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Experimental Alternatives in Bariatric Surgery

  • John H. Rodriguez
  • Dean J. Mikami
  • Bipan Chand
Chapter

Abstract

Bariatric surgery remains the most effective treatment for obesity and weight-related comorbidities. Surgical intervention is often underutilized for a multitude of reasons. Limitations may include side effects, insurance restrictions, and accessibility. Future direction should aim at developing therapies that are less invasive, safer, and potentially allow for greater acceptance and accessibility. Endoluminal bariatric therapies, neurohormonal modulation, and innovative surgical techniques will likely determine the future direction of bariatric surgery. Emerging techniques should focus on offering more options for earlier management of obesity, as well as an alternative in advanced and recurrent disease. In order to achieve this goal, new procedures should offer a safer and less invasive profile than what is currently accepted.

Keywords

Bariatric Surgery Sleeve Gastrectomy Excess Weight Loss Intragastric Balloon Pancreatic Exocrine Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Lee SM, Pryor AD. Future directions in bariatric surgery. Surg Clin North Am. 2011;91(6):1373–95, x [Review].PubMedCrossRefGoogle Scholar
  2. 2.
    Sturm R. Increases in clinically severe obesity in the United States, 1986–2000. Arch Intern Med. 2003;163(18):2146–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Eldar S, Heneghan HM, Brethauer SA, Schauer PR. Bariatric surgery for treatment of obesity. Int J Obes (Lond). 2011;35 Suppl 3:S16–21 [Research Support, Non-U.S. Gov’t Review].CrossRefGoogle Scholar
  4. 4.
    Yimcharoen P, Heneghan HM, Tariq N, Brethauer SA, Kroh M, Chand B. Endoscopic stent management of leaks and anastomotic strictures after foregut surgery. Surg Obes Relat Dis. 2011;7(5): 628–36.PubMedCrossRefGoogle Scholar
  5. 5.
    Levitzky BE, Wassef WY. Endoscopic management in the bariatric surgical patient. Curr Opin Gastroenterol. 2010;26(6):632–9 [Review].PubMedCrossRefGoogle Scholar
  6. 6.
    Ginsberg GG, Chand B, Cote GA, Dallal RM, Edmundowicz SA, Nguyen NT, et al. A pathway to endoscopic bariatric therapies. Gastrointest Endosc. 2011;74(5):943–53.PubMedCrossRefGoogle Scholar
  7. 7.
    O’Brien PE, Dixon JB, Laurie C, Skinner S, Proietto J, McNeil J, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144(9):625–33 [Comparative Study Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov’t].PubMedCrossRefGoogle Scholar
  8. 8.
    Kakoulidis TP, Karringer A, Gloaguen T, Arvidsson D. Initial results with sleeve gastrectomy for patients with class i obesity (bmi 30–35 kg/m2). Surg Obes Relat Dis. 2009;5(4):425–8 [Clinical Trial].PubMedCrossRefGoogle Scholar
  9. 9.
    Gupta PK, Franck C, Miller WJ, Gupta H, Forse RA. Development and validation of a bariatric surgery morbidity risk calculator using the prospective, multicenter nsqip dataset. J Am Coll Surg. 2011;212(3):301–9 [Validation Studies].PubMedCrossRefGoogle Scholar
  10. 10.
    Wagner BD, Grunwald GK, Rumsfeld JS, Hill JO, Ho PM, Wyatt HR, et al. Relationship of body mass index with outcomes after coronary artery bypass graft surgery. Ann Thorac Surg. 2007;84(1):10–6 [Research Support, U.S. Gov’t, Non-P.H.S.].PubMedCrossRefGoogle Scholar
  11. 11.
    Fernandez Jr AZ, Demaria EJ, Tichansky DS, Kellum JM, Wolfe LG, Meador J, et al. Multivariate analysis of risk factors for death following gastric bypass for treatment of morbid obesity. Ann Surg. 2004;239(5):698–702; discussion 702–3.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Poobalan AS, Aucott LS, Smith WC, Avenell A, Jung R, Broom J. Long-term weight loss effects on all cause mortality in overweight/obese populations. Obes Rev. 2007;8(6):503–13 [Research Support, Non-U.S. Gov’t Review].PubMedCrossRefGoogle Scholar
