Table 12.

Description and weight loss associated with endoscopic bariatric interventions²⁷

Site of action	Endoscopic intervention	Endoscopic mechanism	Description	Excess weight loss at 6 or 12 months
Stomach	Intragastric balloon	Reduction in gastric volume	Endoscopic placement of balloons (Orbera or Reshape) that are filled with 400-700mls of blue saline which are removed after 6 months. 1–3 gas-filled balloons (obalon) are swallowed sequentially over a 12-month period and are removed after 3 months.	25%–32% at 12 months (orbera)
				27%–31% at 6 months (Reshape)
				25% at 6 months (Obalon – not available on the NHS)
	Endoscopic sleeve gastroplasty		Endoscopic staples or sutures applied along greater curvature of the stomach to reduce gastric volume by~70%.	28%–52% at 12 months
	Aspiration therapy	Aspiration of gastric contents	Endoscopic placement of a specialised 26Fr gastrostomy tube that is used to flush water into the stomach before aspirating gastric contents 20–30 mins after a meal	49%–54% at 12 months
Small intestine	Small bowel endobarrier sleeve	Bypass small bowel	A 60 cm nutrient-impermeable sleeve that extends from the duodenal bulb to the distal jejunum and remains in for a maximum of 12 months	35% at 12 months
					Duodenal mucosal resurfacing	Duodenal exclusion	Hydrothermal ablation using a 2 cm long balloon filled with 90°C heated fluid destroys superficial duodenal mucosa distal to the papilla of Vater up to the ligament of Treitz.	2.5% at 12 months