Skip to main content
Top
Published in: Surgical Endoscopy 3/2007

01-03-2007 | Review Article

New applications for endoscopy: the emerging field of endoluminal and transgastric bariatric surgery

Authors: P. Schauer, B. Chand, S. Brethauer

Published in: Surgical Endoscopy | Issue 3/2007

Login to get access

Abstract

Endoluminal and transgastric procedures are evolving concepts that combine the skills and techniques of flexible endoscopy with minimally invasive surgery. Precisely how this technology and skill set will be applied in the field of general surgery is not yet known, but the treatment of obesity with an endoluminal or transgastric procedure holds great promise. As the demand for bariatric surgery increases, efforts will be directed toward developing less morbid and less costly treatment options that can provide substantial weight loss and resolution of comorbid conditions. Natural orifice bariatric procedures may include short-term weight loss in preparation for a definitive laparoscopic procedure, revisional procedures to reduce stoma or pouch size or repair fistulas, or primary therapy that provides durable weight loss. The latter application will undoubtedly appeal to patients and referring physicians if it can be performed as an outpatient procedure with significantly less morbidity than a laparoscopic procedure. Early preclinical and clinical work has been published in this area, but many technical obstacles must be overcome before a primary endoluminal or transgastric bariatric procedure can be offered. This article reviews the endoluminal and transgastric technology currently available, the endoluminal procedures currently performed, and the future of these technologies with respect to bariatric surgery.
Literature
1.
go back to reference Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and metaanalysis. JAMA 292: 1724–1737PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and metaanalysis. JAMA 292: 1724–1737PubMedCrossRef
2.
go back to reference Nguyen NT, Root J, Zainabadi K, Sabio A, Chalifoux S, Stevens CM, Mavandadi S, Longoria M, Wilson SE (2005) Accelerated growth of bariatric surgery with the introduction of minimally invasive surgery. Arch Surg 140: 1198–1202PubMedCrossRef Nguyen NT, Root J, Zainabadi K, Sabio A, Chalifoux S, Stevens CM, Mavandadi S, Longoria M, Wilson SE (2005) Accelerated growth of bariatric surgery with the introduction of minimally invasive surgery. Arch Surg 140: 1198–1202PubMedCrossRef
3.
go back to reference Hawes R (2006) ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery. Gastrointest Endosc 63: 199–203CrossRef Hawes R (2006) ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery. Gastrointest Endosc 63: 199–203CrossRef
4.
go back to reference Kadirkamanathan SS, Evans DF, Gong F, Yazaki E, Scott M, Swain CP (1996) Antireflux operations at flexible endoscopy using endoluminal stitching techniques: an experimental study. Gastrointest Endosc 44: 133–143PubMedCrossRef Kadirkamanathan SS, Evans DF, Gong F, Yazaki E, Scott M, Swain CP (1996) Antireflux operations at flexible endoscopy using endoluminal stitching techniques: an experimental study. Gastrointest Endosc 44: 133–143PubMedCrossRef
5.
go back to reference Chen YK, Raijmann I, Ben-Menachem T, Starpoli AA, Liu J, Pazwash H, Weiland S, Shahrier M, Fortajada E, Saltzman JR, Carr-Locke DL (2005) Long-term outcomes of endoluminal gastroplication: a U.S. multicenter trial. Gastrointest Endosc 61: 659–667PubMedCrossRef Chen YK, Raijmann I, Ben-Menachem T, Starpoli AA, Liu J, Pazwash H, Weiland S, Shahrier M, Fortajada E, Saltzman JR, Carr-Locke DL (2005) Long-term outcomes of endoluminal gastroplication: a U.S. multicenter trial. Gastrointest Endosc 61: 659–667PubMedCrossRef
6.
