Totally endoscopic implant to effect a gastric bypass: 12-month safety and efficacy outcomes

Obesity is the underlying constant for the development of the most common modern diseases such as insulin resistance, high blood pressure, lipid metabolism disorders, non-alcoholic steatohepatitis (fatty liver), joint problems and various malignancies. The role of endoscopic diagnostic and therapy in obese patients is highlighted in this chapter. In this chapter all devices and methods used in flexible endoscopy for diagnostic and treatment in obese patients are introduced. Role of endoscopy is presented in three parts: in preoperative setting, in post-operative complication management and instead of surgery as endoscopic bariatric therapy. If possible presentation of the effectiveness is compiled with study data. Finally, the interaction between endoscopy and surgery in the treatment of obesity is complex, essential and promising. Endoscopy is indispensable in preoperative preparation, as a primary therapeutic approach, and also in the detection and treatment of acute complications and long-term complications of obesity surgery.

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“…Implantation and removal of the device according to the study concepts was possible in all patients. EWL after one year was 44.8% [20].…”

Section: The Valentx and Its Successormentioning

confidence: 91%

Bariatric Surgery—from the Non-surgical Approach to the Post-Surgery Individual Care: Role of Endoscopy in Bariatric Therapy

Wichmann¹,

Stüker²,

Schweizer³

et al. 2021

Bariatric Surgery - From the Non-Surgical Approach to the Post-Surgery Individual Care

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“…The latest generation of this device gave results of 17.6 TBWL% at 1 year. In another prospective study, a TBWL of 15.6% was observed at 6 months [100]. None of the studies reported hormones or gut peptides other than insulin resistance markers, so it is hard to make assumptions of the mechanism by which weight loss and insulin resistance is improved.…”

Section: Gastroduodenojejunal Bypass Sleevementioning

confidence: 99%

Food intake regulation: Relevance to bariatric and metabolic endoscopic therapies

Izundegui

Singh

Acosta

2020

Techniques and Innovations in Gastrointestinal Endoscopy

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In this review, we aim to cover the key aspects of food intake regulation in health and obesity as well as the presumed mechanisms of action of bariatric endoscopic procedures for weight loss. Food intake regulation is a tightly controlled homeostatic process. The key stages of food intake regulation are hunger, satiation, and satiety. These different stages are regulated by the brain-gut-liver-fat axis. Disruption in this homeostatic process results in increased food intake and further weight gain and obesity. Bariatric endoscopy is an innovative and evolving field in the treatment of obesity. While its effectiveness is becoming rapidly accepted, the mechanisms of action are many times not well recognized. Bariatric endoscopy targets different stages and organs that control food intake. Understanding the mechanisms of action of each endoscopic bariatric therapy will facilitate the future improvement of each device, as well as the patient selection to maximize outcomes and minimize potential side effects.

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“…Moreover, mean HbA1c and fasting glucose decreased by 1.1% and 29 mg/dL, respectively, in the subgroup of patients with T2DM. The six most frequent AEs were epigastric pain, heartburn or acid reflux, regurgitation, vomiting, dysphagia, and nausea 26 . However, the device is undergoing substantial modifications 25,26 and no clinical trials of the GJBS are currently underway, possibly due to the complex and challenging implantation procedure and common AEs, including epigastric pain, heartburn or acid reflux, regurgitation, and vomiting.…”

Section: Small Intestine‐targeted Ebmts In Clinical Applicationmentioning

confidence: 99%

Small intestine‐targeted endoscopic bariatrics: Current status and future perspectives

Ren

2023

Digestive Endoscopy

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The global obesity epidemic shows no signs of slowing down. Endoscopic bariatric and metabolic therapies (EBMTs) are being increasingly adopted as treatment options for obesity and obesity‐related comorbidities, due to their minimally invasive nature and ease of delivery. According to the site of action along the gastrointestinal tract, EBMTs can be divided into two categories: gastric EBMTs, and small intestine‐targeted EBMTs. Unlike gastric EBMTs, which work through a volume‐restricting mechanism leading to early satiety and reduced caloric intake, small intestine‐targeted EBMTs can be metabolically beneficial through foregut and/or hindgut pathways independent of weight loss, and therefore have great potential for the treatment of obesity‐related metabolic comorbidities such as type 2 diabetes. Although none of the small intestine‐targeted EBMTs have been approved by the US Food and Drug Administration to date, their clinical efficacy and safety have been extensively explored in investigational trials. This review aims to summarize and provide a comprehensive understanding of small intestine‐targeted EBMTs in clinical and preclinical settings, and to further discuss their potential mechanisms of action.

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Totally endoscopic implant to effect a gastric bypass: 12-month safety and efficacy outcomes

Abstract: This study demonstrates the feasibility, safety, and efficacy of a fully trans-oral gastrointestinal bypass implant. This purely endoscopic device may provide a valuable addition to the armamentarium of treatment available for the management of morbid obesity.

Cited by 10 publications

References 9 publications

Bariatric Surgery—from the Non-surgical Approach to the Post-Surgery Individual Care: Role of Endoscopy in Bariatric Therapy

Bariatric Surgery—from the Non-surgical Approach to the Post-Surgery Individual Care: Role of Endoscopy in Bariatric Therapy

Food intake regulation: Relevance to bariatric and metabolic endoscopic therapies

Small intestine‐targeted endoscopic bariatrics: Current status and future perspectives

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