Endoluminal bariatric surgery

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Endoluminal bariatric surgery

  1. 1. Endoluminal bariatric surgery <ul><li>Santiago Horgan, M.D. </li></ul><ul><li>Professor of Surgery </li></ul><ul><li>Director Minimally Invasive and Robotic Surgery </li></ul>
  2. 2. Background <ul><li>Gastric Bypass </li></ul><ul><ul><li>High degree of weight-loss efficacy </li></ul></ul><ul><ul><li>Significant impact on co-morbidities, in particular Type 2 diabetes </li></ul></ul><ul><li>Morbidity and mortality rates deter many from gastric by-pass (0.5/5%) </li></ul><ul><li>Objective of the device is to achieve GBP efficacy while reducing complications </li></ul>
  3. 3. Endo Bypass Concept ValenTx Endo Bypass Sleeve Roux-en-Y Gastric Bypass
  4. 4. Endo-Bypass Sleeve (EBS) <ul><li>Peroral placement and removal </li></ul><ul><li>No Anatomical Modification </li></ul><ul><li>Adjustable (variable sleeve length) </li></ul><ul><li>Removable and replaceable </li></ul><ul><li>Short or long-term therapy </li></ul>
  5. 5. Endo Bypass Sleeve
  6. 6. Procedure Development <ul><li>Surgical approach </li></ul><ul><li>Laparoscopically assisted </li></ul><ul><li>Endoscopic </li></ul>
  7. 7. Surgical technique
  8. 8. Attaching the cuff
  9. 9. Attaching the cuff
  10. 10. X-ray
  11. 11. Pre-clinical Studies <ul><li>Over 75 animal studies </li></ul><ul><li>Iteration on device design and attachment method </li></ul><ul><li>Achieving consistent attachment in survival studies </li></ul><ul><li>Normal organ functions (all examined at necropsy) </li></ul><ul><li>Sleeve is well tolerated by the bowel </li></ul>
  12. 12. Anchors at 5 Weeks
  13. 13. Anchor Histology at 5 weeks Anchor Space Mature Collagen
  14. 14. Device Efficacy <ul><li>Peristalsis acts on sleeve and food passes normally </li></ul><ul><li>Studies not designed for weight loss controls </li></ul><ul><li>Anecdotal Results </li></ul><ul><ul><li>Juvenile Pigs: show less weight gain than normal </li></ul></ul><ul><ul><li>Mature Canines: show weight loss, despite increases in feeding </li></ul></ul>
  15. 15. 25% 11%
  16. 16. -9% -10%
  17. 17. Summary <ul><li>Device can be consistently deployed and attached in animal models </li></ul><ul><li>initial Clinical Studies with in 3 months </li></ul>
  18. 18. Re-do gastric by-pass <ul><li>Endoscopic plications of: </li></ul><ul><ul><li>pouch enlargement </li></ul></ul><ul><ul><li>reduction of anastomosis </li></ul></ul>
  19. 19. Animation
  20. 20. Technique
  21. 21. Treatment of gastric by-pass failure
  22. 22. Conclusion <ul><li>Intragastric bariatric surgery is now a reality </li></ul><ul><li>Endoscopic treatment of failed gastric by-pass is growing as more surgeries are being performed </li></ul><ul><li>Trend towards less invasive surgeries to treat obesity </li></ul><ul><ul><ul><li>lap band </li></ul></ul></ul><ul><ul><ul><li>endoscopic techniques </li></ul></ul></ul>

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