Current status and future perspectives of stomach-targeted endoscopic bariatrics_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

BIAN Jingyuan ¹ , ZHU Baocheng ¹ , YAN Bin ^1,2 ,  WANG Cunchuan ³ ,  PENG Zhiyong ¹

1. Department of General Surgery, The Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, P. R. China;
2. Endoscopy Center, The Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, P. R. China;
3. Weight Loss Center, The First Affiliated Hospital of Jinan University, Guangzhou 510630, P. R. China;

Corresponding author：

WANG Cunchuan, Email: twcc@jnu.edu.cn; PENG Zhiyong, Email: pw.bao.bao@163.com

Keywords：

obesity; endoscopic bariatric; metabolic diseases; stomach

DOI：

10.7507/1007-9424.202403075

Video：

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Endoscopic bariatric treatment (EBT) is an effective method for the treatment of obesity. The principle of weight loss is similar to metabolic bariatric surgery. It can be classified as a food restriction (stomach-targeted) and malabsorption (small intestine-targeted). At present, a lot of EBT devices had been cleared by the US Food and Drug Administration to treat obesity, while the EBT in China lagged behind Western countries. Hence, we reviewed the current stomach-targeted EBT, aiming to provide a reference for the supplement of obesity treatment methods and the development of EBT in China.

Citation： BIAN Jingyuan, ZHU Baocheng, YAN Bin, WANG Cunchuan, PENG Zhiyong. Current status and future perspectives of stomach-targeted endoscopic bariatrics. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(4): 403-408. doi: 10.7507/1007-9424.202403075 Copy

