Bariatric Times - September 2008 - (Page 17)

Bariatric Times • September 2008 Emerging Technologies 17 conventional Roux-en-Y gastric bypass, these include the ileal transposition (moving a segment of the distal ileum more proximally) with or without sleeve gastrectomy, omentectomy, and the duodenaljejunal bypass (connecting the proximal duodenum to the jejunum so food bypasses most of the duodenum). Pilot studies with the ileal transposition and the duodenal-jejunal bypass have demonstrated dramatic improvements in diabetes with or without patient weight loss.21,22 Lastly, a duodenal electrical stimulator is being investigated for the treatment of diabetes. Similar to the IGS and Tantalus systems, the procedure involves the laparoscopic implantation of electrodes into the wall of the duodenum. In animal studies, electrical stimulation of the duodenum resulted in reductions in blood sugar and insulin levels (personal communication— BetaStim). REFERENCES 1. Sjostrom L, Nabro K, Sjostrom CD, et al. Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. New Engl J Med. 2007, 357:741-752. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007,357:753–761. Gostout CJ, Rajan E. Endoscopic treatments for obesity: Past, present and future. Gastroenterol 4. 5. 2. 6. 3. Clin N Am. 2005,34:143–150. Genco A, Cipriano M, Bacci V, et al. BioEnterics® Intragastric Balloon (BIB®): a short-term, double-blind, randomized, contolled, crossover study on weight reduction in morbidly obese patients. Int J Obes. 2006;30:129–133. Al-Momen A, El-Mogy I. Intragastric balloon for obesity: A retrospective evaluation of tolerance and efficacy. Obes Surg. 2005;15:101–105. Schweitzer M. Endoscopic intraluminal suture plication of the gastric pouch and stoma in postoperative Roux-en-Y gastric bypass patients. J 7. 8. Laparoendoscop Adv Surg Tech. 2004;14:223–226. Herron DM, Birkett DH, Thompson CC, et al. Gastric bypass pouch and stoma reduction using a transoral endoscopic anchor placement system: a feasibility study. Surg Endosc. 2008,22:1093–1099. Tarnoff M, Shikora S, Lembo A, Gersin K. Chronic in-vivo experience with an endoscopically delivered and retrieved duodenal-jejunal bypass sleeve in a porcine model. Surg Endosc. 2008,22:1023–1028. CONCLUSION The dramatic increase in demand for surgical remedies for severe obesity and other metabolic disorders has stimulated tremendous interest in developing new technologies and operative procedures. These technologies are striving for less invasiveness, greater safety, lack of permanent alterations of the GI tract, lack of long-term consequences, and even novel mechanisms of action. Although we are entering a very exciting time in bariatric surgery that is rich with rapid change and exciting innovations, keep in mind that currently none of these new modalities has been adequately studied to warrant introduction into practice. Some of these innovations may ultimately be deemed worthy for use, while others will likely fail to achieve meaningful results and be abandoned. Therefore, for the time being Stay tuned! http://www.covidien.com/perfectgj http://www.covidien.com/perfectgj

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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