Newer Endoluminal Interventions for Obesity

At present, several primary endoluminal weight loss procedures are under investigation, all of which aim to reproduce more invasive, restrictive, or malabsorptive operations. They are in various stages of development and clinical application, in the USA and the rest of the world. They have been designed to address refractory obesity for patients with body mass index (BMI) in the range of 30-35, as well as for those individuals who currently are candidates for more traditional bariatric surgery (BMI >35). Although nearly all of those devices have been developed in the USA, most of the clinical trials have been performed outside of the USA, since the regulatory pathways in regions such as Europe and South America are less stringent than those set by the United States Food and Drug Administration (US FDA). This chapter will discuss the results of those trials, along with descriptions of devices and procedures still in the preclinical phase of development.