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01-02-2020 | Obesity | Review

The Role of Minimally Invasive and Endoscopic Technologies in Morbid Obesity Treatment: Review and Critical Appraisal of the Current Clinical Practice

Authors: Francesco Maria Carrano, Miroslav P. Peev, John K. Saunders, Marcovalerio Melis, Valeria Tognoni, Nicola Di Lorenzo

Published in: Obesity Surgery | Issue 2/2020

Abstract

Bariatric surgery is the most effective treatment for morbid obesity. Availability of different procedures with low complication rates, performed through a minimally invasive approach, have caused profound positive effect on patient’s quality of life and has led to their worldwide, rapid expansion of the field. The laparoscopic revolution has introduced the concept of lowering more and more the treatments’ invasiveness, leading to a change in the researchers’ mentality. They are now constantly looking for reducing patients’ discomfort through new methodologies and devices: aim of this review is to provide an in-depth analysis of the most promising, innovative procedures offering an alternative approach to “classic” laparoscopic procedures. They are described from their original development phases to the most recent experimental and clinical evidence. This review will discuss as well their future perspectives, and includes endoluminal techniques and/or procedures based on alternative concepts, all representing an appealing alternative to surgical approach. We conducted a MEDLINE for articles, clinical trials, and a patent search relating to the minimally invasive management of obesity, excluding intragastric balloons, SILS, and NOTES, and we selected 77 articles. Results are reported for each procedure/device, and discussed both in these paragraphs and in the final, general discussion. The concept of minimally invasive procedures continues to change and evolve over time with novel technologies emerging every year.

Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i–xii, 1–253

Eldar S, Heneghan HM, Brethauer SA, et al. Bariatric surgery for treatment of 1055 obesity. Int J Obes. 2011;35(Suppl 3):S16–21.

Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13(41):215.

Bamgbade OA, Adeogun BO, Abbas K. Fast-track laparoscopic gastric bypass surgery: outcomes and lessons from a bariatric surgery service in the United Kingdom. Obes Surg. 2012;22(3):398–402.PubMed

E. M. H. Mathus-Vliegen, J. Dargent, Bariatric Therapy, Springer International Publishing (2018). Current endoscopic/laparoscopic bariatric procedures, Chapter 2. https://doi.org/10.1007/978-3-319-90074-2

Cigaina V, Saggioro A, Rigo V, et al. Long-term effects of gastric pacing to reduce feed intake in swine. Obes Surg. 1996;6(3):250–3.PubMed

Greenway F, Zheng J. Electrical stimulation as treatment for obesity and diabetes. J Diabetes Sci Technol. 2007;1(2):251–9.PubMedCentralPubMed

Favretti F, De Luca M, Segato G, et al. Treatment of morbid obesity with the transcend implantable gastric stimulator (IGS): a prospective survey. Obes Surg. 2004;14(5):666–70.PubMed

Shikora SA. What are the yanks doing? The U.S. experience with implantable gastric stimulation (IGS) for the treatment of obesity—update on the ongoing clinical trials. Obes Surg. 2004;14(Suppl 1):S40–8.PubMed

10.

De Luca M, Segato G, Busetto L, et al. Progress in implantable gastric stimulation: summary of results of the European multi-center study. Obes Surg. 2004;14(Suppl 1):S33–9.PubMed

11.

Shikora SA, Bergenstal R, Bessler M, et al. Implantable gastric stimulation for the treatment of clinically severe obesity: results of the SHAPE trial. Surg Obes Relat Dis. 2009;5(1):31–7.PubMed

12.

Lebovitz HE. Interventional treatment of obesity and diabetes: an interim report on gastric electrical stimulation. Rev Endocr Metab Disord. 2016;17:73–80.PubMed

13.

Peles S, Petersen J, Aviv R, et al. Enhancement of antral contractions and vagal afferent signaling with synchronized electrical stimulation. Am J Physiol Gastrointest Liver Physiol. 2003;285(3):G577–85.PubMed

14.

Sanmiguel CP, Conklin JL, Cunneen SA, et al. Gastric electrical stimulation with the TANTALUS system in obese type 2 diabetes patients: effect on weight and glycemic control. J Diabetes Sci Technol. 2009;3(4):964–70.PubMedCentralPubMed

15.

