Skip to main content
SpringerLink
Log in

A novel endoscopic surgical device for gastric volume reduction bariatric surgery

  • Published:
International Journal of Precision Engineering and Manufacturing Aims and scope Submit manuscript

Abstract

Endoscopic bariatric surgeries have been widely studied to minimize surgical invasion to the patients and operation time. Although some of previous endoscopic bariatric devices have reported successful weight loss in animal and human models, operation time in these surgeries was too long for severely obese patients. We aimed to develop a new endoscopic bariatric surgery device that would complete an entire surgery in a short time and provide clinically effective stomach volume reductions. A new anchoring device and suction system were developed from our successive suturing system. Our surgery reduced the fundus area of the stomach by creating a loop of anchors. We performed endoscopic bariatric surgeries in 32 porcine stomachs. Significantly reduced stomach volumes were found following our new bariatric surgeries (before surgery: 999.53±642.39 mm3, after surgery: 703.13±445.48 mm3, Student’s t-test, p<0.05). Surgery durations were measured to be 14.23±3.01 min in 16 selected stomachs. The new device was tested in three live pigs, and all simulated surgical conditions were successfully completed without any technical difficulties. We successfully developed a new endoscopic device for bariatric surgery, and demonstrated 30% stomach volume reductions, which is comparable volume reductions in clinically proven devices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Flegal, K. M., Carroll, M. D., Kit, B. K., and Ogden, C. L., “Prevalence of Obesity and Trends in the Distribution of Body Mass Index among US Adults, 1999 010, JAMA, Vol. 307, No. 5, pp. 491–497, 2012.

    Article  Google Scholar 

  2. Ogden, C. L., Carroll, M. D., Kit, B. K., and Flegal, K. M., “Prevalence of Obesity in the United States, 2009 010, http://www.cdc.gov/nchs/data/databriefs/db82.pdf (Accessed 3 MAR 2016)

    Google Scholar 

  3. Li, Z., Bowerman, S., and Heber, D., “Health Ramifications of the Obesity Epidemic, Surgical Clinics of North America, Vol. 85, No. 4, pp. 681–701, 2005.

    Article  Google Scholar 

  4. Haslam, D. W. an James, W. P., “Obesity, Lances, Vol. 366, No. 9492, pp. 1197–1209, 2005.

    Article  Google Scholar 

  5. Ali, M. R., Maguire, M. B., and Wolfe, B. M., “Assessment of Obesity-Related Comorbidities: A Novel Scheme for Evaluating Bariatric Surgical Patients, Journal of the American College of Surgeons, Vol. 202, No. 1, pp. 70–77, 2006.

    Article  Google Scholar 

  6. Sj-str-m, L., Narbro, K., Sjöström, C. D., Karason, K., Larsson, B., et al., “Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects, New England Journal of Medicine, Vol. 357, No. 8, pp. 741–752, 2007.

    Article  Google Scholar 

  7. Cawley, J. and Meyerhoefer, C., “The Medical Care Costs of Obesity: An Instrumental Variables Approach, Journal of Health Economics, Vol. 31, No. 1, pp. 219–230, 2012.

    Article  Google Scholar 

  8. U.S. Department of Agriculture & U.S. Department of Health and Human Services, “Dietary Guidelines for Americans, http://health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf (Accessed 3 MAR 2016)

    Google Scholar 

  9. Bray, G. A. and Ryan, D. H., “Update on Obesity Pharmacotherapy, Annals of the New York Academy of Sciences, Vol. 1311, No. 1, pp. 1–13, 2014.

    Article  Google Scholar 

  10. White, B., Jamieson, L., Clifford, S., Shield, J. P. H., Christie, D., et al., “Adolescent Experiences of Anti-Obesity Drugs, Clinical Obesity, Vol. 5, No. 3, pp. 116–126, 2015.

    Article  Google Scholar 

  11. Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M. D., Pories, W., et al., “Bariatric Surgery: A Systematic Review and Meta-Analysis, JAMA, Vol. 292, No. 14, pp. 1724–1737, 2004.

