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Abeezar I. Sarela Consultant/Hon. Sen. Lecturer in Upper GI & Bariatric Surgery St James’s University Hospital, Leeds, UK Visiting Consultant in Bariatric Surgery PN Hinduja National Hospital, Mumbai, India Update and Overview of Endoscopic Bariatric Procedures and Gastric Neuromodulation for Obesity
Agenda ,[object Object],[object Object],[object Object],[object Object]
Surgery for Obesity ,[object Object],[object Object],[object Object],[object Object],[object Object]
Bariatric Operations: Comparison of Weight Loss Sjostrom L et al.  Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects. N Engl J Med 2007;357:741-52.
But…….. ,[object Object],[object Object],[object Object],[object Object]
The Search is On…. ,[object Object],[object Object],[object Object]
Endoscopic Bariatric Procedures ROSE, POSE (USGI) Anchors TOGa (Satiety Inc.) Staplers EndoBarrier (GI Dynamics) ValenTx Sleeves StomaphyX (Endogastric Solutions) T-Fasteners EndoCinch (Bard) Spiderman (J&J) Suturing Sclerotherapy Product Technique
Primary Endoscopic Procedures ValenTx Valen TX (Sleeve – GOJ to jejunum) SAGES 2010 Barosense Restrictive implant Ann Surg. 2010 GI Dynamics Endobarrier (Sleeve – pylorus to jejunum) USGI Primary Obesity Surgery Endoscopic (POSE) SAGES 2010 Endocinch, Bard Endoscopic Vertical Gastroplasty Surg Endosc, DDW, 2009 Satiety Inc.  TransOral GAstroplasty (TOGA)
Revisional Endoscopic Procedures Olympus Endosamurai Storz Anubis Olympus Eagle Claw ASMBS 2009 USGI ROSE Covidien Flexible Endostitch IFSO 2009 J&J Spiderman Surg Endosc 2010 Endogastric Solutions StomaphyX RESTORe Trial, DDW 2010 Bard EndoCinch Sclerotherapy
TOGA
TOGA: Endoscopic View Sleeve Outlet  Staple Line
TOGA:  ex-vivo  Anatomy
TOGA TransOral Gastroplasty ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Search Continues…… ,[object Object],[object Object],[object Object]
Implantable  Gastric Electrical Stimulators
Implantation of Gastric Electrodes
Features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How does it work? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transcend IGS ™ System Transneuronix - Medtronics ,[object Object],[object Object],[object Object]
Transcend IGS ™ - SHAPE Trial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Shikora et al. SOARD 2009 WITHDRAWN
MetaCure  (2003; CE Mark 2006) TANTALUS ™ - Diabetes Control Technology ,[object Object],[object Object],[object Object],[object Object],[object Object],Bohdjalian et al. Surg Endosc. 2009
EnteroMedics  (2002) VBLOC ™  Therapy
VBLOC ™ - EMPOWER Trial ,[object Object],[object Object],[object Object],[object Object]
EnteroMedics - VBLOC ™ ,[object Object],[object Object],[object Object],[object Object],?
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],IntraPace: Abiliti™ Consumption - Expenditure Wt Change =
IntraPace: abiliti ™ GSA102 Analyzer P102 Programmer W102 Programmer Wand LGS102 Stimulator LGL102 Lead
Endoscopy 6 Months Post-Implant
Study Population  Unpublished data Number of Subjects 30 Gender 25 Females  / 5  Males Age  (years) Mean, range 40  (20  to 60) Weight   (lb) Mean, range 284.6  ( 213.4 to 370) Excess weight  (lb) 124.6 (72.9 to 177.5) BMI Mean, range 43.8  (32.5 to  55)
Abiliti ™:  Weight Loss  Unpublished data
Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Emerging Paradigms in  Obesity Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Abeezar I. Sarela Consultant/Hon. Sen. Lecturer in Upper GI & Bariatric Surgery St James’s University Hospital, Leeds, UK Visiting Consultant in Bariatric Surgery PN Hinduja National Hospital, Mumbai, India Update and Overview of Endoscopic Bariatric Procedures and Gastric Neuromodulation for Obesity

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Incisionless procedures and stomach pacemaker for obesity

  • 1. Abeezar I. Sarela Consultant/Hon. Sen. Lecturer in Upper GI & Bariatric Surgery St James’s University Hospital, Leeds, UK Visiting Consultant in Bariatric Surgery PN Hinduja National Hospital, Mumbai, India Update and Overview of Endoscopic Bariatric Procedures and Gastric Neuromodulation for Obesity
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  • 4. Bariatric Operations: Comparison of Weight Loss Sjostrom L et al. Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects. N Engl J Med 2007;357:741-52.
  • 5.
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  • 7. Endoscopic Bariatric Procedures ROSE, POSE (USGI) Anchors TOGa (Satiety Inc.) Staplers EndoBarrier (GI Dynamics) ValenTx Sleeves StomaphyX (Endogastric Solutions) T-Fasteners EndoCinch (Bard) Spiderman (J&J) Suturing Sclerotherapy Product Technique
  • 8. Primary Endoscopic Procedures ValenTx Valen TX (Sleeve – GOJ to jejunum) SAGES 2010 Barosense Restrictive implant Ann Surg. 2010 GI Dynamics Endobarrier (Sleeve – pylorus to jejunum) USGI Primary Obesity Surgery Endoscopic (POSE) SAGES 2010 Endocinch, Bard Endoscopic Vertical Gastroplasty Surg Endosc, DDW, 2009 Satiety Inc. TransOral GAstroplasty (TOGA)
  • 9. Revisional Endoscopic Procedures Olympus Endosamurai Storz Anubis Olympus Eagle Claw ASMBS 2009 USGI ROSE Covidien Flexible Endostitch IFSO 2009 J&J Spiderman Surg Endosc 2010 Endogastric Solutions StomaphyX RESTORe Trial, DDW 2010 Bard EndoCinch Sclerotherapy
  • 10. TOGA
  • 11. TOGA: Endoscopic View Sleeve Outlet Staple Line
  • 12. TOGA: ex-vivo Anatomy
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  • 14.
  • 15. Implantable Gastric Electrical Stimulators
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  • 18.
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  • 20.
  • 21.
  • 22. EnteroMedics (2002) VBLOC ™ Therapy
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  • 24.
  • 25.
  • 26. IntraPace: abiliti ™ GSA102 Analyzer P102 Programmer W102 Programmer Wand LGS102 Stimulator LGL102 Lead
  • 27. Endoscopy 6 Months Post-Implant
  • 28. Study Population Unpublished data Number of Subjects 30 Gender 25 Females / 5 Males Age (years) Mean, range 40 (20 to 60) Weight (lb) Mean, range 284.6 ( 213.4 to 370) Excess weight (lb) 124.6 (72.9 to 177.5) BMI Mean, range 43.8 (32.5 to 55)
  • 29. Abiliti ™: Weight Loss Unpublished data
  • 30.
  • 31.
  • 32. Abeezar I. Sarela Consultant/Hon. Sen. Lecturer in Upper GI & Bariatric Surgery St James’s University Hospital, Leeds, UK Visiting Consultant in Bariatric Surgery PN Hinduja National Hospital, Mumbai, India Update and Overview of Endoscopic Bariatric Procedures and Gastric Neuromodulation for Obesity

Editor's Notes

  1. 11/09/11 Take out patient numbers at the bottom
  2. 11/09/11