Advertisement

Index Endoscopic Malabsorptive Procedures in Obesity Treatment: Techniques and Outcomes

  • Sabrena F. Noria
  • Sara A. Mansfield
  • Dean J. Mikami
Chapter

Abstract

The obesity epidemic is one of the world’s most daunting problems. According to the World Health Organization, there are more than 1.9 billion adults who are overweight, of which 600 million are obese. Mortality increased significantly throughout the overweight range. Additionally, every 5 units of higher BMI above 25 kg/m2 was associated with ~31% higher risk of premature death. Due to the continued need for alternative therapy, transoral/endoscopic approaches to weight loss are gaining traction as they bridge the gap between need and eligibility. This may allow bariatric procedures to be performed in those individuals who are currently precluded due to multiple comorbidities, older age, mild obesity, atypical anatomy (e.g., adhesions secondary to previous abdominal surgery, a history of gastric resection, or bowel resection), or disease states that affect the bowel. Given the surge in endoscopic therapies for obesity, the purpose of this chapter is to review the techniques and outcomes of specific malabsorptive procedures designed to induce weight loss and/or improve metabolic profiles.

Keywords

Endoscopy Bypass sleeve EndoBarrier ValenTx AspireAssist Magnamosis EndoWindow Fractyl/Glyscend 

