suppression immediately post-operatively. In other words, if the person wakes up and feels fine then the surgery wasn't done correctly.

 

Gastric plication has no track record and is not performed by many surgeons as there are other procedures with proven benefit and results.