METABOLIC ENDOBARIATRICS
Metabolic Endobariatrics is a newly evolving medical field that uses endoscopic procedures performed without incisions to treat metabolic diseases; especially type 2 diabetes, Metabolic associated Fatty Liver Disease (MAFLD), Hyperlipidemia, and Metabolic Syndrome.
Metabolic endobariatric techniques focus upon Gastro-intestinal remodeling in order to influence appetite, sense of fullness, and flow of nutrients which result in Metabolic improvements that are independent of weight loss. Rather, they have their impact by enhancing insulin sensitivity and/or causing changes in gut hormone signaling. They represent potentially exciting additions to the field of Endobariatrics.
Gastric Mucosal Ablation (GMA):
Gastric mucosal ablation is an endoscopic, minimally invasive technique in which targeted areas of the stomach’s mucosal lining are intentionally destroyed (ablated) using energy-based devices. The goal is to trigger tissue remodeling and physiologic changes that can improve metabolic function or reduce weight.
How does Gastric Mucosal Ablation work?:
Energy sources such as hydrothermal, radiofrequency, or plasma are applied through an endoscope to ablate (remove/damage) the superficial gastric mucosa.
Why is Gastric Mucosal Ablation done?
GMA is performed to alter gastric physiology in ways that mimic some effects of bariatric surgery, such as slowing gastric emptying or modifying hormonal signaling (e.g., ghrelin).
What happens after Gastric Mucosal Ablation is performed?
The ablated mucosa heals and regenerates, which results in functional changes in the stomach – decreasing ghrelin hormone production. It is an emerging therapy with promising early results
Duodenal Mucosal Resurfacing (DMR)
Duodenal Mucosal Resurfacing (DMR) is an endoscopic, minimally invasive metabolic procedure that uses hydrothermal energy to ablate (remove) the superficial mucosal layer of the duodenum. The goal is to reset abnormal nutrient-sensing mechanisms in the proximal small intestine that contribute to insulin resistance and type 2 diabetes.
How does Duodenal Mucosal Resurfacing works?
An endoscopic catheter delivers controlled hot-water thermal ablation to a circumferential segment of the duodenal mucosa. The tissue then regenerates over a few weeks.
Why is Duodenal Mucosal Resurfacing Done?
DMR is performed in order to improve glycemic control by reducing Insulin resistance. This can decrease HbA1c and improve other metabolic markers. It is presently Intended for patients with type 2 diabetes, often those on oral agents.
What is the mechanism of Duodenal Mucosal Resurfacing?
DMR is thought to “reset” duodenal mucosal signaling, which is altered in insulin-resistant states. This reduces abnormal incretin/anti-incretin signaling and improves metabolic pathways. In addition, it may also have impact upon obesity.
Is Duodenal Mucosal Resurfacing presently available?DMR is considered an emerging therapy. There are presently three different technologies that are undergoing FDA clinical trials.
READY TO GET STARTED WITH DR. CHIASSON?
In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. You are not alone and you do not need to feel any less of a person if you are overweight or obese. Take action now and increase your quality of life with Dr. Patrick Chiasson, the leading Tucson Bariatric Surgeon.