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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2022; 13(03): 170-178
DOI: 10.1055/s-0042-1754335
Review Article

Future of Metabolic Endoscopy

Rabih Ghazi 
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, United States
,
Eric J. Vargas 
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, United States
,
Donna Abboud 
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, United States
,
Farah Abdul Razak
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, United States
,
Tala Mahmoud
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, United States
,
Andrew C. Storm
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, United States
,
Vinay Chandrasekhara
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, United States
,
Barham K. Abu Dayyeh
1   Division of Gastroenterology and Hepatology, Mayo Clinic, Minnesota, United States
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Abstract

Obesity has been escalating as one of the worst public health epidemics. Conservative therapies including lifestyle modifications and weight loss medications have limited efficacy and long-term sustainability. Bariatric surgeries, although effective, remain underutilized due to their cost, safety concerns, and patient acceptance. In the past two decades, endoscopic bariatric and metabolic therapies (EBMTs) have emerged as safe, effective, and less invasive options for the treatment of obesity and its comorbidities, with recent studies reporting favorable outcomes in terms of weight loss and metabolic parameters. This article reviews the major and newly developed EBMTs, with emphasis on their metabolic effects and potential use in the management of metabolic conditions.

Keywords

endoscopic bariatric and metabolic therapies (EBMT) - endoscopic obesity - endoscopic sleeve gastroplasty (ESG) - intragastric balloons (IGB) - metabolic endoscopy - primary obesity surgery endoluminal (POSE)

Authors' Contributions

BKA, RG, and EV were involved in manuscript concept and design.


RG, EV, DA, FA, and TM drafted the manuscript.


BKA, VC, ACS, RG, EV, DA, FA, and TM critically revised the manuscript.




