Evidence map›Paper›PMID 29679149›Full record

Trial reportSurgical endoscopy2018

Totally endoscopic implant to effect a gastric bypass: 12-month safety and efficacy outcomes.

Bryan J Sandler, Laurent Biertho, Mehran Anvari, Roberto Rumbaut, Luis Alonso Morales-Garza, Gustavo Torres-Barrera, Simon Marceau, Dennis Hong, C Daniel Smith, Santiago Horgan

Abstract readClinical TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 12 citations in OpenAlex.

  1. Update on Endoscopic Treatments for Obesity.Current obesity reports · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Bryan J SandlerDivision of Minimally Invasive Surgery, Department of Surgery, UC San Diego, San Diego, CA, USA. bsandler@ucsd.edu.
Laurent BierthoDépartement de Chirurgie, Université Laval, Quebec, QC, Canada.
Mehran AnvariDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Roberto RumbautHospital de Tec de Monterrey, Monterrey, Nuevo León, Mexico.
Luis Alonso Morales-GarzaTecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico.
Gustavo Torres-BarreraHospital de Tec de Monterrey, Monterrey, Nuevo León, Mexico.
Simon MarceauDépartement de Chirurgie, Université Laval, Quebec, QC, Canada.
Dennis HongDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
C Daniel SmithEsophageal Institute of Atlanta, Atlanta, GA, USA.
Santiago HorganDivision of Minimally Invasive Surgery, Department of Surgery, UC San Diego, San Diego, CA, USA.
Tecnológico de Monterrey · MXMcMaster University · CAUniversité Laval · CAUniversity of California, San Diego · USUniversity of Atlanta · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOnly a small percentage of candidates for bariatric surgery ever undergo a procedure for weight loss. Devices duplicating key effects of bariatric surgeries with removable, fully trans-oral implants could extend their benefits to patients unwilling to undergo anatomy-altering abdominal surgeries.

methodsThirty-two obese subjects (mean BMI: 42.3) were enrolled in a prospective, multicenter, single-arm, feasibility trial of the first fully trans-oral endoscopic gastrointestinal bypass device. The device is a cuff attached to the distal esophagus by transmural anchors and connected to a 120-cm sleeve diverting undigested nutrients to the jejunum. Bodyweight, vital signs, adverse events, medications, HbA1c, fasting glucose, and lipids were collected at baseline and follow-up visits. Device status was endoscopically assessed every 6 months.

resultsThe fully trans-oral procedure was successful in all subjects without intraoperative adverse events or postoperative infections. Twenty-eight of 32 subjects (88%) remained implanted with continuing follow-up beyond their 12-month visit. At 12 months, the 32 subjects had lost an average of 44.8% of excess body weight, 17.6% of total body weight, 20.8 kg, and 7.5 BMI points. Weight loss depended on capture of ingesta by the esophageal cuff, with 18 of 32 subjects without visible gaps around their cuffs at the 6 month endoscopy having significantly greater EWL (53.6 vs. 33.4% in the remaining subjects, p < 0.002). Mean HbA1c and fasting glucose declined by 1.1% points and 29 mg/dL in type 2 diabetic subjects, 80% of whom had remission of their diabetes at 12 months.

conclusionThis study demonstrates the feasibility, safety, and efficacy of a fully trans-oral gastrointestinal bypass implant. This purely endoscopic device may provide a valuable addition to the armamentarium of treatment available for the management of morbid obesity.

Indexed as

Prostheses and ImplantsAdultFeasibility StudiesFemaleFollow-Up StudiesGastric BypassHumansMaleMiddle AgedNatural Orifice Endoscopic SurgeryObesity, MorbidPatient SafetyProspective StudiesTreatment OutcomeWeight LossAnd endoscopic surgeryBariatric surgeryEndoluminal bariatric surgeryGastric bypassObesitySurgical endoscopy

Identifiers

PMID29679149
OpenAlexW2799675778

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.