Bariatric Times - September 2008 - (Page 14)

14 Emerging Technologies Bariatric Times • September 2008 Emerging Technologies The Introduction of New Technologies into Bariatric and Metabolic Surgery: Are You Ready to Embrace Them? by Scott Shikora, MD, FACS Column Editor: Marc Bessler, MD The following is the third column in our quarterly series. This column investigates 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 third article in this series is written by DR. SCOTT SHIKORA, Professor of Surgery at Tufts University School of Medicine; Chief of MIS, General, and Bariatric Surgery at Tufts Medical Center in Boston, Massachusetts; and President, American Society for Metabolic and Bariatric Surgery (ASMBS). 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. Continued from Page 1 This large, unmet need is fertile ground for the development of new and novel procedures that might be more appealing to patients. To attract patients, these procedures should have several favorable attributes (Table 1). Clearly, they need to be less complex and have a lower complication profile than the current procedures while still achieving the same or similar beneficial results. To that end, a number of new technologies are in development that promise to radically change the face of bariatric surgery in the next decade. Most offer a less complex procedure likely to result in fewer and less severe complications. Some offer new mechanisms of action that do not rely on the traditional caloric restriction and/or malabsorption that are the mainstays of the current procedures. Still others take advantage of the current interest in natural orifice surgery, in which surgeries are performed endoscopically instead of transabdominally. While the field is rapidly changing, at present the most prominent new technologies in development range from a reincarnation of the gastric balloon to neuromodulation (Table 2). gastric bubble was introduced.3 This single layer silicone balloon that was shaped like a soda can was endoscopically deployed and inflated with saline. However, weight loss was modest at best and serious complications developed. The design of the bubble may have been responsible for these complications. The flat edges of the can-shaped balloon led to pressure ulceration of the stomach and even gastric perforations. The bubble was also single layered and prone to INTRAGASTRIC BALLOONS The concept of achieving weight loss by placing a balloon into the stomach to occupy space and decrease gastric capacity is not new. In the 1980s, the Garron-Edwards

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

Bariatric Times - September 2008 Emerging Technologies Case Report Sleeve Gastrectomy after a Jejunoileal Bypass Reversal Editorial Message Contents Editorial Board Walk from Obesity The Latest on Nutrition and Hair Loss in the Bariatric Patient Consultant’s Corner Journal Watch Calendar of Events Advertiser Index

Bariatric Times - September 2008

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