Publication History

Article published online:
13 September 2022

© 2022. Society of Gastrointestinal Endoscopy of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 World Health Organization. Obesity and overweight. 9 June 2021; Accessed June 30, 2022 from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
    Google Scholar
  • 2 Venkatrao M, Nagarathna R, Majumdar V, Patil SS, Rathi S, Nagendra H. Prevalence of obesity in India and its neurological implications: a multifactor analysis of a nationwide cross-sectional study. Ann Neurosci 2020; 27 (3-4): 153-161
    CrossrefPubMedGoogle Scholar
  • 3 De A, Duseja A. Nonalcoholic fatty liver disease: Indian perspective. Clin Liver Dis (Hoboken) 2021; 18 (03) 158-163
    CrossrefPubMedGoogle Scholar
  • 4 International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels, Belgium: 2021. Accessed June 30, 2022 at: https://www.diabetesatlas.org/
    Google Scholar
  • 5 Courcoulas A, Abu Dayyeh BK, Eaton L. et al. Intragastric balloon as an adjunct to lifestyle intervention: a randomized controlled trial. Int J Obes 2017; 41 (03) 427-433
    CrossrefPubMedGoogle Scholar
  • 6 Singh S, de Moura DTH, Khan A. et al. Intragastric balloon versus endoscopic sleeve gastroplasty for the treatment of obesity: a systematic review and meta-analysis. Obes Surg 2020; 30 (08) 3010-3029
    CrossrefPubMedGoogle Scholar
  • 7 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
    CrossrefPubMedGoogle Scholar
  • 8 Popov VB, Ou A, Schulman AR, Thompson CC. The impact of intragastric balloons on obesity-related co-morbidities: a systematic review and meta-analysis. Am J Gastroenterol 2017; 112 (03) 429-439
    CrossrefPubMedGoogle Scholar
  • 9 Bazerbachi F, Vargas EJ, Rizk M. et al. Intragastric balloon placement induces significant metabolic and histologic improvement in patients with nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol 2021; 19 (01) 146-154.e4
    CrossrefPubMedGoogle Scholar
  • 10 Popov VB, Thompson CC, Kumar N, Ciarleglio MM, Deng Y, Laine L. Effect of intragastric balloons on liver enzymes: a systematic review and meta-analysis. Dig Dis Sci 2016; 61 (09) 2477-2487
    CrossrefPubMedGoogle Scholar
  • 11 Chandan S, Mohan BP, Khan SR. et al. Efficacy and Safety of Intragastric Balloon (IGB) in Non-alcoholic Fatty Liver Disease (NAFLD): a comprehensive review and meta-analysis. Obes Surg 2021; 31 (03) 1271-1279
    CrossrefPubMedGoogle Scholar
  • 12 Marinos G, Eliades C, Raman Muthusamy V, Greenway F. Weight loss and improved quality of life with a nonsurgical endoscopic treatment for obesity: clinical results from a 3- and 6-month study. Surg Obes Relat Dis 2014; 10 (05) 929-934
    CrossrefPubMedGoogle Scholar
  • 13 Rothstein RI, Woodman G, Swain J, Cruz N, Kushnir V, Pryor A. Transpyloric shuttle treatment improves cardiometabolic risk factors and quality of life in patients with obesity: results from a randomized, double-blind, Sham-Controlled Trial. Gastroenterology 2019; 156 (06) 237
    CrossrefGoogle Scholar
  • 14 Singh S, Bazarbashi AN, Khan A. et al. Primary obesity surgery endoluminal (POSE) for the treatment of obesity: a systematic review and meta-analysis. Surg Endosc 2021; 36 (01) 252-266
    CrossrefPubMedGoogle Scholar
  • 15 Miller K, Turró R, Greve JW, Bakker CM, Buchwald JN, Espinós JC. Medical Therapy. MILEPOST multicenter randomized controlled trial: 12-month weight loss and satiety outcomes after pose SM vs. Obes Surg 2017; 27 (02) 310-322
    CrossrefPubMedGoogle Scholar
  • 16 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 (02) 294-301
    CrossrefPubMedGoogle Scholar
  • 17 Espinós JC, Turró R, Moragas G. et al. Gastrointestinal physiological changes and their relationship to weight loss following the POSE procedure. Obes Surg 2016; 26 (05) 1081-1089
    CrossrefPubMedGoogle Scholar
  • 18 Lopez-Nava G, Asokkumar R, Turró Arau R, Neto MG, Dayyeh BA. Modified primary obesity surgery endoluminal (POSE-2) procedure for the treatment of obesity. VideoGIE 2020; 5 (03) 91-93
    CrossrefPubMedGoogle Scholar
  • 19 Lopez-Nava G, Turro R, Maselli DB. et al. 720 Primary obesity surgery endoluminal 2 (POSE2): an international multicenter prospective trial. Gastrointest Endosc 2020; 91 (06) AB60
    CrossrefGoogle Scholar
  • 20 Lopez Nava G, Asokkumar R, Laster J. et al. Primary obesity surgery endoluminal (POSE-2) procedure for treatment of obesity in clinical practice. Endoscopy 2020
    PubMedGoogle Scholar
  • 21 Abu Dayyeh BK, Turro R, Maselli DB. et al. Primary obesity surgery endoluminal 2 (POSE 2.0): an international multicenter prospective trial with plication durability assessment. In Gastrointestinal Endoscopy. New York, NY: Mosby-Elsevier; 2021
    Google Scholar
  • 22 Maselli DB, Matar R, Vargas EJ. et al. Sa1992 primary obesity surgery endoluminal 1 and 2 have distinct impacts on gastric physiology in a prospective cohort study. Gastroenterology 2020; 158 (06) S-492
    CrossrefGoogle Scholar
