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Endoscopic Bariatric Therapies: Intragastric Balloons, Tissue Apposition, and Aspiration Therapy

  • Joshua A. TurkeltaubEmail author
  • Steven A. EdmundowiczEmail author
Endoscopy (P Siersema, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Endoscopy

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.

Summary

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.

Keywords

Endoscopic bariatric therapy Intragastric balloons Endoscopic sleeve gastroplasty Primary obesity surgery endoluminal Aspiration therapy Weight loss 

Notes

Compliance with Ethical Standards

Conflict of Interest

Steven Edmundowicz serves on the medical advisory board for Olympus, is a paid consultant for Elsevier, Medtronic, and Allurion, and receives research support from Medtronic, Spironetics, and Elira. Joshua Turkeltaub declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyUniversity of Colorado School of MedicineAuroraUSA

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