26 results match your criteria: "Endovitta Institute[Affiliation]"

Metabolic and Bariatric Surgeon Criteria-An International Experts' Consensus.

Obes Surg

September 2024

Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Director of Bariatric and Metabolic Surgery, Harvard Medical School, Boston, MA, USA.

Article Synopsis
  • The study highlights the increasing importance of metabolic and bariatric surgery (MBS) in addressing global obesity, emphasizing the need for rigorous academic and fellowship training for surgeons.
  • A Modified Delphi method involving 89 surgeons from 42 countries was used to establish expert consensus on the necessary criteria for surgeons to obtain privileges for performing MBS, reaching agreement on 29 out of 30 statements.
  • Key consensus points include the requirement for surgeons to hold a general surgery degree, complete a dedicated fellowship, and adhere to defined learning curves for various MBS procedures, alongside maintaining patient data and collaborating in a multidisciplinary team.
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Article Synopsis
  • * A study using a consensus method involved 78 bariatric surgeons globally, who agreed on 54 statements regarding when to use MBS for Class I and II obesity, determining a 70% agreement threshold.
  • * The experts concluded that MBS is cost-effective for Class II obesity and Class I obesity with inadequate weight loss from non-surgical methods, and identified specific surgical options including intra-gastric balloon, endoscopic sleeve gastroplasty, sleeve gastrectomy, Roux-en-Y gastric bypass, and one
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Article Synopsis
  • Endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure aimed at treating mild to moderate obesity, but its effectiveness for overweight patients had not been well-documented prior to this study.
  • In a multicenter study involving 189 participants from multiple countries, ESG was shown to be safe with a low rate of adverse events (1.5%) and significant weight loss over a 36-month period (mean 12.28% total weight loss).
  • The procedure also resulted in high rates of BMI normalization, especially in patients with lower initial BMI after 6 and 12 months, suggesting that ESG could be an effective way to halt or delay the progression of obesity.
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Video 1Endoscopic resection of a gastric GI stromal tumor using the helix-snaring technique.

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The use of digital technology is increasing rapidly across surgical specialities, yet there is no consensus for the term 'digital surgery'. This is critical as digital health technologies present technical, governance, and legal challenges which are unique to the surgeon and surgical patient. We aim to define the term digital surgery and the ethical issues surrounding its clinical application, and to identify barriers and research goals for future practice.

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Since its first description in 2013, robust evidence supporting the efficacy and safety of the endoscopic sleeve gastroplasty (ESG) has been on the rise. A large case series and meta-analysis report supported results up to 24 months, while some other studies already described 5-year data. If associated with pharmacotherapy, the ESG may help one to achieve weight loss similar to that of surgical sleeve gastrectomy.

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Adjustable intragastric balloon for obesity.

Lancet

June 2022

Endovitta Institute, São Paulo, Brazil; ABC Faculty of Medicine, Santo Andre, Brazil; Gastroenterology and Surgery Department, Sri Aurobindo Medical College, Indore, India.

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Introduction: Argon plasma coagulation (APC) alone is effective and safe at treating weight regain following Roux-en-Y gastric bypass (RYGB). However, technical details of the treatment vary widely among studies. Therefore, we aimed to create good clinical practice guidelines through a modified Delphi consensus, including experts from the collaborative Bariatric Endoscopy Brazilian group.

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Purpose: Banded Roux-en-Y gastric bypass (RYGB) was a common bariatric procedure in the 2000s, and the ring slippage is one of its late adverse events. Both plastic and metallic stents have been reported as adjunct methods to induce erosion and facilitate endoscopic removal of the ring.

Objective: To compare the safety and effectiveness of self-expanding metallic stents (SEMS) and plastic stents (SEPS) to treat ring slippage.

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Endoscopic Procedures for Weight Loss.

Curr Obes Rep

September 2021

Department of Surgery, ABC Faculty of Medicine, Santo Andre, Brazil.

Purpose Of Review: To provide updated evidence on the endoscopic procedures for weight loss and to bring personal insights on the future of endobariatrics.

