Innovative procedure allows AdventHealth patient to eat again
Special to the FMA from AdventHealth | Oct. 25, 2023

After more than a year of IV nutrition, AdventHealth patient Rene Galloway became the world’s first recipient of a new endoscopic procedure that has allowed her to eat again. Performed by AdventHealth gastroenterologist Kamibiz Kadkhodayan, MD, and his team, this original, two-step procedure was done with an endoscope and other FDA-approved devices, without the need for traditional surgery.

Galloway, a former nurse who worked in the emergency room at AdventHealth Celebration, had undergone nine surgeries over the last 13 years, which left her getting nourishment through an IV on and off for about a year and a half during that time. Because of all her previous surgeries, doctors had told Galloway that she was a poor candidate for future surgeries. Dr. Kadkhodayan (Dr. K.) at AdventHealth’s Center for Interventional Endoscopy became her last resort.

This novel “Candy Cane” procedure gets its name from the shape of the small bowel before the procedure. A problematic portion of the bowel, which looks like the curved end of the candy cane, is reduced in size by using a repurposed endoscopic device. This is followed by a second procedure where a channel for food is created.

Illustration of the new endoscopic procedure by AdventHealth gastroenterologist Kamibiz Kadkhodayan, MD

Before-and-after diagram showing the brand-new procedure called an endoscopic blind limb reduction with septotomy, also known as a “Candy Cane” procedure

After discussing it with Galloway and her husband, they decided to move forward with the surgery. Ready to try anything, she underwent the first of two back-to-back surgeries in March 2023.

“When Dr. K. came into the room, he sat down with my husband and I and took the time to sketch these drawings detailing the surgery and how he was going to help me,” Galloway said. “I’ve never seen that from a physician and we both had tears in our eyes because we knew Dr. K. was in it for me and would do whatever it took to give me a normal life again.”

Using an original two-step endoscopic procedure, Dr. Kadkhodayan and his team were able to treat Galloway’s condition, with no incisions.

“We were able to repurpose FDA-approved gastroenterologist tools to achieve a procedure similar to surgery, but less invasive,” Dr. Kadkhodayan said.

To say the past several months have been life-changing for Galloway would be an understatement. When she came to AdventHealth for her first surgery, she had been on IV nutrition for about three months because she couldn’t always keep food down to nourish her body. After her second procedure, she left the hospital and ate her first meal – a Chick-fil-A sandwich and French fries – and savored every bite. She has been able to eat food normally ever since.

“I don’t have to keep nausea medicine and grocery bags on hand anymore in case I got sick,” said Galloway. “I don’t have to rely on Google maps to plan my route based on where gas station bathrooms are anymore.”

Rene Galloway, left, was the world’s first recipient of a new endoscopic procedure performed by AdventHealth gastroenterologist Kamibiz Kadkhodayan, MD, and his team.
Rene Galloway, left, was the world’s first recipient of a new endoscopic procedure performed by AdventHealth gastroenterologist Kamibiz Kadkhodayan, MD, and his team.
Candy Cane Syndrome refers to patients, like Galloway, who have undergone gastric bypass and develop significant and sometimes debilitating abdominal discomfort. Symptoms typically begin after eating and can often only be relieved by vomiting.

The surgical team celebrated in the operating room once the team realized they’d created a successful new treatment option for their patients.

“We’ve been able to offer it to four more patients who have done just as well,” Dr. Kadkhodayan said. “I can’t tell you how rewarding and satisfying it is as a physician to know that we’ve described a procedure that may help countless patients in the future.”

Dr. Kadkhodayan credits the multidisciplinary approach at AdventHealth for the success of the groundbreaking surgery. By having various subspecialities all sitting together at the table discussing Galloway’s situation, it allowed for more innovation and improved their patients’ lives. “Dr. K. gave me hope,” she said. “It was another trip to the bathroom to get sick, another trip to the hospital and this surgery has allowed me to go back to work full time and spend time with my family again. I can now go out to restaurants and have family dinners and beach days again.”

It’s been a long, sometimes painful journey, for Galloway since her first gastric bypass surgery in 2009, but she’s now able to keep food down and lead a more normal life thanks to this innovative surgery and hopes to be the model patient by adopting a healthier lifestyle after surgery by eating the right foods and exercising to fully enjoy her second lease on life.

“This surgery has given me my life back,” she said.