Bohdjalian A, Prager G, Aviv R, et al. One-year experience with Tantalus: a new surgical approach to treat morbid obesity. Obes Surg. 2006;16(5):627–34.PubMed

16.

Bohdjalian A, Prager G, Rosak C, et al. Improvement in glycemic control in morbidly obese type 2 diabetic subjects by gastric stimulation. Obes Surg. 2009;19(9):1221–7.PubMed

17.

Soler-Majoral J, Sánchez-Escuredo A, Prat Aymerich C, Sanchis Vidal E, Marín-Tàpia A, Prats Bardají MS, et al. Orange sputum in a kidney transplant patient with Legionella micdadei pneumonia. Nefrologia. 2016 Apr 28;

18.

Horbach T, Thalheimer A, Seyfried F, et al. Abiliti closed-loop gastric electrical stimulation system for treatment of obesity: clinical results with a 27-month follow-up. Obes Surg. 2015;25(10):1779–87.PubMedCentralPubMed

19.

Miras M, Serrano M, Durán C, et al. Early experience with customized, mealtriggered gastric electrical stimulation in obese patients. Obes Surg. 2015;25(1):174–9.PubMed

20.

Kral JG, Görtz L, Hermansson G, et al. Gastroplasty for obesity: long-term weight loss improved by vagotomy. World J Surg. 1993;17(1):75–8. discussion 79PubMed

21.

Camilleri M, Toouli J, Herrera MF, et al. Intra-abdominal vagal blocking (VBLOC therapy): clinical results with a new implantable medical device. Surgery. 2008;143(6):723–31.PubMed

22.

Tweden KS, Spadone DP, Terranova VP. Neovascularization of surface demineralized dentin. J Periodontol. 1989;60(8):460–6.PubMed

23.

Shikora S, Toouli J, Herrera MF, et al. Vagal blocking improves glycemic control and elevated blood pressure in obese subjects with type 2 diabetes mellitus. J Obes. 2013;2013:245683.PubMedCentralPubMed

24.

Ikramuddin S, Blackstone RP, Brancatisano A, et al. Effect of reversible intermittent intra-abdominal vagal nerve blockade on morbid obesity: the 1120 ReCharge randomized clinical trial. JAMA. 2014;312(9):915–22.PubMed

25.

Shikora SA, Wolfe BM, Apovian CM, et al. Sustained weight loss with vagal nerve blockade but not with sham: 18-month results of the ReCharge trial. J Obes. 2015;2015:365604.PubMedCentralPubMed

26.

US FDA PMA Database Entry P180024: FDA summary of safety and effectiveness data. https://www.fda.gov/medical-devices/recently-approved-devices/transpyloric-shuttletranspyloric-shuttle-delivery-device-p180024

27.

Marinos G, Eliades C, Raman Muthusamy V, et al. Weight loss and improved quality of life with a nonsurgical endoscopic treatment for obesity: clinical results from a 3- and 6-month study. Surg Obes Relat Dis. 2014;10(5):929–34.PubMed

28.

T-P-3277 weight reduction in patients with obesity using the transpyloric Shuttle®: ENDObesity® II Study–Obesity Week 2018, Nashville, TN, USA November 11–15 2018)

29.

Dargent, J. Etude De L ’ Infiltration De La Jonction Gastro-Œsophagienne Par L ’ Acide Hyaluronique Comme Adjuvant Aux Techniques Bariatriques . Résultats de la combinaison avec la sleeve gastrectomie et perspectives. Le journal de Cœlio-chirurgie Techniques, 51–52 - N° 74 - Juin 2010.

30.

Dargent J Obendo 2 And 3 Study on hyaluronic acid injection at the ge junction: a closer look at the trajectory. 32nd Annual Meeting of the American Society for Metabolic and Bariatric Surgery Presented at ObesityWeek 2015, Los Angeles Convention Center Los Angeles, California, USA, November 2-7, 2015

31.

