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Surgical Endoscopy

, Volume 27, Issue 7, pp 2305–2311 | Cite as

A review of the current status of endoluminal therapy as a primary approach to obesity management

  • Shounak MajumderEmail author
  • John Birk
Review

Abstract

Gastroenterologists are expected to play a pivotal role in the management of the global obesity epidemic in coming years as novel endoscopic approaches become more widely available, safe, and effective. This review focuses on the recent advances in the field of endoluminal therapy as a primary approach to obesity management with the aim of providing the interventional endoscopist an overview of currently available evidence along with an insight into upcoming devices and techniques. The intragastric balloon appears to be safe and effective in the short term, especially as a bridge to bariatric surgery. Although early trials support the safety and feasibility of endoscopic gastroplasty, it is technically demanding and staple-line dehiscence continues to be a problem. Moreover, with ongoing technical innovations, most devices that have been used in published trials are no longer manufactured and results of studies using newer endoscopic suturing systems are currently awaited. The duodenojejunal bypass sleeve mimics the physiology of intestinal bypass and shares the metabolic advantages of intestinal diversion. A high rate of premature device withdrawal has been its major limiting factor. Therapeutic endoscopy may be the next paradigm of bariatric care. Combining restrictive and barrier endoscopic techniques can potentially improve efficacy and should be evaluated in the setting of appropriate clinical trials.

Keywords

Obesity Bariatric endoscopy Intragastric balloon Transoral gastroplasty Duodenojejunal bypass sleeve 

Notes

Disclosures

None of the authors have any financial disclosures.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of ConnecticutFarmingtonUSA
  2. 2.Department of GastroenterologyUniversity of Connecticut Health CenterFarmingtonUSA

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