Recent Findings: Intragastric balloons promote significant improvement in histologic and radiologic aspects of non-alcoholic steatohepatitis; the endoscopic sleeve gastroplasty is effective up to 5 years and seems particularly beneficial to patients with BMI≤40kg/m; distal POSE is a promising technique but still lacks adequate clinical data; aspiration therapy triggers remarkable weight loss, but data on weight trends after removal of the device are still lacking; the satiety-inducing device, the sleeveballoon, the gastric mucosal devitalization, and the endoscopic magnetic partial jejunal diversion are promising procedures still under study and refinements. Several therapeutic options are necessary during obesity's natural history.

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Background: For high-risk classified patients, patients with superobesity and in cases of contraindication to abdominal surgery, traditional bariatric surgery might lead to potential morbidity and mortality. Endoscopic sleeve gastroplasty (ESG) is a novel and effective bariatric therapy for morbidly obese patients. Our research group initially evaluated the safety, feasibility, and efficacy of ESG for high-risk, high body mass index (BMI) patients, and patients contraindicated to abdominal surgeries.

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Duodenal mucosal resurfacing (DMR) is an endoscopic procedure which improves insulin resistant metabolic disease, including type 2 diabetes mellitus (T2DM). The aim of this report was to evaluate the feasibility and procedural aspects of DMR and to provide more specific DMR procedural guidance for endoscopists. In this international multicenter, prospective, open-label study, patients on oral anti-diabetic agents for treating T2DM underwent single DMR.

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Brazilian Consensus on Endoscopic Sleeve Gastroplasty.

Obes Surg

January 2021

Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 W Copeland Dr, 1st Floor, Orlando, FL, USA.

Purpose: Bariatric endoscopy is a less invasive approach for obesity management, with better efficacy than pharmacological treatment and low morbidity. Endoscopic sleeve gastroplasty (ESG) is the remodeling of the stomach using a suturing device showing technical feasibility, safety, and sustained weight loss. With growing numbers of procedures worldwide, there is a need to standardize the procedure.

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Unlabelled: Insulin resistance is a core pathophysiological defect underscoring type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). Both conditions improve with duodenal exclusion surgery. Duodenal mucosal resurfacing (DMR) is an endoscopic intervention developed to treat metabolic disease which has been shown to improve glycaemia in patients with poorly controlled T2DM.

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Article Synopsis
  • Roux-en-Y gastric bypass is a common bariatric surgery, but about 20% of patients experience weight regain, often due to the enlargement of the anastomosis.
  • A study evaluated the effects of endoscopic argon plasma coagulation (APC) on these enlarged anastomoses compared to standard multidisciplinary management.
  • Results showed that patients treated with APC had significant improvements in weight loss, satiety, and overall quality of life, indicating that APC is a safe and effective option for managing weight regain after surgery.
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Efficacy and Safety of Endoscopic Sleeve Gastroplasty: A Systematic Review and Meta-Analysis.

Clin Gastroenterol Hepatol

May 2020

Division of Gastroenterology, Johns Hopkins Medicine, Baltimore, Maryland. Electronic address:

Background & Aims: Bariatric surgery is the most successful treatment for obesity. However, many patients avoid surgery due to its perceived invasive nature and fear of complications. Endoscopic sleeve gastroplasty (ESG) is a seemingly less invasive option for patients with obesity.

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Outcomes of a novel bariatric stent in the management of sleeve gastrectomy leaks: a multicenter study.

Surg Obes Relat Dis

August 2019

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:

Background: The management of laparoscopic sleeve gastrectomy leaks remains a challenge. This can be treated with placement of self-expandable metal stents, which are most effective in the acute and early settings. However, migration is a frequent adverse event (AE).

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Background And Aims: We aimed to develop duodenal mucosal resurfacing (DMR), a minimally invasive upper endoscopic hydrothermal ablation procedure, to treat insulin-resistant metabolic diseases.

Methods: We completed a sham-controlled, rodent proof-of-concept study and longitudinal safety study in pigs to demonstrate feasibility to test DMR in humans. Subsequently, the DMR procedure was implemented in an open-label first-in-human (FIH) study of safety and efficacy in patients with type 2 diabetes (T2D).

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