  13. 13.
    Ryou M, Ryan MB, Thompson CC. Current status of endoluminal bariatric procedures for primary and revision indications. Gastrointest Endosc Clin N Am. 2011;21(2):315–33 [Research Support, Non-U.S. Gov’t Review].PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Mahmood Z, McMahon BP, Arfin Q, Byrne PJ, Reynolds JV, Murphy EM, et al. Endocinch therapy for gastro-oesophageal reflux disease: a one year prospective follow up. Gut. 2003;52(1):34–9 [Evaluation Studies Research Support, Non-U.S. Gov’t].PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Fogel R, De Fogel J, Bonilla Y, De La Fuente R. Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients. Gastrointest Endosc. 2008;68(1):51–8 [Clinical Trial].PubMedCrossRefGoogle Scholar
  16. 16.
    Brethauer SA, Chand B, Schauer PR, Thompson CC. Transoral gastric volume reduction for weight management: technique and feasibility in 18 patients. Surg Obes Relat Dis. 2010;6(6):689–94 [Clinical Trial Multicenter Study Research Support, Non-U.S. Gov’t Video-Audio Media].PubMedCrossRefGoogle Scholar
  17. 17.
    Brethauer SA, Chand B, Schauer PR, Thompson CC. Transoral gastric volume reduction as intervention for weight management: 12-month follow-up of trim trial. Surg Obes Relat Dis. 2012;8(3): 296–303.PubMedCrossRefGoogle Scholar
  18. 18.
    Deviere J, Ojeda Valdes G, Cuevas Herrera L, Closset J, Le Moine O, Eisendrath P, et al. Safety, feasibility and weight loss after transoral gastroplasty: first human multicenter study. Surg Endosc. 2008;22(3):589–98 [Controlled Clinical Trial Multicenter Study].PubMedCrossRefGoogle Scholar
  19. 19.
    Moreno C, Closset J, Dugardeyn S, Barea M, Mehdi A, Collignon L, et al. Transoral gastroplasty is safe, feasible, and induces significant weight loss in morbidly obese patients: results of the second human pilot study. Endoscopy. 2008;40(5):406–13 [Controlled Clinical Trial Research Support, Non-U.S. Gov’t].PubMedCrossRefGoogle Scholar
  20. 20.
    Herron DM, Birkett DH, Thompson CC, Bessler M, Swanstrom LL. Gastric bypass pouch and stoma reduction using a transoral endoscopic anchor placement system: a feasibility study. Surg Endosc. 2008;22(4):1093–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Benjamin SB, Maher KA, Cattau Jr EL, Collen MJ, Fleischer DE, Lewis JH, et al. Double-blind controlled trial of the garren-edwards gastric bubble: an adjunctive treatment for exogenous obesity. Gastroenterology. 1988;95(3):581–8 [Clinical Trial Randomized Controlled Trial].PubMedGoogle Scholar
  22. 22.
    Genco A, Bruni T, Doldi SB, Forestieri P, Marino M, Busetto L, et al. Bioenterics intragastric balloon: the Italian experience with 2,515 patients. Obes Surg. 2005;15(8):1161–4.PubMedCrossRefGoogle Scholar
  23. 23.
    Sandler BJ, Rumbaut R, Swain CP, Torres G, Morales L, Gonzales L, et al. Human experience with an endoluminal, endoscopic, gastrojejunal bypass sleeve. Surg Endosc. 2011;25(9):3028–33 [Clinical Trial].PubMedCrossRefGoogle Scholar
  24. 24.
    Rodriguez-Grunert L, Galvao Neto MP, Alamo M, Ramos AC, Baez PB, Tarnoff M. First human experience with endoscopically delivered and retrieved duodenal-jejunal bypass sleeve. Surg Obes Relat Dis. 2008;4(1):55–9 [Clinical Trial].PubMedCrossRefGoogle Scholar
  25. 25.
    Tarnoff M, Rodriguez L, Escalona A, Ramos A, Neto M, Alamo M, et al. Open label, prospective, randomized controlled trial of an endoscopic duodenal-jejunal bypass sleeve versus low calorie diet for pre-operative weight loss in bariatric surgery. Surg Endosc. 2009;23(3):650–6 [Multicenter Study Randomized Controlled Trial].PubMedCrossRefGoogle Scholar
  26. 26.