    Article  Google Scholar 

  12. Jones Jr, K. B., Afram, J. D., Benotti, P. N., Capella, R. F., Cooper, C. G., et al., “Open Versus Laparoscopic Roux-en-Y Gastric Bypass: A Comparative Study of Over 25,000 Open Cases and the Major Laparoscopic Bariatric Reported Series, Obesity Surgery, Vol. 16, No. 6, pp. 721–727, 2006.

    Article  Google Scholar 

  13. Maggard, M. A., Shugarman, L. R., Suttorp, M., Maglione, M., Sugerman, H. J., et al., “Meta-Analysis: Surgical Treatment of Obesity, Annals of Internal Medicine, Vol. 142, No. 7, pp. 547–559, 2005.

    Article  Google Scholar 

  14. Schauer, P. R., Burguera, B., Ikramuddin, S., Cottam, D., Gourash, W., et al., “Effect of Laparoscopic Roux-en-Y Gastric Bypass on Type 2 Diabetes Mellitus, Annals of Surgery, Vol. 238, No. 4, pp. 467–485, 2003.

    Google Scholar 

  15. Ayloo, S. and Bueno, R., “Band Erosion: Laparoscopic Removal of Lap-Band, Surgical Endoscopy, Vol. 23, No. 3, pp. 657–658, 2009.

    Article  Google Scholar 

  16. Varela, J. E., “Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Adjustable Gastric Banding for the Treatment Severe Obesity in High Risk Patients, Vol. 15, No. 4, pp. 486–491, 2011.

    Google Scholar 

  17. O’brien, P. E., McPhail, T., Chaston, T. B., and Dixon, J. B., “Systematic Review of Medium-Term Weight Loss after Bariatric Operations, Obesity Surgery, Vol. 16, No. 8, pp. 1032–1040, 2006.

    Article  Google Scholar 

  18. Suter, M., Calmes, J., Paroz, A., and Giusti, V., “A 10-Year Experience with Laparoscopic Gastric Banding for Morbid Obesity: High Long-Term Complication and Failure Rates, Obesity Surgery, Vol. 16, No. 7, pp. 829–835, 2006.

    Article  Google Scholar 

  19. Hainaux, B., Coppens, E., Sattari, A., Vertruyen, M., Hubloux, G., and Cadiere, G.-B., “Laparoscopic Adjustable Silicone Gastric Banding: Radiological Appearances of a New Surgical Treatment for Morbid Obesity, Abdominal Imaging, Vol. 24, No. 6, pp. 533–537, 1999.

    Article  Google Scholar 

  20. McGrath, V., Needleman, B. J., and Melvin, W. S., “Evolution of the Laparoscopic Gastric Bypass, Journal of Laparoendoscopic & Advanced Surgical Techniques, Vol. 13, No. 4, pp. 221–227, 2003.

    Article  Google Scholar 

  21. de Csepel, J., Burpee, S., Jossart, G., Andrei, V., Murakami, Y., et al., “Laparoscopic Biliopancreatic Diversion with a Duodenal Switch for Morbid Obesity: A Feasibility Study in Pigs, Journal of Laparoendoscopic & Advanced Surgical Techniques, Vol. 11, No. 2, pp. 79–83, 2001.

    Article  Google Scholar 

  22. Tsesmeli, N. and Coumaros, D., “The Future of Bariatrics: Endoscopy, Endoluminal Surgery, and Natural Orifice Transluminal Endoscopic Surgery, Endoscopy, Vol. 42, No. 2, pp. 155–162, 2010.

    Article  Google Scholar 

  23. Brethauer, S. A., Chand, B., Schauer, P. R., and Thompson, C. C., “Transoral Gastric Volume Reduction for Weight Management: Technique and Feasibility in 18 Patients, Surgery for Obesity and Related Diseases, Vol. 6, No. 6, pp. 689–694, 2010.

    Article  Google Scholar 

  24. Brethauer, S. A., Chand, B., Schauer, P. R., and Thompson, C. C., “Transoral Gastric Volume Reduction as Intervention for Weight Management: 12-Month Follow-Up of Trim Trial, Surgery for Obesity and Related Diseases, Vol. 8, No. 3, pp. 296–303, 2012.

