Endoscopy 2009; 41(12): 1082-1089
DOI: 10.1055/s-0029-1215269

© Georg Thieme Verlag KG Stuttgart · New York

Review of endoscopic devices for weight reduction: old and new balloons and implantable prostheses

N.  Tsesmeli1 , D.  Coumaros1
  • 1Service d’ Hépatogastroentérologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Further Information

Publication History

submitted 23 August 2008

accepted after revision 16 July 2009

Publication Date:
06 November 2009 (online)


The worldwide epidemic of obesity is forecast to worsen with a concomitant increase in the burden of co-morbid conditions. Bariatric surgery has some disadvantages, and intragastric balloons (IGBs) represent a generally safe, reversible and less invasive approach to weight reduction, based on occupying gastric space to enhance the sensation of satiety. A literature review found that the majority of the published data on IGBs relates to the Bioenterics intragastric balloon (BIB). The evidence for the efficacy of the BIB as a primary means of weight loss is still unconvincing, but it appears to have value in subgroups of patients, for example to improve quality of life, ameliorate co-morbidities, or provide a bridge to surgery. Regarding other IGBs, even if there are promising weight loss results, more evidence and development is generally needed: it is difficult to evaluate the Heliosphere Bag because of the limited clinical experience; the Adjustable Totally Implantable Intragastric Prosthesis (ATIIP)-Endogast may have problems associated with the percutaneous endoscopic gastrotomy (PEG)-type insertion method; the Semistationary Antral Balloon (SAB) may require technical improvements; and the Silimed Gastric Balloon (SGB) warrants further investigation. Another implantable device, the endoscopic duodenal-jejunal sleeve is based on a different concept, that of mimicking bariatric surgery; it effectively bypasses the duodenum and jejunum, and shows promising results. Other endoscopically implantable devices, such as the ”Butterfly“ and tubular membranes are at an experimental stage.


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N. TsesmeliMD 

Service d’Hépatogastroentérologie
Hôpitaux Universitaires de Strasbourg

1, place de l’Hôpital

Fax: +33-3-88116337

Email: tsesniki@gmail.com