Sapala-Wood Micropouch

The Sapala-Wood Micropouch procedure is the result of lessons learned over the past 17 years in several thousand bariatric patients. It is an operation in which the stomach is reduced in size.

The puoch is durable and does not stretch over time. The pouch also contains very few acid cells, so patients with heartburn or GERD are virtually cured of their acid reflux symptoms. The bottom of the stomach still has its nerve supply. Consequently, acid production in the cephalic phase of gastric acid secretion is intact as well as normal gastric emptying. In other words, the bottom of the stomach still produces acid even though food does not pass through it.

This innovative smaller pouch empties more rapidly than the traditional 30-cc pouches. When patients eat slowly and chew thoroughly, a medium-sized meal (one salad plate) can be eaten in 30 minutes. Patients are encouraged to eat 6-8 small meals a day with fluids taken between meals. Multiple small meals minimize insulin production, so fat can be burned as an energy source.

Since there is very little acid in our Sapala-Wood Micropouch, patients do not develop acid reflux or marginal ulceration. Typically, the gastric reservoir outlet with marlex bands or silastic rings is not constricted. Therefore, band erosions or abscesses from foreign body reactions do not occur.

This great innovation in bariatric medicine has since grown and the procedure can now be performed by incorporating the Roux-en-Y method. In the Sapala-Wood Micropouch operation the very top of the stomach is completely divided. It is not stapled. This division results in the creation of a small "micropouch" completely separate from the lower part of the stomach. This Sapala-Wood Micropouch® is about the size of a grape.

The small intestine is divided into two ends. One end travels upward to be connected to the Sapala-Wood Micropouch. The other end is attached downward to the side of the distal small intestine to complete the circuit. Food travels down the esophagus, through the Sapala-Wood Micropouch®, to the intestine See Figure 3. It bypasses the stomach. The bottom of the stomach no longer receives any food or liquids. But the stomach will still function because its nerve and blood supply are intact

When you smell, taste, or think about food, the bottom of the stomach produces stomach acid. This acid and other digestive juices travel out of the stomach, through the bypassed duodenum, and part of the small intestine to mix with the food from the pouch. Through the last 8-15 feet of the intestine, this food is then absorbed into the bloodstream, along with most vitamins and minerals.

The Sapala-Wood Micropouch operation allows you to absorb a normal amount of calories, not an excess amount. This is why patients will have a weight loss close to normal and do not keep losing beyond their ideal body weight.