Saturday October 25, 2014
Weight Loss Surgery Improves Health
The Blue Cross and Blue Shield Association Technology Evaluation Center reported that "surgery improves health outcomes for patients with morbid obesity as compared to nonsurgical treatment."

EndoBarrier Gastrointestinal Liner

EndoBarrier Gastrointestinal Liner

The EndoBarrier mimics the beneficial effects of gastric bypass surgery, without the risks of surgery.

The EndoBarrier Gastrointestinal Liner is an innovative and non-surgical medical device for the treatment of type 2 diabetes and obesity. It is designed to help patients gain metabolic control by placing a barrier between food and a portion of the small intestine where digestion occurs.

The EndoBarrier does not require surgical incisions, does not alter the anatomy, and is easily removed upon completion of treatment. Results to date have shown benefits similar to those achieved with weight loss surgery, but without the need for surgery.

Based on the growing body of clinical evidence, the EndoBarrier has the potential to dramatically change the treatment approach for people living with type 2 diabetes, obese people at risk for type 2 diabetes, and people with severe weight problems.

The EndoBarrier received the European CE mark of approval in December 2009 and will be available in select markets later in 2010. In the United States, the EndoBarrier is in advanced investigation studies and not yet available.

About the EndoBarrier Technology

Developed by GI Dynamics, the EndoBarrier Technology platform fits into a new class of metabolic treatment, called non-surgical therapeutics. Non-surgical therapeutics bridge the gap between pharmaceuticals and surgery, offering an effective treatment alternative for patients who are unhappy with the current methods of treating and managing type 2 diabetes or obesity.

The medical devices developed with the EndoBarrier Technology include:

  • EndoBarrier Gastrointestinal Liner
  • EndoBarrier Flow Restrictor

The EndoBarrier Gastrointestinal Liner, also called a GI sleeve, is a teflon liner that is placed in the gastrointestinal (GI) tract endoscopically (via the mouth) to create a barrier between food and the wall of the intestine. Physicians believe that the hormonal signals that originate in the intestine may be altered when food is prevented from coming into contact with the intestinal wall.

The EndoBarrier Flow Restrictor is an additional mechanism which adds to the therapeutic effects of the liner. It is a membrane with a small opening that is designed to delay gastric emptying by providing adjustable restriction at the stomach outlet.

The EndoBarrier Technology is designed to eliminate or reduce the risks and side effects associated with pharmaceutical therapy or surgical options, while providing similar benefits.

The EndoBarrier Procedure

EndoBarrier Gastrointestinal Liner

The EndoBarrier placement and removal are quick, easy, and incision-free endoscopic procedures.

The EndoBarrier placement is an outpatient procedure that takes about 30 minutes to perform. It is placed in the GI tract endoscopically (via the mouth) and does not require incisions. The medical device is positioned in the duodenal bulb and fastened into place with an anchor. The liner extends approximately 2 feet through the small intestine (duodenum and proximal jejunum).

The EndoBarrier is removed after the treatment period, which has ranged anywhere from three to twelve months in clinical trials. The removal process is a quick (about 15 minutes) and easy endoscopic procedure that is performed using a custom retrieval system.

Results with EndoBarrier

Clinical data has shown that the EndoBarrier Gastrointestinal Liner, when combined with certain diet and lifestyle modifications, can help patients achieve significant weight loss and a rapid improvement in diabetes. The amount of weight loss is approximately doubled when the EndoBarrier Flow Restrictor is used in combination with the EndoBarrier Gastrointestinal Liner.

The following results were achieved by patients who were treated with the EndoBarrier:

  • Near normalization of glycemic control in just one week
  • A significant reduction in HbA1c glucose levels at 24 weeks
  • A reduction in fasting blood glucose levels at 24 weeks
  • Excess weight loss of 24.3% at 24 weeks

While the EndoBarrier is still considered an investigational device in the United States, it has the potential to revolutionize the way we treat individuals with obesity and type 2 diabetes.

Cost of EndoBarrier

The EndoBarrier is not yet FDA approved for marketing in the United States and the cost has yet been determined; however, GI Dynamics has indicated that it will be about half the cost of a gastric band procedure and a quarter of the cost of gastric bypass surgery.

Summary

The EndoBarrier Technology is a promising new treatment approach for type 2 diabetes and obesity. Although the EndoBarrier is still investigational in the United States, preliminary study results have demonstrated it to be a feasible and safe non-invasive medical device with excellent short-term weight loss results and a significant positive effect on type 2 diabetes.

Interested individuals can visit WLS Help News for Related Articles on EndoBarrier.

Consumer Guide to WLS

WLS Diet

EndoBarrier Quick Facts

  • A non-surgical, medical device to treat type 2 diabetes and obesity.
  • Alters digestion to decrease blood sugar and body weight.
  • Reversible and does not alter the body's natural anatomy.
  • Quick, endoscopic (through the mouth), outpatient procedure.
  • Treatment period lasts up to 12 months.

How It Works

The EndoBarrier is a thin, flexible, tube-shaped liner that forms a physical barrier between food and the top portion of the wall of the small intestine.

The device is designed to alter the digestion process by reducing food absorption, resulting in improved glucose control and significant weight loss.

Clinical Trials

The ENDO Trial is currently underway in the United States to gain FDA approval.

Endobarrier is not yet available for sale in the U.S. and is limited by federal law to investigational use only in the U.S.

Outside the U.S., EndoBarrier has been approved for use in Europe (in 2010), Australia (in 2011), and in select regions of South America and the Middle East.

Patient Criteria

  • Age 21 to 65 years
  • Uncontrolled diabetes (HbA1c from 8.0% to 10%)
  • Obesity (BMI from 30 to 50)
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  • Without surgery, diet and exercise alone achieve an average long term weight loss of only 10% in severely obese individuals.
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