Emerging technology: endoluminal treatment of obesity
Received 15 July 2009; accepted 6 September 2009.
Background
Bariatric surgery remains the most effective treatment for the management of obesity. Endoluminal interventions offer the potential for an ambulatory weight loss procedure that may be safer and more cost-effective compared with current laparoscopic approaches.
Objective
We review the currently available endoluminal techniques for obesity that have been presented or discussed in public forums and meetings, focusing on those with published trials.
Design
Literature review.
Results
Human trials of endoluminal treatments of obesity are primarily limited to restrictive interventions, including intragastric balloons, transoral gastroplasty, and endoluminal vertical gastroplasty. Currently, the duodenojejunal bypass sleeve is the only endoluminal device that has been studied in humans that promotes weight loss through malabsorption. Early results of these technologies are promising, but long-term data are lacking.
Conclusions
Endoluminal treatments for obesity have promise, and recent technological advances have been astounding. However, these interventions will need to be held to the same standards of current operative techniques. Each device will need to be scrutinized within clinical trials to determine its safety, efficacy, and durability.
Current affiliations: Washington University School of Medicine (S.A.E.) St. Louis, Missouri, Indiana University School of Medicine (G.A.C.), Indianapolis, Indiana, USA
Reprint requests: Steven A. Edmundowicz, MD, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8124, St. Louis, MO 63110.
DISCLOSURE: The following author disclosed financial relationships relevant to this publication: S. A. Edmundowicz: Stock options from Satiety; research support from Davol; consultant to and research support from Boston Scientific. The other author disclosed no financial relationship relevant to this publication.