title: [Endobarrier: a unique but still premature concept].
abstract: The EndoBarrier, an endoscopically delivered duodeno-jejunal bypass device, is a unique concept that starts to ameliorate the symptoms of diabetes mellitus type 2, soon after positioning. Weight-loss results are moderate, with 85% of patients showing a more than 10% excess weight loss in the 12 weeks preoperatively. Sufficient implant training is required, but problems can still occur, e.g., due to a short duodenal bulb length. The stability of the anchors and the tolerability of the device still leave much to be desired. In 25% of patients the EndoBarrier is explanted early, because of migration, physical symptoms, gastrointestinal haemorrhage, rotation and obstruction. Only seven studies on the EndoBarrier are available and these are mostly small in size, short-term and with limited follow-up, and many questions regarding the safety and long-term effects of the device remain. This calls for a large, long-term, randomised, placebo-controlled, double-blind trial. Lessons should have been learned from the disastrous results with intragastric balloon implantation before commercialising another such product.
authors.affiliation: Academisch Medisch Centrum/UvA, afd. Maag-, Darm- en Leverziekten, Amsterdam, The Netherlands. e.mathus-vliegen@amc.uva.nl
authors.forename: E M H
authors.initials: EM
authors.lastname: Mathus-Vliegen
mesh_terms: D050110:Bariatric Surgery / Q000295:instrumentation*; D004386:Duodenum / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D009767:Obesity, Morbid / Q000601:surgery*; D015431:Weight Loss / Q000502:physiology*