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Review
. 2023 Jul 21:11:goad043.
doi: 10.1093/gastro/goad043. eCollection 2023.

Advances in endobariatrics: past, present, and future

Abhishek Shenoy  1 , Allison R Schulman  1   2
Affiliations
Review

Advances in endobariatrics: past, present, and future

Abhishek Shenoy et al. Gastroenterol Rep (Oxf). .

Abstract

The obesity epidemic in the USA and worldwide is well documented and continues to grow. Endoscopic metabolic and bariatric therapies may offer a less invasive approach than surgical intervention. This article will review advances in endobariatrics over the last several decades, addressing the past and current state of bariatric and metabolic endoscopy. Food and Drug Administration-cleared devices and interventions currently under investigation are described including gastric devices, gastric remodeling procedures, small-bowel devices, duodenal ablation, as well as procedures to address weight regain after bariatric surgery. Future studies evaluating gastric and duodenal combination therapy, adjunctive pharmacotherapy, as well as individualized precision-health algorithms are underway.

Keywords: bariatric therapy; endobariatrics; endoscopic sleeve gastroplasty; metabolic devices; obesity.

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Conflict of interest statement

Dr Schulman is a consultant for Apollo Endosurgery, Boston Scientific, MicroTech, and Olympus, and has received research/grant support from GI Dynamics and Fractyl. The other author declares that there are no conflicts of interest in this study.

Figures

Figure 1.
Figure 1.
ORBERA™ Intragastric Balloon System (A) during and (B) after filling the balloon with fluid.
Figure 2.
Figure 2.
The procedure of endoscopic sleeve gastroplasty. (A) Marking of the anterior, greater curvature, and posterior surfaces with argon plasma coagulation prior to endoscopic suturing. (B) Following placement of the first suture. (C) Subsequent suture cinching, which is repeated numerous times moving proximally until the gastroesophageal junction is reached, leaving a small fundic pouch (D).
Figure 3.
Figure 3.
Plications placed during primary obesity surgery endoluminal 2.0.
Figure 4.
Figure 4.
Endomina™ gastric remodeling procedure during the creation of plications (A) from distal to proximal (B) and (C).
Figure 5.
Figure 5.
The procedure of transoral outlet reduction. (A) Marking of the dilated gastrojejunal anastomosis with argon plasma coagulation in preparation for purse-string suture placement. (B) The suture is cinched over a through-the-scope hydrostatic balloon and (C) ultimately removed demonstrating effective endoscopic revision. (D) Endoscopic evaluation 1 year later showed durability.
See this image and copyright information in PMC

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