  • 23 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 (03) 530-535
    CrossrefPubMedGoogle Scholar
  • 24 Hedjoudje A, Abu Dayyeh BK, Cheskin LJ. et al. Efficacy and safety of endoscopic sleeve gastroplasty: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2020; 18 (05) 1043-1053.e4
    Google Scholar
  • 25 Sharaiha RZ, Kumta NA, Saumoy M. et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol 2017; 15 (04) 504-510
    CrossrefPubMedGoogle Scholar
  • 26 Sartoretto A, Sui Z, Hill C. et al. Endoscopic sleeve gastroplasty (ESG) is a reproducible and effective endoscopic bariatric therapy suitable for widespread clinical adoption: a large, international multicenter study. Obes Surg 2018; 28 (07) 1812-1821
    CrossrefPubMedGoogle Scholar
  • 27 Lopez-Nava G, Galvão MP, Bautista-Castaño I, Fernandez-Corbelle JP, Trell M, Lopez N. Endoscopic sleeve gastroplasty for obesity treatment: two years of experience. Arq Bras Cir Dig 2017; 30 (01) 18-20
    CrossrefPubMedGoogle Scholar
  • 28 Sharaiha RZ, Hajifathalian K, Kumar R. et al. Five-year outcomes of endoscopic sleeve gastroplasty for the treatment of obesity. Clin Gastroenterol Hepatol 2021; 19 (05) 1051-1057.e2
    Google Scholar
  • 29 Fayad L, Adam A, Schweitzer M. et al. Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study. Gastrointest Endosc 2019; 89 (04) 782-788
    CrossrefPubMedGoogle Scholar
  • 30 Alqahtani A, Elahmedi M, Alqahtani YA, Al-Darwish A. Endoscopic sleeve gastroplasty in 109 consecutive children and adolescents with obesity: two-year outcomes of a new modality. Am J Gastroenterol 2019; 114 (12) 1857-1862
    CrossrefPubMedGoogle Scholar
  • 31 Hajifathalian K, Mehta A, Ang B. et al. Improvement in insulin resistance and estimated hepatic steatosis and fibrosis after endoscopic sleeve gastroplasty. Gastrointest Endosc 2021; 93 (05) 1110-1118
    CrossrefPubMedGoogle Scholar
  • 32 Jagtap N, Kalapala R, Katakwar A. et al. Endoscopic sleeve gastroplasty - minimally invasive treatment for non-alcoholic fatty liver disease and obesity. Indian J Gastroenterol 2021; 40 (06) 572-579
    CrossrefPubMedGoogle Scholar
  • 33 Cheskin LJ, Hill C, Adam A. et al. Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy: a case-matched study. Gastrointest Endosc 2020; 91 (02) 342-349.e1
    CrossrefPubMedGoogle Scholar
  • 34 Fayad L, Cheskin LJ, Adam A. et al. Endoscopic sleeve gastroplasty versus intragastric balloon insertion: efficacy, durability, and safety. Endoscopy 2019; 51 (06) 532-539
    Article in Thieme ConnectPubMedGoogle Scholar
  • 35 Abu Dayyeh BK, Acosta A, Camilleri M. et al. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol 2017; 15 (01) 37-43.e1
    CrossrefPubMedGoogle Scholar
  • 36 Huberty V, Machytka E, Boškoski I, Barea M, Costamagna G, Deviere J. Endoscopic gastric reduction with an endoluminal suturing device: a multicenter prospective trial with 1-year follow-up. Endoscopy 2018; 50 (12) 1156-1162
    Article in Thieme ConnectPubMedGoogle Scholar
  • 37 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 gutjnl-2020-322026
    Google Scholar
  • 38 van Baar ACG, Holleman F, Crenier L. et al. Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes mellitus: one year results from the first international, open-label, prospective, multicentre study. Gut 2020; 69 (02) 295-303
    CrossrefPubMedGoogle Scholar
  • 39 de Oliveira GHP, de Moura DTH, Funari MP. et al. Metabolic effects of endoscopic duodenal mucosal resurfacing: a systematic review and meta-analysis. Obes Surg 2021; 31 (03) 1304-1312
    CrossrefPubMedGoogle Scholar
  • 40 Koehestanie P, de Jonge C, Berends FJ, Janssen IM, Bouvy ND, Greve JW. The effect of the endoscopic duodenal-jejunal bypass liner on obesity and type 2 diabetes mellitus, a multicenter randomized controlled trial. Ann Surg 2014; 260 (06) 984-992
    CrossrefPubMedGoogle Scholar
  • 41 Jirapinyo P, Haas AV, Thompson CC. Effect of the duodenal-jejunal bypass liner on glycemic control in patients with type 2 diabetes with obesity: a meta-analysis with secondary analysis on weight loss and hormonal changes. Diabetes Care 2018; 41 (05) 1106-1115
    CrossrefPubMedGoogle Scholar
  • 42 Machytka E, Bužga M, Zonca P. et al. Partial jejunal diversion using an incisionless magnetic anastomosis system: 1-year interim results in patients with obesity and diabetes. Gastrointest Endosc 2017; 86 (05) 904-912
    CrossrefPubMedGoogle Scholar
  • 43 Khan Z, Khan MA, Hajifathalian K. et al. Efficacy of endoscopic interventions for the management of obesity: a meta-analysis to compare endoscopic sleeve gastroplasty, aspire assist, and primary obesity surgery endolumenal. Obes Surg 2019; 29 (07) 2287-2298
    CrossrefPubMedGoogle Scholar
  • 44 Ghoz H, Jaruvongvanich V, Matar R. et al. A preclinical animal study of combined intragastric balloon and duodenal-jejunal bypass liner for obesity and metabolic disease. Clin Transl Gastroenterol 2020; 11 (09) e00234
    CrossrefPubMedGoogle Scholar