Dargent J, Mion F, Costil V, et al. Multicenter randomized study of obesity treatment with minimally invasive injection of hyaluronic acid versus and combined with intragastric balloon. Obes Surg. 2015;25(10):1842–7.PubMed

32.

Devière J, Ojeda Valdes G, Cuevas Herrera L, et al. Safety, feasibility and weight loss after transoral gastroplasty: first human multicenter study. Surg Endosc. 2008;22(3):589–98.PubMed

33.

Zagol B, Mikami D. Advances in transoral fundoplication for oesophageal reflux. Dig Liver Dis. 2011;43(5):361–4.PubMed

34.

Fogel R, De Fogel J, Bonilla Y, et al. Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients. Gastrointest Endosc. 2008;68(1):51–8.PubMed

35.

Awan AN, Swain CP. Endoscopic vertical band gastroplasty with an endoscopic sewing machine. Gastrointest Endosc. 2002;55(2):254–6.PubMed

36.

Schiefke I, Zabel-Langhennig A, Neumann S, et al. Long term failure of endoscopic gastroplication (EndoCinch). Gut. 2005;54(6):752–8.PubMedCentralPubMed

37.

Familiari P, Costamagna G, Bléro D, et al. Transoral gastroplasty for morbid obesity: a multicenter trial with a 1-year outcome. Gastrointest Endosc. 2011;74(6):1248–58.PubMed

38.

Chiellini C, Iaconelli A, Familiari P, et al. Study of the effects of transoral gastroplasty on insulin sensitivity and secretion in obese subjects. Nutr Metab Cardiovasc Dis. 2010;20(3):202–7.PubMed

39.

Brethauer SA, Chand B, Schauer PR, et al. Transoral gastric volume reduction as intervention for weight management: 12 months follow-up of the TRIM trial. Surg Obes Relat Dis. 2012;8:296–303.PubMed

40.

Brethauer SA, Chand B, Schauer PR, et al. Transoral gastric volume reduction for weight management: technique and feasibility in 18 patients. Surg Obes Relat Dis. 2010;6(6):689–94.PubMed

41.

Biertho L, Hould FS, Lebel S, et al. Transoral endoscopic restrictive implant system: a new endoscopic technique for the treatment of obesity. Surg Obes Relat Dis. 2010;6(2):203–5.PubMed

42.

De Jong K, Mathus-Vliegen EM, Veldhuyzen EA, et al. Short-term safety and efficacy of the trans-oral endoscopic restrictive implant system for the treatment of obesity. Gastrointest Endosc. 2010;72(3):497–504.PubMed

43.

Verlaan T, de Jong K, de la Mar-Ploem ED, Veldhuyzen LA, Mathus-Vliegen EM, Fockens P. Trans-oral endoscopic restrictive implant system: endoscopic treatment of obesity? Surg Obes Relat Dis. 2016;12(9):1711–1718. https://doi.org/10.1016/j.soard.2016.02.027.PubMed

44.

Legner A, Altorjay A, Juhasz A, et al. Transoral mucosal excision sutured gastroplasty: a pilot study for GERD and obesity with two-year follow-up. Surg Innov. 2014;21(5):456–63.PubMedCentralPubMed

45.

Sauer N, Rösch T, Pezold J, et al. A new endoscopically implantable device (SatiSphere) for treatment of obesity—efficacy, safety, and metabolic effects on glucose, insulin, and GLP-1 levels. Obes Surg. 2013;23(11):1727–33.PubMed

46.

De la Mora JG, Rajan E, Rea D, et al. In vivo full thickness endoluminal gastroplication using tissue anchors in a live pig model. Gastrointest Endosc. 2005;61(5):AB223.

47.

Espinós JC, Turró R, Mata A, et al. Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity: the primary obesity surgery endolumenal (POSE) procedure. Obes Surg. 2013;23(9):1375–83.PubMed

48.

Lopez-Nava G, Galvão MP, Bautista-Castaño I, et al. Endoscopic sleeve gastroplasty: how I do it? Obes Surg. 2015;25(8):1534–8.PubMed

49.

Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc. 2013;78(3):530–5.PubMed

50.