go back to reference Corley DA, Katz P, Wo JM, Stefan A, Patti M, Rothstein R, Edmundowicz S, Kline M, Mason R, Wolfe MM (2003) Improvement of gastroesophageal reflux symptoms after radiofrequency energy: a randomized, sham-controlled trial. Gastroenterology 125: 668–676PubMedCrossRef Corley DA, Katz P, Wo JM, Stefan A, Patti M, Rothstein R, Edmundowicz S, Kline M, Mason R, Wolfe MM (2003) Improvement of gastroesophageal reflux symptoms after radiofrequency energy: a randomized, sham-controlled trial. Gastroenterology 125: 668–676PubMedCrossRef
7.
go back to reference Deviere J, Costamagna G, Neuhaus H, Voderholzer W, Louis H, Tringali A, Marchese M, Fiedler T, Darb-Esfahani P, Schumacher B (2005) Nonresorbable copolymer implantation for gastroesophageal reflux disease: a randomized sham-controlled multicenter trial. Gastroenterology 128: 532–540PubMedCrossRef Deviere J, Costamagna G, Neuhaus H, Voderholzer W, Louis H, Tringali A, Marchese M, Fiedler T, Darb-Esfahani P, Schumacher B (2005) Nonresorbable copolymer implantation for gastroesophageal reflux disease: a randomized sham-controlled multicenter trial. Gastroenterology 128: 532–540PubMedCrossRef
8.
go back to reference Doldi SB, Micheletto G, Perrini MN, Rapetti R,(2004) Intragastric balloon: another option for treatment of obesity and morbid obesity. Hepatogastroenterology 51: 294–297PubMed Doldi SB, Micheletto G, Perrini MN, Rapetti R,(2004) Intragastric balloon: another option for treatment of obesity and morbid obesity. Hepatogastroenterology 51: 294–297PubMed
9.
go back to reference Spaulding L (2003) Treatment of dilated gastrojejunostomy with sclerotherapy. Obesi Surg 13: 254–257CrossRef Spaulding L (2003) Treatment of dilated gastrojejunostomy with sclerotherapy. Obesi Surg 13: 254–257CrossRef
10.
go back to reference European Patent Office. Retrieved October 2005 at www.european-patent-office.org European Patent Office. Retrieved October 2005 at www.european-patent-office.org
11.
go back to reference Regan JP, Inabnet WB, Gagner M, Pomp A (2003) Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the supersuper obese patient. Obes Surg 13: 861–864PubMedCrossRef Regan JP, Inabnet WB, Gagner M, Pomp A (2003) Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the supersuper obese patient. Obes Surg 13: 861–864PubMedCrossRef
12.
go back to reference Cottam D, Mattar S, Sharma S, Thodiyil P, Bonomani G, Holover S, Sebastian J, Ramanathan R, Eid G, Schauer P (2006) Laparoscopic sleeve gastrectomy as an initial weight loss procedure for high risk patients with morbid obesity. Surg Endosc 20:859–863PubMedCrossRef Cottam D, Mattar S, Sharma S, Thodiyil P, Bonomani G, Holover S, Sebastian J, Ramanathan R, Eid G, Schauer P (2006) Laparoscopic sleeve gastrectomy as an initial weight loss procedure for high risk patients with morbid obesity. Surg Endosc 20:859–863PubMedCrossRef
13.
go back to reference Almogy G, Crookes PF, Anthone GJ (2004) Longitudinal gastrectomy as a treatment for the high-risk superobese patient. Obes Surg 14: 492–497PubMedCrossRef Almogy G, Crookes PF, Anthone GJ (2004) Longitudinal gastrectomy as a treatment for the high-risk superobese patient. Obes Surg 14: 492–497PubMedCrossRef
14.
go back to reference Sallet JA, Marchesini JC, Ribeiro MR, Pizani CE, Kamoto K, Sallet PC (2004) Utilization of the intragastric balloon (BIB) in preoperative preparation for superobese patients with high surgical risk. Presented at the 21st Annual Meeting of American Society for Bariatric Surgery p 69 Sallet JA, Marchesini JC, Ribeiro MR, Pizani CE, Kamoto K, Sallet PC (2004) Utilization of the intragastric balloon (BIB) in preoperative preparation for superobese patients with high surgical risk. Presented at the 21st Annual Meeting of American Society for Bariatric Surgery p 69
15.
go back to reference Busetto L, Segato G, De Luca M, Bortolozzi E, MacCari T, Magon A, Inelmen EM, Favretti F, Enzi G (2004) Preoperative weight loss by intragastric balloon in superobese patients treated with laparoscopic gastric banding: a case-control study. Obes Surg 14: 671–676PubMedCrossRef Busetto L, Segato G, De Luca M, Bortolozzi E, MacCari T, Magon A, Inelmen EM, Favretti F, Enzi G (2004) Preoperative weight loss by intragastric balloon in superobese patients treated with laparoscopic gastric banding: a case-control study. Obes Surg 14: 671–676PubMedCrossRef
