Saturday, Sep 18, 2010
Gulf News
Surgeon saves woman from a major operation by using a snare, claimed to be first of its kind used in endoscopy
Dubai A gastric balloon in a woman’s stomach slipped into her small intestine making it impossible for her to go to the toilet and she rushed to the hospital seeking help.
The surgeon saved her from a major operation by making an endoscopic removal, using a snare. This is the only reported case with this procedure.
“You are supposed to change it [the balloon] after six months, but she apparently had forgotten about it,” said Dr J.C. Mathias, head of surgery at Welcare Hospital, who had to perform an endoscopy procedure to get it out. The woman had resorted to a gastric balloon to lose weight.
The gastric balloon is usually filled with half a litre of liquid and lies in the stomach giving a feeling of fullness. “With this you can only eat half a burger, though you would like to eat four burgers,” said the doctor.
He said this procedure is less common nowadays and that gastric banding and bypass, where a portion of the stomach is cordoned off, is more effective. The doctor said the case was initially mysterious as her file showed that she had done gastric banding and there was no mention of a gastric balloon. It took a little medical detective work to find it.
The gastric balloon burst, the liquid leaked inside and the rubber balloon slid and lodged itself in a valve between the small intestines, which made it hard for her to perform her natural functions.
The woman, who did not wish to be identified, was not obese at all, but weighed 75 kilograms, said the doctor. “She looked unwell when she came in. She hadn’t been to the toilet for five days.” An X-ray showed the balloon in the junction between the intestines. The extreme step of such procedures as gastric ballooning, banding or bypass is done for people weighing 300 kilograms or so, said the doctor.
Operation
The surgeon decided to perform a non-invasive procedure as an open operation would mean more pain, longer stay and a scar in the abdomen. A more than a metre-long endoscope with a snare at the end was put inside the woman. “It was a tricky procedure,” said the doctor as the rubber balloon kept slipping away while he controlled the camera at the end of the endoscope to see it. “It required patience and prayers.”
An endoscope is an amazing piece of equipment. It looks like a fishing line with hand controls. It is used for diagnosing cancer of the colon, stop internal bleeding, diagnose infections, inflammation or tumours in a patient and remove polyps.
A simpler way to lose weight is diet and exercise, said the doctor. “It is not easy and you have to show some restraint yourself.”
He said that only those whose BMI (Body Mass Index) was more than 35 are less likely to lose weight with diet and exercise and he would recommend such extreme procedures as a gastric band or bypass, which are surgical procedures.
MEGAN HIRONS MAHON/Gulf News
Offering an explanation
Dr. J.C. Mathias, Specialist General Surgeon and Head of the Department of Surgery of Welcare Hospital points on an X-ray of the gastric balloon that he removed from a patient after it passed into her small intestine causing a blockage.
MEGAN HIRONS MAHON/Gulf News
Mystery solved
The tip of a gastric balloon is seen in the centre of this X-ray. The patient had a balloon inserted into her stomach to facilitate weight loss.
MEGAN HIRONS MAHON/Gulf News
Successful removal
Dr J.C. Mathias holds a gastric balloon that he removed from a patient after it passed into her small intestine causing a blockage.
health
You are supposed to change it [the balloon] after six months, but she apparently had forgotten about it.”
Dr J.C. Mathias
Specialist General Surgeon and Head of the Department of Surgery,?Welcare Hospital
By Mahmood Saberi?Senior Reporter
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