References

  1. 1.
    Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord. 1998 Jan;22(1):39–47.CrossRefPubMedGoogle Scholar
  2. 2.
    Katherine M, Flegal KM, Kruszon-Moran D, Carroll MD. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315(21):2284–91.CrossRefGoogle Scholar
  3. 3.
    Fryar CD, Ogden CL. World health organization: obesity and overweight fact sheet. Updated June 2016. http://www.who.int/mediacentre/factsheets/fs311/en/.
  4. 4.
    Danesh J, Di Angelantonio E, Bhupathiraju SN, Wormier D, Gao P, Kaptoge S, et al. The global BMI mortality collaboration: body-mass index and all-cause mortality: individual participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388:776–86.CrossRefPubMedGoogle Scholar
  5. 5.
    Serdula MK, Mokdad AH, Williamson DF, Galuska DA, Mendlein JM, Heath GW. Prevalence of attempting weight loss and strategies for controlling weight. JAMA. 1999;282:1353–8.CrossRefPubMedGoogle Scholar
  6. 6.
    North American Association for the Study of Obesity, National Heart, Lung, and Blood Institute. The practical guide identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, MD: National Institutes of Health; 2000. Available from: URL: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf.Google Scholar
  7. 7.
    Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMedGoogle Scholar
  8. 8.
    New procedure estimates for bariatric surgery: what the numbers reveal. Connect: The Official News Magazine of the ASMBS. May 2014. Available from: http://connect.asmbs.org/may-2014-bariatric-surgery-growth.html.
  9. 9.
    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;4:55–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Tarnoff M, Rodriguez L, Escalona A, Ramos A, Neto M, Alamo M, Reyes E, Pimentel F, Ibanez L. Open label, prospective, randomized controlled trial of an endoscopic duodenal-jejunal bypass sleeve versus low calorie diet for preoperative weight loss in bariatric surgery. Surg Endosc. 2009;23:650–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Schouten R, Rijs CS, Bouvy ND, Hameeteman W, Koek GH, Janssen IMC, et al. A multicenter, randomized efficacy study of the EndoBarrier gastrointestinal liner for presurgical weight loss prior to bariatric surgery. Ann Surg. 2010;251:236–43.CrossRefPubMedGoogle Scholar
  12. 12.
    Gersin KS, Rothstein RI, Rosenthal J, 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;71:976–82.CrossRefPubMedGoogle Scholar
  13. 13.
    De Moura EG, Martins BC, Lopes GS, Orso IR, de Oliveira SL, Neto MPG, et al. Metabolic improvements in obese type 2 diabetes subjects implanted for 1 year with an endoscopically deployed duodenojejunal bypass liner. Diabetes Technol Ther. 2012;14:183–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Koehestanie P, de Jonge C, Berends FJ, Janssen IM, Bouvy ND, Greve JW. The effect of the endoscopic duodenojejunal bypass liner on obesity and type 2 diabetes mellitus, a multicenter randomized controlled trial. Ann Surg. 2014;260:984–92.CrossRefPubMedGoogle Scholar
  15. 15.
    Maggi U, Formiga A, Lauro R. Hepatic abscess as a complication of duodenal-jejunal bypass sleeve system and review of the literature. Open access, online-only case report. SOARD. 2016;12:e47–50.Google Scholar
  16. 16.
  17. 17.
  18. 18.
    Sandler BJ, Rumbaut R, Swain CP, Torres G, Morales L, Gonzales K, et al. Human experience with an endoluminal, endoscopic, gastrojejunal bypass sleeve. Surg Endosc. 2011;25:3028–33.CrossRefPubMedGoogle Scholar
  19. 19.
    Sandler BJ, Rumbaut R, Swain CP, Torres G, Morales L, Gonzales K, et al. One-year human experience with a novel endoluminal, endoscopic gastric bypass sleeve for morbid obesity. Surg Endosc. 2015;29:3298–303.CrossRefPubMedGoogle Scholar
  20. 20.
    Sullivan S, Stein R, Jonnalagadda S, Mullady D, Edmundowicz S. Aspiration therapy leads to weight-loss in obese subjects: a pilot study. Gastroenterology. 2013;145:1245–52.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Thompson CC, Abu Dayyeh BK, Kushner R, Sullivan S, Schorr AB, Amaro A, et al. Percutaneous gastrostomy device for the treatment of class II and class III obesity: results of a randomized controlled trial. Am J Gastroenterol. 2017;112:447–57.CrossRefPubMedGoogle Scholar
  22. 22.
    Jamshidi R, Stephenson JT, Clayc JG, Pichakronc KO, Harrison MR. Magnamosis: magnetic compression anastomosis with comparison to suture and staple techniques. J Pediatr Surg. 2009;44:222–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Pichakron KO, Jelin EB, Hirose S, Curran PF, Jamshidi R, Stephenson JT, Fechter R, Strange M, Harrison MR. Magnamosis II: magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy. J Am Coll Surg. 2011;212:42–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Gonzales KD, Douglas G, Pichakron KO, Kwiat DA, Gallardo SG, Encinas JL, Hirose S, Harrison MR. Magnamosis III: delivery of a magnetic compression anastomosis device using minimally invasive endoscopic techniques. J Pediatr Surg. 2012;47(6):1291–5.CrossRefPubMedGoogle Scholar
  25. 25.
    Endoscopic Dual-Path Enteral Anastomosis Using Self-Assembling Magnets. First-in-human clinical feasibility. Gastroenterology. 2016;150:S232.Google Scholar
  26. 26.
    Machytka E, Buzga M, Ryou M, Lautz DB, Thompson CC. 103 a dual-path enteral bypass procedure created by a novel incision less anastomosis system (IAS): 6 month clinical results. Gastroenterology. 2016;150:S26.CrossRefGoogle Scholar
  27. 27.
    Rajagopalan H, Cherrington AD, Thompson CC, Kaplan LM, Rubino F, Mingrone G, et al. Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes: 6-month interim analysis from the first-in-human proof-of-concept study. Diabetes Care. 2016;39:2254–61.CrossRefPubMedGoogle Scholar
  28. 28.
    Narula VK, Mikami DJ, Hazey JW. Endoscopic considerations in morbid obesity. In: Marks J, Dunkin B, editors. Principles of flexible endoscopy for surgeons. New York: Springer Nature; 2013.Google Scholar
  29. 29.
    de Moura EG, Lopes GS, Martins BC, Orso IR, Coutinho AM, de Oliveira SL, Sakai P, Galvão-Neto Mdos P, Santo MA, Sapienza MT, Cecconello I, Buchpiguel CA. Effects of duodenal-jejunal bypass liner (EndoBarrier®) on gastric emptying in obese and type 2 diabetic patients. Obes Surg. 2015;25(9):1618–25.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sabrena F. Noria
    • 1
  • Sara A. Mansfield
    • 2
  • Dean J. Mikami
    • 3
  1. 1.Comprehensive Weight Management Program, The Ohio State University Wexner Medical Center, Department of Surgery, Division of General and Gastrointestinal SurgeryThe Ohio State UniversityColumbusUSA
  2. 2.Department of SurgeryThe Ohio State UniversityColumbusUSA
  3. 3.Department of SurgeryUniversity of Hawaii John A. Burns School of MedicineHonoluluUSA

Personalised recommendations