1.	Perdomo CM, Cohen RV, Sumithran P, et al. Contemporary medical, device, and surgical therapies for obesity in adults. Lancet, 2023, 401(10382): 1116-1130.
2.	Elmaleh-Sachs A, Schwartz JL, Bramante CT, et al. Obesity management in adults: a review. JAMA, 2023, 330(20): 2000-2015.
3.	Boškoski I, Pontecorvi V, Ibrahim M, et al. Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy, 2023, 55(3): 276-293.
4.	Nieben OG, Harboe H. Intragastric balloon as an artificial bezoar for treatment of obesity. Lancet, 1982, 1(8265): 198-199.
5.	Weight-loss and weight-management devices. FDA. https://www.fda.gov/medical-devices/products-and-medical-procedures/weight-loss-and-weight-management-devices.
6.	Bazerbachi F, Haffar S, Sawas T, et al. Fluid-filled versus gas-filled intragastric balloons as obesity interventions: a network meta-analysis of randomized trials. Obes Surg, 2018, 28(9): 2617-2625.
7.	Swei E, Almuhaidb A, Sullivan S, et al. Comparison of the efficacy and safety of the FDA-approved intragastric balloon systems in a clinical setting. J Clin Gastroenterol, 2023, 57(6): 578-585.
8.	Abu Dayyeh BK, Maselli DB, Rapaka B, et al. Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial. Lancet, 2021, 398(10315): 1965-1973.
9.	Loo JH, Lim YH, Seah HL, et al. Intragastric balloon as bridging therapy prior to bariatric surgery for patients with severe obesity (BMI ≥ 50 kg/m²): a systematic review and meta-analysis. Obes Surg, 2022, 32(2): 489-502.
10.	Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc, 2013, 78(3): 530-535.
11.	Fogel R, De Fogel J, Bonilla Y, et al. Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients. Gastrointest Endosc, 2008, 68(1): 51-58.
12.	Abu Dayyeh BK, Bazerbachi F, Vargas EJ, et al. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet, 2022, 400(10350): 441-451.
13.	Alqahtani AR, Elahmedi M, Aldarwish A, et al. Endoscopic gastroplasty versus laparoscopic sleeve gastrectomy: a noninferiority propensity score-matched comparative study. Gastrointest Endosc, 2022, 96(1): 44-50.
14.	Beran A, Matar R, Jaruvongvanich V, et al. Comparative effectiveness and safety between endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy: a meta-analysis of 6 775 individuals with obesity. Obes Surg, 2022, 32(11): 3504-3512.
15.	Gudur AR, Geng CX, Kshatri S, et al. Comparison of endoscopic sleeve gastroplasty versus surgical sleeve gastrectomy: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database analysis. Gastrointest Endosc, 2023, 97(1): 11-21.
16.	Gudur AR, Geng CX, Podboy A. Early safety and efficacy comparison of endoscopic bariatric interventions. Surg Obes Relat Dis, 2023, 19(10): 1148-1153.
17.	Rattner D, Kalloo A; ASGE/SAGES Working Group. ASGE/SAGES Working Group on natural orifice translumenal endoscopic surgery. October 2005. Surg Endosc, 2006, 20(2): 329-333.
18.	Swanstrom LL, Kozarek R, Pasricha PJ, et al. Development of a new access device for transgastric surgery. J Gastrointest Surg, 2005, 9(8): 1129-1136.
19.	Mellinger JD, MacFadyen BV, Kozarek RA, et al. Initial experience with a novel endoscopic device allowing intragastric manipulation and plication. Surg Endosc, 2007, 21(6): 1002-1005.
