Joshua A Turkeltaub1, Steven A Edmundowicz2. 1. Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, MSB-158, Aurora, CO, 80045, USA. joshua.turkeltaub@ucdenver.edu. 2. Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, MSB-158, Aurora, CO, 80045, USA. steven.edmundowicz@ucdenver.edu.
Abstract
PURPOSE OF REVIEW: Endoscopic bariatric therapies (EBTs) have been identified as a group of procedures that can bridge the treatment gap between bariatric surgical procedures and non-procedural treatments such as pharmacotherapy and lifestyle therapy. We will review the recent progress that has been made in this important area in the past several years. RECENT FINDINGS: Traditional intragastric balloons (IGB) that are both placed and removed endoscopically have been the fixture of IGB therapy. They have been shown to be safe and effective, when kept in place for 6 months. Newer IGBs, both currently FDA approved and those in clinical trials, have unique features. The Obalon gastric balloon system is gas filled and does not require endoscopy for placement. The Elipse balloon system that is in clinical trials neither requires endoscopy for placement nor removal. The Spatz3 balloon is in clinical trials and can be adjusted endoscopically by adding or subtracting volume to titrate balloon volume to symptoms and weight loss. In addition to IGBs, several other promising therapies have continued to evolve. Endoscopic sleeve gastroplasty (ESG) is a promising gastric restriction technique that has efficacy and durability. POSE is a gastric plication technique that is available in Europe and in clinical trials in the USA. Aspiration therapy is a novel approach to weight loss that requires patient compliance but can be very effective and used long term. EBTs are an evolving effective and safe approach for patients who do not qualify for or do not want bariatric surgery. There are multiple EBTs currently FDA approved as well as prospective endoscopic therapies in clinical trials that appear promising.
PURPOSE OF REVIEW: Endoscopic bariatric therapies (EBTs) have been identified as a group of procedures that can bridge the treatment gap between bariatric surgical procedures and non-procedural treatments such as pharmacotherapy and lifestyle therapy. We will review the recent progress that has been made in this important area in the past several years. RECENT FINDINGS: Traditional intragastric balloons (IGB) that are both placed and removed endoscopically have been the fixture of IGB therapy. They have been shown to be safe and effective, when kept in place for 6 months. Newer IGBs, both currently FDA approved and those in clinical trials, have unique features. The Obalon gastric balloon system is gas filled and does not require endoscopy for placement. The Elipse balloon system that is in clinical trials neither requires endoscopy for placement nor removal. The Spatz3 balloon is in clinical trials and can be adjusted endoscopically by adding or subtracting volume to titrate balloon volume to symptoms and weight loss. In addition to IGBs, several other promising therapies have continued to evolve. Endoscopic sleeve gastroplasty (ESG) is a promising gastric restriction technique that has efficacy and durability. POSE is a gastric plication technique that is available in Europe and in clinical trials in the USA. Aspiration therapy is a novel approach to weight loss that requires patient compliance but can be very effective and used long term. EBTs are an evolving effective and safe approach for patients who do not qualify for or do not want bariatric surgery. There are multiple EBTs currently FDA approved as well as prospective endoscopic therapies in clinical trials that appear promising.
Entities:
Keywords:
Aspiration therapy; Endoscopic bariatric therapy; Endoscopic sleeve gastroplasty; Intragastric balloons; Primary obesity surgery endoluminal; Weight loss
Authors: Eric J Vargas; Carl M Pesta; Ahmad Bali; Eric Ibegbu; Fateh Bazerbachi; Rachel L Moore; Vivek Kumbhari; Reem Z Sharaiha; Trace W Curry; Gina DosSantos; Ramsey Schmitz; Abhishek Agnihotri; Aleksey A Novikov; Tracy Pitt; Margo K Dunlap; Andrea Herr; Louis Aronne; Erin Ledonne; Hoda C Kadouh; Lawrence J Cheskin; Manpreet S Mundi; Andres Acosta; Christopher J Gostout; Barham K Abu Dayyeh Journal: Clin Gastroenterol Hepatol Date: 2018-02-07 Impact factor: 11.382
Authors: Shelby Sullivan; James M Swain; George Woodman; Marc Antonetti; Nestor De La Cruz-Muñoz; Sreeni S Jonnalagadda; Michael Ujiki; Sayeed Ikramuddin; Jaime Ponce; Marvin Ryou; Jason Reynoso; Rajiv Chhabra; G Brent Sorenson; Wendell K Clarkston; Steven A Edmundowicz; J Christopher Eagon; Daniel K Mullady; Daniel Leslie; Thomas E Lavin; Christopher C Thompson Journal: Obesity (Silver Spring) Date: 2016-12-21 Impact factor: 5.002
Authors: Barham K Abu Dayyeh; Andres Acosta; Michael Camilleri; Manpreet S Mundi; Elizabeth Rajan; Mark D Topazian; Christopher J Gostout Journal: Clin Gastroenterol Hepatol Date: 2015-12-31 Impact factor: 11.382
Authors: Nitin Kumar; Barham K Abu Dayyeh; Gontrand Lopez-Nava Breviere; Manoel P Galvao Neto; Nicole P Sahdala; Sohail N Shaikh; Robert H Hawes; Christopher J Gostout; Mahesh K Goenka; Jorge R Orillac; Alonso Alvarado; Pichamol Jirapinyo; Natan Zundel; Christopher C Thompson Journal: Surg Endosc Date: 2017-10-26 Impact factor: 4.584
Authors: Evzen Machytka; Pavel Klvana; Asher Kornbluth; Steven Peikin; Lisbeth E M Mathus-Vliegen; Christopher Gostout; Gontrand Lopez-Nava; Scott Shikora; Jeffrey Brooks Journal: Obes Surg Date: 2011-10 Impact factor: 4.129
Authors: Christopher C Thompson; Barham K Abu Dayyeh; Robert Kushner; Shelby Sullivan; Alan B Schorr; Anastassia Amaro; Caroline M Apovian; Terrence Fullum; Amir Zarrinpar; Michael D Jensen; Adam C Stein; Steven Edmundowicz; Michel Kahaleh; Marvin Ryou; J Matthew Bohning; Gregory Ginsberg; Christopher Huang; Daniel D Tran; Joseph P Glaser; John A Martin; David L Jaffe; Francis A Farraye; Samuel B Ho; Nitin Kumar; Donna Harakal; Meredith Young; Catherine E Thomas; Alpana P Shukla; Michele B Ryan; Miki Haas; Heidi Goldsmith; Jennifer McCrea; Louis J Aronne Journal: Am J Gastroenterol Date: 2016-12-06 Impact factor: 10.864