    Article  Google Scholar 

  25. Herron, D. M., Birkett, D. H., Thompson, C. C., Bessler, M., and Swanström, L. L., “Gastric Bypass Pouch and Stoma Reduction using a Transoral Endoscopic Anchor Placement System: A Feasibility Study, Surgical Endoscopy, Vol. 22, No. 4, pp. 1093–1099, 2008.

    Article  Google Scholar 

  26. Overcash, W. T., “Natural Orifice Surgery (NOS) using Stomaphyx₿for Repair of Gastric Leaks after Bariatric Revisions, Obesity Surgery, Vol. 18, No. 7, pp. 882–885, 2008.

    Article  Google Scholar 

  27. Overcash, W. T., “Natural Orifice Surgery (NOS) using Stomaphyx₿for Repair of Gastric Leaks after Bariatric Revisions, Obesity Surgery, Vol. 18, No. 7, pp. 882–885, 2008.

    Article  Google Scholar 

  28. Mikami, D., Needleman, B., Narula, V., Durant, J., and Melvin, W. S., “Natural Orifice Surgery: Initial US Experience Utilizing the Stomaphyxtm Device to Reduce Gastric Pouches after Roux-en-Y Gastric Bypass, Surgical Endoscopy, Vol. 24, No. 1, pp. 223–228, 2010.

    Article  Google Scholar 

  29. Behrns, K. E., Smith, C. D., Kelly, K. A., and Sarr, M. G., “Reoperative Bariatric Surgery. Lessons Learned to improve Patient Selection and Results, Annals of Surgery, Vol. 218, No. 5, pp. 646–653, 1993.

    Article  Google Scholar 

  30. Kyzer, S., Raziel, A., Landau, O., Matz, A., and Charuzi, I., “Use of Adjustable Silicone Gastric Banding for Revision of Failed Gastric Bariatric Operations, Obesity Surgery, Vol. 11, No. 1, pp. 66–69, 2001.

    Article  Google Scholar 

  31. Bessler, M., Daud, A., DiGiorgi, M. F., Olivero-Rivera, L., and Davis, D., “Adjustable Gastric Banding as a Revisional Bariatric Procedure after Failed Gastric Bypass, Obesity Surgery, Vol. 15, No. 10, pp. 1443–1448, 2005.

    Article  Google Scholar 

  32. Song, Y., Choi, H., Kim, K., Kim, Y., Kim, B., et al., “A Simple Novel Endoscopic Successive Suture Device: A Validation Study for Closure Strength and Reproducibility, Endoscopy, Vol. 45, No. 8, pp. 655–660, 2013.

    Article  MathSciNet  Google Scholar 

  33. Marti-Valeri, C., Sabate, A., Masdevall, C., and Dalmau, A., “Improvement of Associated Respiratory Problems in Morbidly Obese Patients after Open Roux-en-Y Gastric Bypass, Obesity Surgery, Vol. 17, No. 8, pp. 1102–1110, 2007.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea

    Yoonjin Kim, Kyungnam Kim, Byoung Gon Kim, Daehie Hong & Yongnam Song

  2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Gastrointestinal Medical Instrument Research, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, Seoul, 02841, South Korea

    Hyuk Soon Choi, Bora Keum & Hoon Jai Chun

Authors
  1. Yoonjin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hyuk Soon Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kyungnam Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Byoung Gon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bora Keum
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Daehie Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hoon Jai Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yongnam Song
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Hoon Jai Chun or Yongnam Song.

Additional information

Yoonjin Kim and Hyuk Soon Choi contributed equally to this work

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, Y., Choi, H.S., Kim, K. et al. A novel endoscopic surgical device for gastric volume reduction bariatric surgery. Int. J. Precis. Eng. Manuf. 17, 467–472 (2016). https://doi.org/10.1007/s12541-016-0058-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12541-016-0058-0

Keywords

Search

Navigation