BACKGROUND: Decreased absorption of nutrients results in weight loss. Apart from a surgical bypass or restriction, or pharmacological manipulations, novel approaches include endoluminal devices placed inside the stomach or intestine which could be used to achieve weight loss. Our goal is to verify the technical feasibility of an Endoluminal Duodeno-Jejunal Tube (EDJT) in reducing weight gain in a living porcine model and its safety in a short to medium survival. METHODS: 8 45-kg Yorkshire pigs were used for this study. 4 pigs were used as controls, whereas 3 pigs had a 180-cm and 1 had a 360-cm EDJT implanted and fixed to the first part of the duodenum proximal to the ampulla of Vater with a solenoid circumferential suture by way of a duodenotomy. The EDJT is a 25-mm diameter and 0.05-mm thickness polyethylene tube. The intent was to avoid the mixing of food and biliopancreatic juice for its entire length. RESULTS: Each pig was evaluated daily for symptoms of distress and weighed weekly for 7 weeks. No major complications were observed. The percentage weight changes 7 weeks after surgery in the control group, 180-cm group, and 360-cm group were 22.5%, 6%, and -2.8%, respectively. The EDJT groups (180-cm, 360-cm) had significantly slower weight gains than the control group (P=0.005). CONCLUSION: Use of an EDJT is safe; no major complications, such as obstruction, intussusception, or pancreatitis occurred. The EDJT slowed weight gain dramatically in a porcine model when compared to the controls. A trend of reduced weight gain was obtained with a longer tube.
BACKGROUND: Decreased absorption of nutrients results in weight loss. Apart from a surgical bypass or restriction, or pharmacological manipulations, novel approaches include endoluminal devices placed inside the stomach or intestine which could be used to achieve weight loss. Our goal is to verify the technical feasibility of an Endoluminal Duodeno-Jejunal Tube (EDJT) in reducing weight gain in a living porcine model and its safety in a short to medium survival. METHODS: 8 45-kg Yorkshire pigs were used for this study. 4 pigs were used as controls, whereas 3 pigs had a 180-cm and 1 had a 360-cm EDJT implanted and fixed to the first part of the duodenum proximal to the ampulla of Vater with a solenoid circumferential suture by way of a duodenotomy. The EDJT is a 25-mm diameter and 0.05-mm thickness polyethylene tube. The intent was to avoid the mixing of food and biliopancreatic juice for its entire length. RESULTS: Each pig was evaluated daily for symptoms of distress and weighed weekly for 7 weeks. No major complications were observed. The percentage weight changes 7 weeks after surgery in the control group, 180-cm group, and 360-cm group were 22.5%, 6%, and -2.8%, respectively. The EDJT groups (180-cm, 360-cm) had significantly slower weight gains than the control group (P=0.005). CONCLUSION: Use of an EDJT is safe; no major complications, such as obstruction, intussusception, or pancreatitis occurred. The EDJT slowed weight gain dramatically in a porcine model when compared to the controls. A trend of reduced weight gain was obtained with a longer tube.
Authors: Gianmattia del Genio; Michel Gagner; David Nocca; Federico Cuenca-Abente; Laurent Biertho; Anne Waage; Barbara Faife; Federica del Genio; Camilo Boza; Rajesh Aggarwal; Alberto Del Genio Journal: Obes Surg Date: 2008-05-28 Impact factor: 4.129
Authors: Gianmattia Del Genio; Michel Gagner; Federico Cuenca-Abente; David Nocca; Laurent Biertho; Federica Del Genio; Ahmad Assalia; Alberto Del Genio Journal: Obes Surg Date: 2008-06-18 Impact factor: 4.129
Authors: Michael Alan Glaysher; Aruchuna Mohanaruban; Christina Gabriele Prechtl; Anthony P Goldstone; Alexander Dimitri Miras; Joanne Lord; Navpreet Chhina; Emanuela Falaschetti; Nicholas Andrew Johnson; Werd Al-Najim; Claire Smith; Jia V Li; Mayank Patel; Ahmed R Ahmed; Michael Moore; Neil Poulter; Stephen Bloom; Ara Darzi; Carel Le Roux; James P Byrne; Julian P Teare Journal: BMJ Open Date: 2017-11-15 Impact factor: 2.692