Sartoretto A, Sui Z, Hill C, et al. 236 endoscopic sleeve gastroplasty is a safe, effective and reproducible bariatric therapy with potential for widespread clinical adoption. Gastrointest Endosc. 2018;87(6):AB65–6. https://doi.org/10.1016/j.gie.2018.04.052.CrossRef

51.

Graus Morales J, Crespo Pérez L, Marques A, et al. Modified endoscopic gastroplasty for the treatment of obesity. Surg Endosc. 2018;32(9):3936–42. https://doi.org/10.1007/s00464-018-6133-0.CrossRefPubMed

52.

De Moura EG, Orso IR, Martins BC, et al. Improvement of insulin resistance and reduction of cardiovascular risk among obese patients with type 2 diabetes with the duodenojejunal bypass liner. Obes Surg. 2011;21(7):941–7.PubMed

53.

Rodriguez-Grunert L, Galvao Neto MP, Alamo M, et al. First human experience with endoscopically delivered and retrieved duodenal-jejunal bypass sleeve. Surg Obes Relat Dis. 2008;4(1):55–9.PubMed

54.

Gersin KS, Rothstein RI, Rosenthal RJ, et al. Openlabel, sham-controlled trial of an endoscopic duodenojejunal bypass liner for preoperative weight loss in bariatric surgery candidates. Gastrointest Endosc. 2010;71(6):976–82.PubMed

55.

Rodriguez L, Reyes E, Fagalde P, et al. Pilot clinical study of an endoscopic, removable duodenal-jejunal bypass liner for the treatment of type 2 diabetes. Diabetes Technol Ther. 2009;11(11):725–32.PubMed

56.

Schouten R, Rijs CS, Bouvy ND, et al. A multicenter, randomized efficacy study of the EndoBarrier gastrointestinal liner for presurgical weight loss prior to bariatric surgery. Ann Surg. 2010;251(2):236–43.PubMed

57.

Escalona A, Yáñez R, Pimentel F, et al. Initial human experience with restrictive duodenal-jejunal bypass liner for treatment of morbid obesity. Surg Obes Relat Dis. 2010;6(2):126–31.PubMed

58.

Rohde U, Hedbäck N, Gluud LL, et al. Effect of the EndoBarrier gastrointestinal liner on obesity and type 2 diabetes: protocol for systematic review and meta-analysis of clinical studies. BMJ Open. 2013;3(9):e003417.PubMedCentralPubMed

59.

ASGE Bariatric Endoscopy Task Force and ASGE Technology Committee, Abu Dayyeh BK, Kumar N, et al. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82(3):425–38.e5.

60.

Betzel B, Drenth JPH, Siersema PD. Adverse events of the duodenal-Jejunal bypass liner: a systematic review. Obes Surg. 2018;28(11):3669–77. https://doi.org/10.1007/s11695-018-3441-3.CrossRefPubMed

61.

Betzel B, Cooiman MI, Aarts EO, et al. Clinical follow-up on weight loss, glycemic control, and safety aspects of 24 months of duodenal-jejunal bypass liner implantation. Surg Endosc. 2019;0(0):0. https://doi.org/10.1007/s00464-019-06752-8.CrossRef

62.

Sandler BJ, Rumbaut R, Swain CP, et al. Human experience with an endoluminal, endoscopic, gastrojejunal bypass sleeve. Surg Endosc. 2011;25(9):3028–33.PubMed

63.

ASGE Technology Committee, Enestvedt BK, Kothari S, Pannala R, Yang J, Fujii-Lau LL, et al. Devices and techniques for ERCP in the surgically altered GI tract. Gastrointest Endosc. 2016;83(6):1061–75. https://doi.org/10.1016/j.gie.2016.03.018 PubMed

64.

The Invention That Could End Obesity - BuzzFeed News https://www.buzzfeed.com/joeloliphint/the-invention-that-could-endobesity?utm_term=.wrEx2vlAK#.it1GLVZOJ.

65.

