[EndoBarrier for counteracting obesity and metabolic syndrome]

The prevalence of obesity is increasing worldwide. Its primary treatment consists of lifestyle changes. In severely obese (BMI > 40 kg/m2 or ≥ 35 kg/m2 with comorbidity) patients though, bariatric surgery has been found to be the only way to achieve permanent weight loss. Operations such as the placement of a gastric band or a gastric bypass can, however, lead to complications and necessitate secondary interventions. In search of less invasive treatments, placement of the EndoBarrier duodenal jejunal bypass liner appears to be a promising, safe and effective method for facilitating weight loss. The EndoBarrier is a plastic flexible tube which is gastroscopically placed in the duodenal bulb, directly behind the pylorus. It extends from the duodenum to the proximal jejunum. Recent studies have demonstrated significant weight reduction in comparison to control-diet patients. Concomitant positive effects on cardiovascular risk factors including diabetes type 2 were observed. A multicentre trial is currently being executed in order to unravel the mechanism behind these effects.