Bariatric Times - June 2008 - (Page 26)

26 Emerging Technologies Bariatric Times • June 2008 Endoluminal Treatment Options for Morbid Obesity: Devices and Techniques for Natural Orifice Approaches by Rebecca P. Petersen, MD, MSc; Bipan Chand, MD; and Aurora D. Pryor, MD Column Editor: Marc Bessler, MD The following is the second column in a series that will appear quarterly in Bariatric Times. This column will investigate current research in the surgical and clinical aspects of obesity treatment, and will educate bariatric care professionals on the most up-to-date, concrete information in the field of obesity treatment. The second article in this series is written by DRS. REBECCA P. PETERSEN AND AURORA D. PRYOR, from the Duke Center for Weight Loss and Metabolic Surgery, Duke University Medical Center, Durham, North Carolina; and DR. BIPAND CHAND, from the Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio. Dr. Marc Bessler, a leading authority in the surgical treatment of obesity, is the Column Editor of this series, and Surgical Director, New York-Presbyterian Hospital Center, for Obesity Surgery, and Assistant Professor of Surgery, Department of Surgery, Director of Laparoscopic Surgery, Columbia University College of Physicians and Surgeons, New York, New York. Emerging Technologies Continued from Page 1 In recent years, more than 100,000 bariatric procedures were estimated to have been performed annually3 and—given the increasing prevalence of obesity—use of these procedures likely will increase. However, no optimal single procedure has been identified, and the procedures currently performed for morbid obesity have risks associated with them. For example, among patients undergoing Rouxen-Y gastric bypass procedures a recent meta-analysis found a mortality of 0.5 percent.4 Given the prevalence of the disease and the risks of conventional procedures, considerable effort has been directed toward improving current surgical techniques. Many of the advances on the horizon in bariatric medicine focus on natural orifice therapies, which are the focus of this review. Natural orifice approaches may minimize the anesthetic and wound issues associated with traditional surgical approaches. NATURAL ORIFICE PROCEDURES—THE NEW FRONTIER A common use of the natural orifice route may be the placement of a short-term device to reduce operative mortality or morbidity of a definitive bariatric procedure. Natural orifice approaches are also used for revisional bariatric procedures to reduce a stoma size, to repair a fistula, or to create a new anastomosis. In many cases, endoluminal revision may help minimize some of the difficulty in standard revisional surgery by avoiding adhesions in the new operative plane. Finally, de novo primary bariatric surgical procedures via a natural orifice are considered the new frontier for bariatric procedures.5, 6 ENDOLUMINAL PROCEDURES Several devices have been developed (and adapted) to facilitate the endoluminal approach to bariatric procedures. These devices range from simple spaceoccupying devices to complex

Table of Contents Feed for the Digital Edition of Bariatric Times - June 2008

Bariatric Times - June 2008 Endoluminal Treatment Options for Morbid Obesity: Devices and Techniques for Natural Orifice Approaches The Multidisciplinary Approach to Weight Loss: Defining the Roles of the Necessary Providers Acute Bleeding after Gastric Bypass Editorial Message Contents ASMBS: 25 Years Editorial Board Surgical Site Infection In The Morbidly Obese Patient: A Review Consultant's Corner The Link Between Sleep Loss and Obesity: Understanding the Mechanisms Responsible for Weight Gain with Sleep Deprivation Volume Matters Journal Watch Advertiser Index

Bariatric Times - June 2008

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