Endoscopic therapy for weight loss： Gastroplasty, duodenalsleeves, intragastric balloons, and aspiration

• 作者: Nitin Kumar.
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Weight loss OverStitch ASPIRE Transoraloutlet reduction Gastric BALLOON Orbera EndoBarrier APOLLO Primary Obesity Surgery Endolumenal Gastricbypass DUODENAL sleeve Intragastric
• 年，卷（期）: 2015,（9）
• 页码范围: 847-859
• 页数: 13页
• 分类号: R

摘要

A new paradigm in the treatment of obesity and metabolicdisease is developing. The global obesity epidemiccontinues to expand despite the availability of dietand lifestyle counseling, pharmacologic therapy, andweight loss surgery. Endoscopic procedures have thepotential to bridge the gap between medical therapyand surgery. Current primary endoscopic bariatrictherapies can be classified as restrictive, bypass, spaceoccupying,or aspiration therapy. Restrictive proceduresinclude the USGI Primary Obesity Surgery Endolumenalprocedure, endoscopic sleeve gastroplasty using ApolloOverStitch, TransOral GAstroplasty, gastric volumereduction using the ACE stapler, and insertion of theTERIS restrictive device. Intestinal bypass has beenreported using the EndoBarrier duodenal-jejunal bypassliner. A number of space-occupying devices have beenstudied or are in use, including intragastric balloons（Orbera, Reshape Duo, Heliosphere BAG, Obalon）,Transpyloric Shuttle, and SatiSphere. The AspireAssistaspiration system has demonstrated efficacy. Finally,endoscopic revision of gastric bypass to address weightregain has been studied using Apollo OverStitch, theUSGI Incisionless Operating Platform Revision ObesitySurgery Endolumenal procedure, Stomaphyx, andendoscopic sclerotherapy. Endoscopic therapies forweight loss are potentially reversible, repeatable, lessinvasive, and lower cost than various medical andsurgical alternatives. Given the variety of devices underdevelopment, in clinical trials, and currently in use,patients will have multiple endoscopic options withgreater efficacy than medical therapy, and with lowerinvasiveness and greater accessibility than surgery.