Endoscopic bariatrics: Current status and emerging technologies

Table 1 Endoscopic bariatric techniques

Techniques
Gastric resection	Space occupying devices
	Intragastric balloons
	Transpyloric shuttle
	SatiSphere
	Gelesis100
	Stapling devices
	Apollo OverStitch
	Primary obesity surgery endolumenal
	Endomnia
	Articulating circular endoscopic devise
Malabsorption	Endobarrier
	Gastroduodenojejunal bypass sleeve
	SatiSphere
	REVITA DMR system
	Incision-less anastomosis system
Other mechanisms	Aspire assist
	Botulinum toxin injection

DMR: Duodenal mucosal resurfacing system.

Table 2 Intragastric balloon characteristics

Balloon type	Orbera	ReShape Duo1	Obalon	Heliosphere	Spatz2	Elipse
Manufacturer	Apollo Endosurgery	ReShape Medical	Obalon Therapeutics	Helioscopie Medical Implants	Spatz FGIA	Allurion Technologies
Filled with	Saline	Saline	Nitrogen gas	Air	Saline	Liquid
Capacity (mL) adjustable	400-700	450 × 2	250 × 3	900-1000	300-900	550
Number of balloons	1	2	Up to 3	1	1	1
Insertion	Endoscopy	Endoscopy	Swallowed	Endoscopy	Endoscopy	Endoscopy
Removal	Endoscopy
Duration	6	6	6	6	12	6
Adjustable	No	No	No	No	Yes	No

¹Obtained Food and Drug Administration/conformity European approval.

²Obtained conformity European approval.

Table 3 Adverse events, %

Adverse event	ReShape Duo	Orbera	Obalon
Vomiting	86.7	86.8	17.3
Nausea	61.0	75.6	56.0
Abdominal pain	54.5	57.5	72.6
Gastric ulcer	35.2	0.0	0.9
Dyspepsia	17.8	21.3	16.9

Table 4 Estimated weight loss

Endoscopic bariatric techniques
Fluid-filled intragastric balloons
Orbera/BIB	34%-42% EWL at 6 months
Silimed gastric balloon	8 kg after 6 months
MedSil intragastric balloon	19% EWL at 6 months
Spatz adjustable balloon system	46% EWL at 12 months
ReShape dual intragastric balloon system	25% EWL at 6 months
Air/gas-filled intragastric balloons
Heliosphere BAG balloon	18% EWL at 6 months
Obalon gastric balloon	5 kg after 12 weeks
Ullorex oral intragastric balloon	1.5 kg over 2 weeks
Other space-occupying devices
SAB	6.5 kg after 4 months
TPS	25% EWL at 3 months 41% EWL at 6 months
SatiSphere	18.4 kg after 3 months
Gelesis100	29% EWL after 24 weeks
Suturing/stapling procedures
EndoCinch suturing system	40% EWL at 3 months 58% EWL at 12 months
Restore suturing system	28% EWL at 12 months
Overstitch endoscopic suturing system	30% EWL at 6 months 55% EWL at 12 months
TOGA	25%-46% EWL at 6 months 39% EWL at 12 months
TERIS	30% EWL at 6 months POSE 45% EWL at 12 months
Endomina suturing system	29% EWL at 12 months
Malabsorptive endoscopic weight loss procedures DJBS	12-24% EWL at 3 months 32% EWL at 6 months
Gastroduodenal-DJBS months 54% EWL	40% EWL at 3 at 12 months
Other endoscopic weight loss procedures
DMR	2.5 kg after 24 weeks Incisionless magnetic anastomosis system 40% EWL at 12 months
Intragastric injections of botulinum toxin A	11 kg after 2 months V-BLOC 17% EWL at 12 months
GES	5 kg after 6 months Gastric aspiration therapy/AspireAssist 41% EWL at 6 months 50% EWL at 12 months

Values extrapolated from representative reviews and clinical trials of each intervention. BIB: BioEnterics intragastric balloon; SAB: Semi-stationary antral balloon; TPS: TransPyloric shuttle; TOGA: Transoral gastroplasty; TERIS: Trans-oral endoscopic restrictive implant system; DJBS: Duodenaljejunal bypass sleeve; EWL: Excess weight loss; DMR: Duodenal mucosal resurfacing; GES: Gastric electrical stimulation; POSE: Primary obesity surgery endoluminal; V-BLOC: Vagal blockade.