20.	Espinós JC, Turró R, Mata A, et al. Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity: the Primary Obesity Surgery Endolumenal (POSE) procedure. Obes Surg, 2013, 23(9): 1375-1383.
21.	Sullivan S, Swain JM, Woodman G, et al. Randomized sham-controlled trial evaluating efficacy and safety of endoscopic gastric plication for primary obesity: The ESSENTIAL trial. Obesity (Silver Spring), 2017, 25(2): 294-301.
22.	Lopez-Nava G, Asokkumar R, Turró Arau R, et al. Modified primary obesity surgery endoluminal (POSE-2) procedure for the treatment of obesity. VideoGIE, 2020, 5(3): 91-93.
23.	Lopez Nava G, Arau RT, Asokkumar R, et al. Prospective multicenter study of the primary obesity surgery endoluminal (POSE 2.0) procedure for treatment of obesity. Clin Gastroenterol Hepatol, 2023, 21(1): 81-89.
24.	Al Khatry M, Abu Dayyeh BK. The primary obesity surgery endoluminal 2.0 enfolding technique (POSE 2.0et): modification to enhance efficiency and increase restriction. Obes Surg, 2023, 33(6): 1953-1954.
25.	Huberty V, Ibrahim M, Hiernaux M, et al. Safety and feasibility of an endoluminal-suturing device for endoscopic gastric reduction (with video). Gastrointest Endosc, 2017, 85(4): 833-837.
26.	Huberty V, Machytka E, Boškoski I, et al. Endoscopic gastric reduction with an endoluminal suturing device: a multicenter prospective trial with 1-year follow-up. Endoscopy, 2018, 50(12): 1156-1162.
27.	Huberty V, Boskoski I, Bove V, et al. Endoscopic sutured gastroplasty in addition to lifestyle modification: short-term efficacy in a controlled randomised trial. Gut, 2020 Oct 28: gutjnl-2020l-322026l. doi: 10.1136/gutjnl-2020-322026.
28.	Pizzicannella M, Lapergola A, Fiorillo C, et al. Does endoscopic sleeve gastroplasty stand the test of time? Objective assessment of endoscopic ESG appearance and its relation to weight loss in a large group of consecutive patients. Surg Endosc, 2020, 34(8): 3696-3705.
29.	Nyström M, Machytka E, Norén E, et al. Aspiration therapy as a tool to treat obesity: 1- to 4-year results in a 201-patient multi-center post-market European registry study. Obes Surg, 2018, 28(7): 1860-1868.
30.	Abeid M, Kaddah T. Endoscopic band ligation for weight loss. Endoscopy, 2021, 53(8): E287-E288. doi: doi: 10.1055/a-1264-6360.
31.	Yen YA, Wang CC, Sung WW, et al. Intragastric injection of botulinum toxin A for weight loss: A systematic review and meta-analysis of randomized controlled trials. J Gastroenterol Hepatol, 2022, 37(6): 983-992.
32.	Neto MG, Silva LB, Grecco E, et al. Brazilian Intragastric Balloon Consensus Statement (BIBC): practical guidelines based on experience of over 40 000 cases. Surg Obes Relat Dis, 2018, 14(2): 151-159.
33.	Espinet Coll E, Del Pozo García AJ, Turró Arau R, et al. Spanish Intragastric Balloon Consensus Statement (SIBC): practical guidelines based on experience of over 20 000 cases. Rev Esp Enferm Dig, 2023, 115(1): 22-34.
34.	ASGE/ASMBS Task Force on endoscopic bariatric therapy. A pathway to endoscopic bariatric therapies. Surg Obes Relat Dis, 2011, 7(6): 672-682.
35.	Estimate of Bariatric Surgery. Numbers, 2011-2022. https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers/.
36.	Salminen P, Kow L, Aminian A, et al. IFSO consensus on definitions and clinical practice guidelines for obesity management—an International Delphi Study. Obes Surg, 2024, 34(1): 30-42.