16.
17.
go back to reference Thompson CC (2005) Per-oral endoscopic reduction of dilated gastrojejunal anastomosis following Roux-en-Y gastric bypass: a possible new option for patients with weight regain. SOARD 1: 223 Thompson CC (2005) Per-oral endoscopic reduction of dilated gastrojejunal anastomosis following Roux-en-Y gastric bypass: a possible new option for patients with weight regain. SOARD 1: 223
18.
go back to reference Schweitzer M (2004) Endoscopic intraluminal suture plication of the gastric pouch and stoma in postoperative Roux-en-Y gastric bypass patients. J Laparoendosc Adv Surg Tech A 14: 223–226PubMed Schweitzer M (2004) Endoscopic intraluminal suture plication of the gastric pouch and stoma in postoperative Roux-en-Y gastric bypass patients. J Laparoendosc Adv Surg Tech A 14: 223–226PubMed
19.
go back to reference Catalano MJ, George S, Thomas M, Geenen JE, Chua T (2004) Weight gain following bariatric surgery secondary to staple line disruption and stomal dilation: endotherapy using sodium morrhuate to induce stomal stenosis prevents need for surgical revision. Gastrointest Endosc 59: 149CrossRef Catalano MJ, George S, Thomas M, Geenen JE, Chua T (2004) Weight gain following bariatric surgery secondary to staple line disruption and stomal dilation: endotherapy using sodium morrhuate to induce stomal stenosis prevents need for surgical revision. Gastrointest Endosc 59: 149CrossRef
20.
go back to reference Papavramidis ST, Eleftheriadis EE, Papavramidis TS, Kotzampassi KE, Gamvros OG (2004) Endoscopic management of gastrocutaneous fistula after bariatric surgery by using a fibrin sealant. Gastrointest Endosc 59: 296–300PubMedCrossRef Papavramidis ST, Eleftheriadis EE, Papavramidis TS, Kotzampassi KE, Gamvros OG (2004) Endoscopic management of gastrocutaneous fistula after bariatric surgery by using a fibrin sealant. Gastrointest Endosc 59: 296–300PubMedCrossRef
21.
go back to reference U.S. surgical procedure volumes (2005) MedTech Insight 7: 136 U.S. surgical procedure volumes (2005) MedTech Insight 7: 136
22.
go back to reference Roman S, Napoleon B, Mion F, Bory RM, Guyot P, D’Orazio H, Benchetrit S (2004) Intragastric balloon for “nonmorbid” obesity: a retrospective evaluation of tolerance and efficacy. Obes Surg 14: 539–544PubMedCrossRef Roman S, Napoleon B, Mion F, Bory RM, Guyot P, D’Orazio H, Benchetrit S (2004) Intragastric balloon for “nonmorbid” obesity: a retrospective evaluation of tolerance and efficacy. Obes Surg 14: 539–544PubMedCrossRef
23.
go back to reference Mathus-Vliegen EM, Tytgat GN (2005) Intragastric balloon for treatment-resistant obesity: safety, tolerance, and efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up. Gastrointest Endosc 61: 19–27PubMedCrossRef Mathus-Vliegen EM, Tytgat GN (2005) Intragastric balloon for treatment-resistant obesity: safety, tolerance, and efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up. Gastrointest Endosc 61: 19–27PubMedCrossRef
24.
go back to reference Kelleher B, Stone C, Burns M, Gaskill H (2003) The butterfly procedure for endoluminal treatment of obesity. Gastrointest Endosc 57: AB186 Kelleher B, Stone C, Burns M, Gaskill H (2003) The butterfly procedure for endoluminal treatment of obesity. Gastrointest Endosc 57: AB186
25.
go back to reference Swain CP, Park P-O, Savides T, Kelleher B, Stone C, Burns M (2003) In vivo evaluation of the butterfly endoluminal gastroplasty procedure for obesity. Gastrointest Endosc 57: AB83 Swain CP, Park P-O, Savides T, Kelleher B, Stone C, Burns M (2003) In vivo evaluation of the butterfly endoluminal gastroplasty procedure for obesity. Gastrointest Endosc 57: AB83
26.
go back to reference Fogel R, De La Fuente R, Bonilla Y (2005) Endoscopic vertical gastroplasty: a novel technique for treatment of obesity: a preliminary report. Gastrointest Endosc 61: AB106CrossRef Fogel R, De La Fuente R, Bonilla Y (2005) Endoscopic vertical gastroplasty: a novel technique for treatment of obesity: a preliminary report. Gastrointest Endosc 61: AB106CrossRef
