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Transoral Gastroplasty (Toga)

Transoral gastroplasty, also known as Toga, is new innovative procedure in weight loss surgery where no incisions need to be made. This type of surgery uses natural openings in the body to perform surgery rather than making incisions in the skin.

Typically with this type of surgery, one of the most well known types of weight loss surgery that comes to mind is stomach stapling. In this type of surgery a surgeon will actually insert the stapler through the mouth down the throat and into the stomach where he or she will staple the stomach from the inside.

Over the past few years, this procedure has been practiced primarily in Europe and Mexico. Over 100 people in both countries combined have had the Toga surgery; these patients have lost on average approximately 42% of their excess weight within the first year. While those who go through gastric bypass surgery lose a bit more weight the surgery itself holds more risk factors than Toga and is more painful as well.

The Toga Procedure

The Toga system uses a set of devices that are extremely flexible and are designed to specifically be inserted into the mouth through to the stomach in order to stable the stomach. This procedure is typically performed under general anesthesia and usually lasts anywhere from an hour to two or more hours. Due to safety concerns, the patient is put on a respirator to keep breathing patterns of the patient regulated.

Once the patient is sedated and breathing has been regulated, the surgeon inserts the stapler into your mouth which is then fed through down to your stomach. Once the stapler has been inserted, an endoscope is also fed through to the stomach to allow the surgeon to see what he or she is doing.

In order for this procedure to be completely effective, the surgeon must fill the stomach with carbon dioxide or air to help create enough room to staple the stomach from the inside and to create another small pouch. When food is ingested and reaches the stomach it goes into a four inch sleeve or tube which will give you full feeling more quickly helping you to lose weight. Essentially a normal sized stomach is the size of a football; with this surgery it is reduced to a size equivalent to a golf ball.

Qualifying for this Surgery

Currently the Toga surgery is not FDA-approved. It is available through clinical trials. To qualify for this surgery through clinical trials a prospective patient must have a BMI of between 35 and 55 as determined by weight and height. Adults who have a BMI of 30 or more are considered obese. This trial surgery is only available to adults and should not be done on children.

People who want to participate in this study must have been considered medically obese for two or more years and their obese weight must have been stable during that timeframe. Candidates should be between the ages of 18 and 60 and have proven to have failed in other types of exercise and diet programs.

Because this surgery is only available through clinical trials, all prospective candidates need to know the risk factors involved and must agree to follow through with all medical appointments required after the surgery is completed. Before being considered for this clinical trial surgery prospective candidate must meet the following requirements and agree to these specific terms:

  1. Candidates for Toga surgery must undergo a series of rigorous testing.
  2. Candidates must attend counseling sessions for behavior modification and diet.
  3. Candidates must comply with the extensive diet restrictions required for the procedure to be effective.
  4. Candidates must commit to significant prolonged changes in lifestyle

Important “Things-to-Do” Before Toga Surgery

There are several things that a prospective candidate must do before deciding to go with Toga surgery. The most important thing to do is quit smoking as it increases risk of infection, ulcers, pneumonia, and blood clots as well as other life-threatening conditions post-surgery. Also, depending on your surgeon and your specific situation, you may be required to go on a specialized diet several weeks before getting the Toga surgery. Also, there will be a list of instructions that you will be required to follow after you have had your surgery.