Gastric Bypass Procedure and AspireAssist Aspiration Therapy System for the Treatment of Morbid Obesity, Observational Study Over 5 Years

Overweight and obesity is increasing rapidly in Sweden and is the greatest threat to future public health. Obesity, defined according to the World Health Organization (WHO) as a body mass index (BMI) greater than 30 kg/m2, is an intractable disease in healthcare today. Obesity results in reduced life expectancy and increased morbidity.

Weight reduction by lifestyle changes or with different pharmacological preparations have in many studies not made lasting long term results. Obesity surgery has so far been the only way to achieve permanent weight loss. During the 1980s, restrictive procedures were performed, e.g., vertical banded gastro-plasty (VBG) with good but unfortunately transient effect. Later developed, is the now prevalent gastric bypass procedure (GBP) which today uses the keyhole technique and causes combined restrictive and mal-absorptive changes in gastrointestinal anatomy.

GBP is currently the standard method in clinical practice for the surgical treatment of morbid obesity (i.e., BMI over 35). GBP is a procedure that is not reversible, which entail certain pre - and postoperative risks. GBP quickly brings a sharp reduction in weight and also regression of diabetes mellitus type 2. Unfortunately, the surgery cause lifelong mal-absorption and requirements of vitamin and mineral supplements.

Swedish Obese Subjects study (SOS) that emanated from Gothenburg was the first controlled intervention study of overweight individuals. Approximately 4000 patients were included, half of which were surgical, the other half were treated optimally, but without surgery. The patients have been followed for 10-20 years. Total mortality was 24% lower in the surgical group.

A new alternative approach to obesity surgery, AspireAssist™ Aspiration Therapy System (CE Marked), comes from the United States and in this method the individual empties out digesta from the stomach. Percutaneous endoscopic gastrostomy (PEG) has been used internationally since the early 1980s for nutrition therapy for stroke or cancer. In a gastroscopy a tube is placed between the stomach and abdominal wall and nutrition administered via tube directly into the stomach.