    Gersin KS, Rothstein RI, Rosenthal RJ, Stefanidis D, Deal SE, Kuwada TS, et al. Open-label, sham-controlled trial of an endoscopic duodenojejunal bypass liner for preoperative weight loss in bariatric surgery candidates. Gastrointest Endosc. 2010;71(6):976–82 [Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov’t].PubMedCrossRefGoogle Scholar
  27. 27.
    Ryou M, Cantillon-Murphy P, Azagury D, Shaikh SN, Ha G, Greenwalt I, et al. Smart self-assembling magnets for endoscopy (samsen) for transoral endoscopic creation of immediate gastrojejunostomy (with video). Gastrointest Endosc. 2011;73(2):353–9 [Comparative Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t Video-Audio Media].PubMedCrossRefGoogle Scholar
  28. 28.
    Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A. 2007;17(6):793–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Brethauer SA, Harris JL, Kroh M, Schauer PR. Laparoscopic gastric plication for treatment of severe obesity. Surg Obes Relat Dis. 2011;7(1):15–22 [Clinical Trial Comparative Study].PubMedCrossRefGoogle Scholar
  30. 30.
    Anonymous. ASMBS policy statement on gastric plication. Surg Obes Relat Dis. 2011;7(3):262.Google Scholar
  31. 31.
    Skrekas G, Antiochos K, Stafyla VK. Laparoscopic gastric greater curvature plication: results and complications in a series of 135 patients. Obes Surg. 2011;21(11):1657–63 [Clinical Trial].PubMedCrossRefGoogle Scholar
  32. 32.
    Huang CK, Lo CH, Shabbir A, Tai CM. Novel bariatric technology: laparoscopic adjustable gastric banded plication: technique and preliminary results. Surg Obes Relat Dis. 2012;8(1):41–5.PubMedCrossRefGoogle Scholar
  33. 33.
    Chand B. Comment on: novel bariatric technology: laparoscopic adjustable gastric banded plication: technique and preliminary results. Surg Obes Relat Dis. 2012;8(1):46–7 [Comment Editorial].PubMedCrossRefGoogle Scholar
  34. 34.
    Santoro S, Malzoni CE, Velhote MC, Milleo FQ, Santo MA, Klajner S, et al. Digestive adaptation with intestinal reserve: a neuroendocrine-based operation for morbid obesity. Obes Surg. 2006;16(10):1371–9.PubMedCrossRefGoogle Scholar
  35. 35.
    Koopmans HS, Sclafani A, Fichtner C, Aravich PF. The effects of ileal transposition on food intake and body weight loss in vmh-obese rats. Am J Clin Nutr. 1982;35(2):284–93 [Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, P.H.S.].PubMedGoogle Scholar
  36. 36.
    Boza C, Gagner M, Devaud N, Escalona A, Munoz R, Gandarillas M. Laparoscopic sleeve gastrectomy with ileal transposition (sgit): a new surgical procedure as effective as gastric bypass for weight control in a porcine model. Surg Endosc. 2008;22(4):1029–34 [Research Support, Non-U.S. Gov’t].PubMedCrossRefGoogle Scholar
  37. 37.
    DePaula AL, Stival AR, Halpern A, Vencio S. Surgical treatment of morbid obesity: mid-term outcomes of the laparoscopic ileal interposition associated to a sleeve gastrectomy in 120 patients. Obes Surg. 2011;21(5):668–75.PubMedCrossRefGoogle Scholar
  38. 38.
    Camilleri M, Toouli J, Herrera MF, Kulseng B, Kow L, Pantoja JP, et al. Intra-abdominal vagal blocking (vbloc therapy): clinical results with a new implantable medical device. Surgery. 2008;143(6):723–31 [Controlled Clinical Trial Multicenter Study Research Support, Non-U.S. Gov’t].PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • John H. Rodriguez
    • 1
  • Dean J. Mikami
    • 2
  • Bipan Chand
    • 3
  1. 1.Department of General SurgeryCleveland Clinic FoundationClevelandUSA
  2. 2.Department of Gastrointestinal SurgeryThe Ohio State University Medical CenterColumbusUSA
  3. 3.Division of GI/Minimally Invasive SurgerySurgery Loyola University Medical Center, Stritch School of MedicineMaywoodUSA

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