New Advances

Intragastric Balloon and Implantable Gastric Stimulation Device
The implantable gastric stimulation device uses small electrodes attached to the stomach to create the feeling of fullness using electrical stimulation [5]. The intragastric balloon (Gastric Balloon Insertion or GBI) is a simple procedure that can be performed through an endoscope. The balloon is designed to “take up space” and thereby decrease the amount of food patients can eat [6]. Both of these procedures, while interesting in their simplicity, have not produced enough documented long-term weight loss. However, as these procedures are potentially much safer than other operations, they may have a significant role in the future.

Staged Procedures

Surgeons are devising cutting-edge procedures to decrease the complication rate in high-risk patients with extreme obesity or severe medical co-morbidities. Some surgeons are using a staged approach to bariatric surgery [7]. This approach involves two steps: first, a less invasive procedure that reduces weight to a safer level (which is not effective enough on its own) and improves overall medical condition; second, a more complex, definitive procedure is performed once the operative risks of the patient decrease significantly due to the initial weight loss. The primary, less invasive stage could include such procedures as the sleeve gastrectomy, the gastric balloon, and the adjustable band as an interim step before a gastric bypass or duodenal switch is performed [8].