1. Perdomo CM, Cohen RV, Sumithran P, et al. Contemporary medical, device, and surgical therapies for obesity in adults. Lancet, 2023, 401(10382): 1116-1130.
2. Elmaleh-Sachs A, Schwartz JL, Bramante CT, et al. Obesity management in adults: a review. JAMA, 2023, 330(20): 2000-2015.
3. Boškoski I, Pontecorvi V, Ibrahim M, et al. Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy, 2023, 55(3): 276-293.
4. Nieben OG, Harboe H. Intragastric balloon as an artificial bezoar for treatment of obesity. Lancet, 1982, 1(8265): 198-199.
5. Weight-loss and weight-management devices. FDA. https://www.fda.gov/medical-devices/products-and-medical-procedures/weight-loss-and-weight-management-devices.
6. Bazerbachi F, Haffar S, Sawas T, et al. Fluid-filled versus gas-filled intragastric balloons as obesity interventions: a network meta-analysis of randomized trials. Obes Surg, 2018, 28(9): 2617-2625.
7. Swei E, Almuhaidb A, Sullivan S, et al. Comparison of the efficacy and safety of the FDA-approved intragastric balloon systems in a clinical setting. J Clin Gastroenterol, 2023, 57(6): 578-585.
8. Abu Dayyeh BK, Maselli DB, Rapaka B, et al. Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial. Lancet, 2021, 398(10315): 1965-1973.
9. Loo JH, Lim YH, Seah HL, et al. Intragastric balloon as bridging therapy prior to bariatric surgery for patients with severe obesity (BMI ≥ 50 kg/m²): a systematic review and meta-analysis. Obes Surg, 2022, 32(2): 489-502.
10. Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc, 2013, 78(3): 530-535.
11. Fogel R, De Fogel J, Bonilla Y, et al. Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients. Gastrointest Endosc, 2008, 68(1): 51-58.
12. Abu Dayyeh BK, Bazerbachi F, Vargas EJ, et al. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet, 2022, 400(10350): 441-451.
13. Alqahtani AR, Elahmedi M, Aldarwish A, et al. Endoscopic gastroplasty versus laparoscopic sleeve gastrectomy: a noninferiority propensity score-matched comparative study. Gastrointest Endosc, 2022, 96(1): 44-50.
14. Beran A, Matar R, Jaruvongvanich V, et al. Comparative effectiveness and safety between endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy: a meta-analysis of 6 775 individuals with obesity. Obes Surg, 2022, 32(11): 3504-3512.
15. Gudur AR, Geng CX, Kshatri S, et al. Comparison of endoscopic sleeve gastroplasty versus surgical sleeve gastrectomy: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database analysis. Gastrointest Endosc, 2023, 97(1): 11-21.
16. Gudur AR, Geng CX, Podboy A. Early safety and efficacy comparison of endoscopic bariatric interventions. Surg Obes Relat Dis, 2023, 19(10): 1148-1153.
17. Rattner D, Kalloo A; ASGE/SAGES Working Group. ASGE/SAGES Working Group on natural orifice translumenal endoscopic surgery. October 2005. Surg Endosc, 2006, 20(2): 329-333.
18. Swanstrom LL, Kozarek R, Pasricha PJ, et al. Development of a new access device for transgastric surgery. J Gastrointest Surg, 2005, 9(8): 1129-1136.
19. Mellinger JD, MacFadyen BV, Kozarek RA, et al. Initial experience with a novel endoscopic device allowing intragastric manipulation and plication. Surg Endosc, 2007, 21(6): 1002-1005.
20. Espinós JC, Turró R, Mata A, et al. Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity: the Primary Obesity Surgery Endolumenal (POSE) procedure. Obes Surg, 2013, 23(9): 1375-1383.
21. Sullivan S, Swain JM, Woodman G, et al. Randomized sham-controlled trial evaluating efficacy and safety of endoscopic gastric plication for primary obesity: The ESSENTIAL trial. Obesity (Silver Spring), 2017, 25(2): 294-301.
22. Lopez-Nava G, Asokkumar R, Turró Arau R, et al. Modified primary obesity surgery endoluminal (POSE-2) procedure for the treatment of obesity. VideoGIE, 2020, 5(3): 91-93.
23. Lopez Nava G, Arau RT, Asokkumar R, et al. Prospective multicenter study of the primary obesity surgery endoluminal (POSE 2.0) procedure for treatment of obesity. Clin Gastroenterol Hepatol, 2023, 21(1): 81-89.
24. Al Khatry M, Abu Dayyeh BK. The primary obesity surgery endoluminal 2.0 enfolding technique (POSE 2.0et): modification to enhance efficiency and increase restriction. Obes Surg, 2023, 33(6): 1953-1954.
25. Huberty V, Ibrahim M, Hiernaux M, et al. Safety and feasibility of an endoluminal-suturing device for endoscopic gastric reduction (with video). Gastrointest Endosc, 2017, 85(4): 833-837.
26. Huberty V, Machytka E, Boškoski I, et al. Endoscopic gastric reduction with an endoluminal suturing device: a multicenter prospective trial with 1-year follow-up. Endoscopy, 2018, 50(12): 1156-1162.
27. Huberty V, Boskoski I, Bove V, et al. Endoscopic sutured gastroplasty in addition to lifestyle modification: short-term efficacy in a controlled randomised trial. Gut, 2020 Oct 28: gutjnl-2020l-322026l. doi: 10.1136/gutjnl-2020-322026.
28. Pizzicannella M, Lapergola A, Fiorillo C, et al. Does endoscopic sleeve gastroplasty stand the test of time? Objective assessment of endoscopic ESG appearance and its relation to weight loss in a large group of consecutive patients. Surg Endosc, 2020, 34(8): 3696-3705.
29. Nyström M, Machytka E, Norén E, et al. Aspiration therapy as a tool to treat obesity: 1- to 4-year results in a 201-patient multi-center post-market European registry study. Obes Surg, 2018, 28(7): 1860-1868.
30. Abeid M, Kaddah T. Endoscopic band ligation for weight loss. Endoscopy, 2021, 53(8): E287-E288. doi: doi: 10.1055/a-1264-6360.
31. Yen YA, Wang CC, Sung WW, et al. Intragastric injection of botulinum toxin A for weight loss: A systematic review and meta-analysis of randomized controlled trials. J Gastroenterol Hepatol, 2022, 37(6): 983-992.
32. Neto MG, Silva LB, Grecco E, et al. Brazilian Intragastric Balloon Consensus Statement (BIBC): practical guidelines based on experience of over 40 000 cases. Surg Obes Relat Dis, 2018, 14(2): 151-159.
33. Espinet Coll E, Del Pozo García AJ, Turró Arau R, et al. Spanish Intragastric Balloon Consensus Statement (SIBC): practical guidelines based on experience of over 20 000 cases. Rev Esp Enferm Dig, 2023, 115(1): 22-34.
34. ASGE/ASMBS Task Force on endoscopic bariatric therapy. A pathway to endoscopic bariatric therapies. Surg Obes Relat Dis, 2011, 7(6): 672-682.
35. Estimate of Bariatric Surgery. Numbers, 2011-2022. https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers/.
36. Salminen P, Kow L, Aminian A, et al. IFSO consensus on definitions and clinical practice guidelines for obesity management—an International Delphi Study. Obes Surg, 2024, 34(1): 30-42.

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Current status and future perspectives of stomach-targeted endoscopic bariatrics

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