Manatee Drs. Rekkas, Erbella say Orbera balloon is perfect for some
MANATEE -- Like many of us, Pat could not lose significant weight no matter how hard she tried.
A 58-year-old Manatee County woman who prefers to remain anonymous, Pat was 85 pounds overweight.
A friend had told her about Dr. Stelios Rekkas, a weight-loss surgeon at Manatee Surgical Alliance, 5317 Fourth Ave. Circle E., just off State Road 64 in East Manatee. Rekkas is on the staff at Manatee Memorial Hospital.
"She had been through multiple diets and multiple exercise programs," Rekkas said of Pat last week. "She had a good program but whatever she did she wasn't able to lose the weight and keep it off. But she didn't want surgery."
Rekkas realized Pat fit all the criteria to get a new, non-surgical weight loss procedure that has seen patients lose an average of 22 pounds in six months with the help also of diet and exercise.
Two weeks ago, Pat became Rekkas' and Manatee Memorial Hospital's first Orbera gastric balloon recipient. Although just approved last October in the United States, the Orbera balloon has been placed in 250,000 patients in other parts of the world, Rekkas said.
"She did great," Rekkas said of Pat, who was an out-patient. "She went home the same day. Her first week post-op visit went great. We expect her to lose 12 pounds in the first two or three weeks and 40 percent of her extra weight after six months."
Rekkas' commitment to Pat will include regular exercise and diet counseling even after six months, which is when the balloon must be removed, the doctor said.
How a balloon promotes weight loss
Body mass index, known as BMI, is a measure of body fat based on height and weight. A BMI of 18.5 to roughly 25 is considered healthy, Rekkas said.
Pat's BMI was 39.85.
Before the gastric balloon, people who needed to lose about 80 to 100 pounds, like Pat, and who have BMIs around 40 usually had to get surgery, Rekkas said.
"In the past people would be very afraid to come because no one wants incisions, no one wants to be cut, no one wants a long hospital stay," Rekkas said.
Rekkas, a graduate of Manatee High School, the University of Florida and Florida State University Medical School, was one of the first physicians in Florida to be trained to use the Orbera balloon.
The Orbera balloon comes to the surgeon as a flat, uninflated piece of silicone, very much like the material used for a breast implant. The patient is put under a "twilight" anesthesia exactly like the kind used during a colonoscopy then, using an
endoscope, a flexible tube with a light and camera attached, the surgeon checks the patient's digestive tract and stomach for any ulcers or abnormalities.
People who have had gastric surgeries in the past are ineligible for the balloon, Rekkas said.
If the gastrointestinal system looks good, the surgeon inserts the balloon through the mouth and into the stomach.
The balloon is then inflated with 650 cubic centimeters of saline or water turning it into a squishy ball the size of a grapefruit. It remains in the stomach for six months until it is punctured by the surgeon and removed.
While it is in the stomach, the balloon takes up space. When the patient eats, they get full rather quickly, Rekkas said.
"I am told it feels like you have had Thanksgiving dinner after a few bites," Rekkas said.
The patient still gets hunger pangs during the day, but they can't stuff themselves as they did before, Rekkas added.
"The stretch preceptors in the stomach get stimulated earlier," Rekkas said.
Rekkas, who thinks the balloon could be a solution for even people who are at the fringe of obesity, offers a free monthly weight-loss seminar to explain the procedure and others he does. The next one is 6-7 p.m. April 28 in the Manatee Memorial Hospital Auditorium, 206 Second St. E., Bradenton.
Side affects, cost of the balloon
Bradenton's Dr. Jose Erbella is a general surgeon specializing in bariatric surgery. His practice is inside Manatee Memorial Hospital, 250 Second St. E., No. 1A, Bradenton. Erbella is also performing the Orbera procedure and expects to insert his first "orb" in two weeks.
Addressing side affects, Erbella said nausea is the most prominent. The stomach realizes something is inside of it that it needs to digest or get rid of some other way and tries for awhile, Erbella said.
"The first week can be uncomfortable and we give medication for the nausea," Erbella added.
Some patients may be concerned about the balloon bursting and moving into the bowels. But Erbella said that is highly unlikely.
"It would take a tremendous blow, like the impact from a car crash, to break this balloon," Erbella said. "It could break but we think if it did it would pass from the body."
Insurance doesn't cover the balloon procedure and both Rekkas and Erbella confirm the procedure will cost between $7,000 to $8,000.
"Unfortunately the Orbera is so new and like any new procedures insurance is not covering it," Erbella said. "When the lap band came out, same thing, insurance didn't cover it for a few years. But I suspect insurance will eventually cover it."
The fee covers putting the balloon in and taking it out and the anesthesiologist, Erbella said.
Information: Dr. Rekkas at Manatee Surgical Alliance, 941-254-4957; Dr. Erbella at Manatee Memorial Hospital, 941-896-4788.
OTHER Weight loss surgeries
Adjustable gastric band -- A band is placed between the esophagus and stomach which creates a small reservoir. Surgery time: 30 minutes to one hour. Expected excess weight loss estimated at 40 to 50 percent. Advantages: simple to perform, low mortality rate, no need to manipulate intestines. Disadvantages: No alteration of metabolism, requires more commitment from patient, long term foreign body complications possible, need adjustment with a needle.
Gastric bypass -- The surgeon creates a small stomach reservoir and attaches a section of the small intestine directly to the pouch. This allows food to bypass a portion of the small intestine. Surgery time: 1.5 to 3.5 hours. Expected weight loss estimated at 65 to 75 percent at two years. Advantages: changes metabolism, most weight loss, rapid weight loss. Disadvantages: Big operation and slower recovery, highest complication rate, practically irreversible, need to take vitamins and minerals lifelong.
Laparoscopic gastric sleeve -- Surgeon removes about two-thirds of the stomach. Surgery time: one to two hours. Expected weight loss 60 to 70 percent in two years. Advantages: Simple to perform, changes metabolism, decrease in hunger cravings, no foreign body. Disadvantages: Slightly higher complication rate than gastric band but much less than bypass.
Gastric balloon -- A balloon is filled with water once inside the stomach. Out-patient procedure takes about 15 minutes. Expected excess weight loss 22 pounds in six months. Advantages: Non-surgical, results quickly. Disadvantages: Balloon is removed after six months so patients must change lifestyle to avoid weight re-gain.
-- Information supplied by Dr. Stelios Rekkas
Richard Dymond, Herald reporter, can be reached at 941-745-7072 or contact him via Twitter@RichardDymond.
This story was originally published April 18, 2016 at 5:49 PM with the headline "Manatee Drs. Rekkas, Erbella say Orbera balloon is perfect for some ."