Unit of Endoscopy, Gastrodex, Hospital Universitario Dexeus, Barcelona, Spain.
Rev Esp Enferm Dig. 2012 Feb;104(2):72-87. doi: 10.4321/s1130-01082012000200006.
in recent years new endoscopic strategies and techniques for the treatment of obesity have emerged and developed.
in this article we will review and analyze the current state of the following techniques and the basic differential characteristics between each of them: balloons and prosthesis, injection of substances, systems of sutures, malabsorptives techniques and others currently in research.
we will evaluate the endoscopic technique and their main indications, results, tolerances, complications and adverse effects observed, reporting our personal experience and in relation with an extensive literature review.
comparatively with the most widespread technique of the Bioenterics balloon, the Spatz balloon can provide greater weight loss but with worse tolerance and more complications and the Heliosphere Bag gets a similar weight loss but with greater technical difficulty. Other balloons and prosthesis (Ullorex, Semistationary, Silimed, Endogast) still require technical improvements and higher studies. The injection of botulinum toxin, although secure, seems to offer a smaller and more transient efficacy. Suture systems (TOGa, endoluminal vertical gastroplasty and POSE) appear to be effective but are technically more laborious. Malabsorptives procedures (Endobarrier, ValenTX) are somewhat laborious but effective, particularly indicated in obese patients with type 2 diabetes mellitus.
the development of new endoscopic techniques and improvement in existing designs, suggest an increasingly important role of the endoscopist in the treatment of obesity. We consider it important to individually select and use the endoscopic technique, depending on the desirable outcomes (efficacy, tolerance, safety, adverse effects and risks) and the experience of each hospital. We believe that these techniques should be applied by specifically trained endoscopists in specialized hospitals.
近年来，出现并发展了新的内镜策略和技术来治疗肥胖症。
本文将回顾和分析以下技术的现状以及它们之间的基本差异特征：球囊和假体、物质注射、缝合系统、吸收不良技术等，目前正在研究中。
我们将评估内镜技术及其主要适应证、结果、耐受性、观察到的并发症和不良反应，并报告我们的个人经验以及与广泛文献综述相关的内容。
与最广泛应用的生物反馈球囊技术相比，Spatz 球囊可提供更大的减重效果，但耐受性更差且并发症更多，而 Heliosphere 袋可获得相似的减重效果，但技术难度更大。其他球囊和假体（Ullorex、Semitationary、Silimed、Endogast）仍需要技术改进和更高的研究。肉毒杆菌毒素注射虽然安全，但效果似乎更小且更短暂。缝合系统（TOGa、内镜垂直胃成形术和 POSE）似乎有效，但技术上更繁琐。吸收不良手术（Endobarrier、ValenTX）有点繁琐但有效，特别适用于肥胖合并 2 型糖尿病的患者。
新内镜技术的发展和现有设计的改进，提示内镜医生在肥胖症治疗中的作用越来越重要。我们认为，根据期望的结果（疗效、耐受性、安全性、不良反应和风险）以及每家医院的经验，个体化选择和使用内镜技术非常重要。我们认为这些技术应由专门培训的内镜医生在专门的医院应用。
