New developments in endoscopic procedures for weight loss

By Jeff W. Allen, M.D.

Weight loss surgery is moving toward nonsurgical interventions, particularly endoscopy.

Already, Norton Healthcare bariatric surgeons are using intragastric balloon procedures. A silicone balloon is put into the stomach endoscopically. The balloon is then blown up with saline, giving the patient a feeling of fullness all the time.

Monthly follow-ups are suggested while the balloon is in place, and the balloon must be removed endoscopically within six months. The environment of the stomach is so intense and acidic that the acid would break down the balloon if it were left in place longer, and it would deflate and pass through the body.

The U.S. Food and Drug Administration has approved three balloon systems for weight loss: the Orbera lntragastric Balloon System, the ReShape Integrated Dual Balloon System and the ObaIon Balloon System. The Orbera and ReShape devices are put in place endoscopically. The Obalon is swallowed by the patient through guided fluoroscopy. Endoscopy is required to remove it. In addition to the balloon placement being temporary, insurance companies currently are not paying for intragastric balloon procedures.

Under development now is a pill that blows up when it is exposed to the stomach’s acidic environment. The pill would eliminate the need to insert the balloon via endoscopy. Looking ahead to 15 years in the future, more and more procedures are going to be done without surgical incisions, either through endoscopy or natural orifice surgery. Certainly, as a patient, you’d want that.

Dr. Allen is director of bariatric surgery at Norton Weight Management Services and a general, bariatric and laparoscopic surgeon with Norton Surgical Specialists.

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