Endoprothèse duodénale

Morbid obesity is a rapidly growing problem in western society. Bariatric surgery is now recommanded in obese patients in order to manage the excess of body weight and associated co-morbidities. Roux-en-Y gastric bypass method demonstrated that the control of type 2 diabetes is independent of the body weight loss and suggested that the duodenal exclusion is one of the key of diabetes resolution after the surgery. GI Dynamics™, Inc. has recently developed an EndoBarrier® gastrointestinal liner (EndoBarrier®) which results in improvement in glycemic control and weight loss. This device is an endoscopic implant mimicking the hormonal changes (i.e. increase in glucagon-like peptide-1 [GLP-1] and peptide YY [PYY] circulating levels) observed after a gastric bypass surgery. Preliminary clinical studies showed the safety of this device and its reversibility. Duodenal endobarrier remained functional for 12 months. It opens the new area of surgical-like management of obesity and type 2 diabetes.