ET09 A NOVEL ENDOSCOPIC REVERSIBLE BARIATRIC DEVICE: ANIMAL RESULTS AND INITIAL HUMAN CLINICAL EXPERIENCE Foote J, Baker R, Trevino J, Kemmeter P, Fred Walburn, PhD, Peter Freswick, BS, Grand Health Partners, Grand Rapids MI, Sentinel Group, Grand Rapids MI, Hospital Galenia, Cancun Mexico - SAGES 2009 Annual Meeting (Phoenix, AZ)

66.

Park JH, Bakheet N, Na HK, et al. A novel full sense device to treat obesity in a porcine model: preliminary results. Obes Surg. 2019;29:1521–7. https://doi.org/10.1007/s11695-018-03692-5.CrossRefPubMed

67.

Diaz R, Davalos G, Welsh LK, et al. Use of magnets in gastrointestinal surgery. Surg Endosc. 2019;33(6):1721–30. https://doi.org/10.1007/s00464-019-06718-w.CrossRefPubMed

68.

Ryou M, Ryan MB, Thompson CC. Current status of endoluminal bariatric procedures for primary and revision indications. Gastrointest Endosc Clin N Am. 2011;21(2):315–33.PubMedCentralPubMed

69.

Ryou M, Cantillon-Murphy P, Azagury D, et al. Smart SelfAssembling MagnetS for ENdoscopy (SAMSEN) for transoral endoscopic creation of immediate gastrojejunostomy (with video). Gastrointest Endosc. 2011;73(2):353–9.PubMed

70.

Ryou M, Aihara H, Thompson CC. Minimally invasive entero-enteral dual-path bypass using self-assembling magnets. Surg Endosc. 2016;30(10):4533–8. https://doi.org/10.1007/s00464-016-4789-x PubMed

71.

Machytka E, Bužga M, Zonca P, et al. Partial jejunal diversion using an incisionless magnetic anastomosis system: 1-year interim results in patients with obesity and diabetes. Gastrointest Endosc. 2017;86(5):904–12. https://doi.org/10.1016/j.gie.2017.07.009.CrossRefPubMed

72.

Graves CE, Co C, Hsi RS, et al. Magnetic compression anastomosis (Magnamosis): first-in-human trial. J Am Coll Surg. 2017;225(5):676–681.e1. https://doi.org/10.1016/j.jamcollsurg.2017.07.1062.CrossRefPubMed

73.

Haidry RJ, van Baar AC, Galvao Neto MP, et al. Duodenal mucosal resurfacing: proof-of-concept, procedural development, and initial implementation in the clinical setting. Gastrointestinal Endoscopy. 2019; https://doi.org/10.1016/j.gie.2019.03.024.PubMed

74.

Thompson CC, Abu Dayyeh BK, Kushner R, et al. Percutaneous gastrostomy tube device for the treatment of class II and class III obesity: results of a randomized controlled trial. Am J Gastroenterol. 2017;112:447–57.PubMed

75.

Thompson CC, Abu Dayyeh BK, Kushnir V, et al. Aspiration therapy for the treatment of obesity: four year results of a multicenter randomized controlled trial. Surg Obes Relat Dis. 2019; https://doi.org/10.1016/j.soard.2019.04.026.PubMed

76.

Nyström M, Machytka E, Norén E, et al. Aspiration therapy as a tool to treat obesity: 1-to 4-year results in a 201-patient multi-center post-market European registry study. Obes Surg. 2018;28(7):1860–8.PubMedCentralPubMed

Title: The Role of Minimally Invasive and Endoscopic Technologies in Morbid Obesity Treatment: Review and Critical Appraisal of the Current Clinical Practice
Authors: Francesco Maria Carrano
Miroslav P. Peev
John K. Saunders
Marcovalerio Melis
Valeria Tognoni
Nicola Di Lorenzo
Publication date: 01-02-2020
Publisher: Springer US
Keywords: Obesity
Endoscopy
Obesity
Bariatric Surgery
Foreign Body Aspiration
Bariatric Surgery
Foreign Body Aspiration
Aspiration
Minimally Invasive Surgery
Published in: Obesity Surgery / Issue 2/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-019-04302-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Role of Minimally Invasive and Endoscopic Technologies in Morbid Obesity Treatment: Review and Critical Appraisal of the Current Clinical Practice

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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