Obesity is a growing health problem that jeopardizes the lives of adults and children worldwide. Bariatric surgeries like sleeve gastrectomy or RNY gastric bypass are obesity-relieving tools that aid in weight loss, cure underlying medical illnesses, and are proven to prolong life expectancy. One new experimental procedure resembling a clip for weight loss, known as the BariClip, is gaining attention from individuals interested in a less-invasive approach.
We will discuss the pros and cons of the bariclip – how it works and what to expect long-term.
What is the BariClip?
The Bariclip is a foreign titanium device inserted laparoscopically and placed around the stomach wall to restrict food capacity to mimic the effects of the gastric sleeve. Instead of surgically removing a portion of the stomach, the laparoscopic vertical clip gastroplasty cuts off food from entering a part of the stomach by clamping the clip to restrict access.
The digestive anatomy stays intact while the stomach becomes fuller faster, allowing less food to be consumed and absorbed into the body.
Bariclip patients are expected to lose an average of 35% of their excess weight whereas sleeve gastrectomy patients lose over 60% of their excess weight.
- This kind of stomach clip surgery is reversible
- No removing a portion of the stomach
- No rerouting small bowel or changing anatomy
- Decreases the intragastric pressure
- Post-operative GERD decreases
- A foreign device inserted into the body
- Risk of slippage and erosion
- The Gastric Clip is still a new, experimental operation
- Testing has yet to be performed to see any long-term effects on the stomach
- Most surgeons refuse to offer bariclip as it may have the same negative effects as gastric band
How Does it Work?
Made of silicone-coated titanium, the BariClip is a 15-cm long bar placed laparoscopically over the stomach.
Using 3-5 surgical instruments known as trocars are inserted into small incisional ports to access the abdominal cavity. The bariatric doctor then carefully places the clipbar to close off a part of the stomach following a calibration bougie.
Restriction helps less food from entering the stomach. The clip is then sutured to the gastric wall to keep it from sliding. Because the clip is coated in silicone, it is unlikely to puncture the stomach, making it low risk for leakage.
- Placement of the bariatric clip around the stomach wall
- Close and adjust the clip
- Applying sutures to adhere the clip to the stomach to prevent slipping.
- Gastroplasty: stomach is segmented to create restriction
Division of the Stomach into Two (Gastroplasty)
- Inner side with reduced stomach volume (which will result in restriction and reduced food intake).
- The unused outer portion of the stomach.
The pressure of the clip on the stomach prevents food from passing through but does not prevent liquids from passing through.
Am I Eligible for a Gastric Clip?
Currently, the bariatric clip is designed for patients with a body mass index (BMI) between 29 and 40. For patients with higher BMIs, some studies may be required before being approved for the procedure.
Because of its vertical placement around the stomach, the BARICLIP is an alternative for those who want the gastric sleeve but are susceptible to GERD and acid reflux. The clip results in lower intragastric pressure, reducing the odds of post-operative reflux.
“[The Bariclip] rectifies the stomach and does not allow the acid to return, which makes it an effective option for treating conditions such as gastroesophageal reflux,” stated Dr. Liza María Pompa.
How Effective is the Bariclip?
Between 2012 and 2016, 117 patients were given gastric clips at the Jackson South Community Hospital in Miami, Florida. The average time for surgery was 69 minutes and patients had to stay less than 2 days at the hospital. After 39 months, most patients lost 66.7% excess weight with only 15 of them choosing to remove the implant.
With the Bariclip, there are 2 factors that can affect the success of the procedure: slippage and erosion. As the clip is stapled around the stomach, a common concern is that the implant will slip off of the stomach, making it ineffective and causing issues with the rest of the body. Another concern is that because the clip is similar to the gastric band, it will have the same level of erosion which can lead to infections and complications.
In 2020, the effects of the gastric clip were tested on a bariatric patient. After a normal recovery, the patient did not have reflux and lost 31% of her total weight. Because of the low pressure caused by the implant, the rate of erosion was expected to be 1.3% in the next 7 years. While slippage was more common in the initial bariclip operations, there was only a 3% chance of the clip slipping off.
Should I Choose the Bariclip Instead of the Gastric Sleeve?
While it can have the same results as the gastric sleeve, the bariclip is not yet an industry standard. Until it is proven that the clip will not cause the same erosion and slippage issues as the Lap-Band, the VSG surgery is still a safer option even if it is not reversible. If the patient is concerned about GERD, gastric bypass is the more proven option. The Bariclip is currently not FDA approved.
BariClip is suitable for individuals with BMI of 29 to 40 without comorbidities.
At Mexico Bariatric Center®, Dr. Christian Rodriguez Lopez is one of the first surgeons to perform the operation in Baja California. The all-inclusive BariClip cost in Mexico starts at around $6,995. Dr. Rodriguez Lopez can perform the Bariclip if requested but the gastric sleeve and gastric bypass are typically the best options for patients.
The Future of BariClip
The idea of reversibility and possibly fewer complications with this procedure is always attractive to patients. However, we need more time and data to say if this is a promising tool to stay around.
This procedure makes no changes to the Ghrelin hormones that control hunger and limit the body’s food intake and the stomach’s interaction with the brain. Therefore it may not be as effective of a procedure like a gastric sleeve when the body’s thermostat gets completely reset. It lacks the hormonal component that changes the body’s metabolic thermostat which leads to rapid and long-term weight loss.
The main question is will this operation be another kind of Band with all the complications we experienced in the past? Until there is enough data to answer this question, the gastric sleeve and RNY gastric bypass will be the better surgery options.