27.
go back to reference Kantsevoy S, Jagannath S, Niiyama H, Chung S, Cotton P, Gostout C, Hawes R, Pasricha P, Magee C, Vaughn C, Barlow D, Shimonaka H, Kalloo A (2005) Endoscopic gastrojejunostomy with survival in a porcine model. Gastrointest Endosc 62: 287–292PubMedCrossRef Kantsevoy S, Jagannath S, Niiyama H, Chung S, Cotton P, Gostout C, Hawes R, Pasricha P, Magee C, Vaughn C, Barlow D, Shimonaka H, Kalloo A (2005) Endoscopic gastrojejunostomy with survival in a porcine model. Gastrointest Endosc 62: 287–292PubMedCrossRef
28.
go back to reference Park A, Adrales G, McKinlay R, Knapp C (2004) A novel anastomotic device in a porcine model. Am Surg 70: 767–773PubMed Park A, Adrales G, McKinlay R, Knapp C (2004) A novel anastomotic device in a porcine model. Am Surg 70: 767–773PubMed
29.
go back to reference Swanstrom L, Kozarek R, Pasricha P, Gross S, Birkett D, Park PO, Saadat V, Ewers R, Swain P (2005) Development of a new access device for transgastric surgery. J Gastrointest Surg 9: 1129–1137PubMedCrossRef Swanstrom L, Kozarek R, Pasricha P, Gross S, Birkett D, Park PO, Saadat V, Ewers R, Swain P (2005) Development of a new access device for transgastric surgery. J Gastrointest Surg 9: 1129–1137PubMedCrossRef
31.
go back to reference O’Brien PE, Brown WA, Smith A, McMurrick PJ, Stephens M (1999) Prospective study of a laparoscopically placed, adjustable gastric band in the treatment of morbid obesity. Br J Surg 86: 113–118PubMedCrossRef O’Brien PE, Brown WA, Smith A, McMurrick PJ, Stephens M (1999) Prospective study of a laparoscopically placed, adjustable gastric band in the treatment of morbid obesity. Br J Surg 86: 113–118PubMedCrossRef
32.
go back to reference Scopinaro N, Gianetta E, Adami GF, Friedman D, Traverso E, Marinari GM, Cuneo S, Vitale B, Ballari F, Colombini M, Baschieri G, Bachi V (1996) Biliopancreatic diversion for obesity at eighteen years. Surgery 119: 261–268PubMedCrossRef Scopinaro N, Gianetta E, Adami GF, Friedman D, Traverso E, Marinari GM, Cuneo S, Vitale B, Ballari F, Colombini M, Baschieri G, Bachi V (1996) Biliopancreatic diversion for obesity at eighteen years. Surgery 119: 261–268PubMedCrossRef
33.
go back to reference Wittgrove AC, Clark GW (2000) Laparoscopic gastric bypass, Roux-en-Y, 500 patients: technique and results, with 3–60 month follow-up. Obes Surg 10: 233–239PubMedCrossRef Wittgrove AC, Clark GW (2000) Laparoscopic gastric bypass, Roux-en-Y, 500 patients: technique and results, with 3–60 month follow-up. Obes Surg 10: 233–239PubMedCrossRef
34.
go back to reference Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J (2000) Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 232: 515–529PubMedCrossRef Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J (2000) Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 232: 515–529PubMedCrossRef
35.
go back to reference Shikora SA, Storch K (2005) Implantable gastric stimulation for the treatment of severe obesity: the American experience. SOARD 1: 334–342 Shikora SA, Storch K (2005) Implantable gastric stimulation for the treatment of severe obesity: the American experience. SOARD 1: 334–342
36.
go back to reference Weiner R, Gutberlet H, Bockhorn H (1999) Preparation of extremely obese patients for laparoscopic gastric banding by gastric-balloon therapy. Obes Surg 9: 261–264PubMedCrossRef Weiner R, Gutberlet H, Bockhorn H (1999) Preparation of extremely obese patients for laparoscopic gastric banding by gastric-balloon therapy. Obes Surg 9: 261–264PubMedCrossRef
Metadata
Title
New applications for endoscopy: the emerging field of endoluminal and transgastric bariatric surgery
Authors
P. Schauer
B. Chand
S. Brethauer
Publication date
01-03-2007
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 3/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-9008-8

Other articles of this Issue 3/2007

Surgical Endoscopy 3/2007 Go to the issue