Utilization of Temporary Controllable Intragastric Pseudobezoars for the Treatment of Obesity

Abstract

The growing worldwide obesity epidemic has prompted the development of two main treatment streams: 1) conservative approaches and 2) invasive techniques. However, only invasive surgical methods have delivered significant and sustainable benefits. Therefore, contemporary research exploration has focused on the development of gastric volume reduction methods having noninvasive administration and termination, while featuring a safe but reliable and long-term sustainable weight loss effect similar to the one delivered by bariatric surgeries. This antiobesity approach is based on placing external devices in the stomach ranging from intragastric balloons to temporary pseudobezoars for a predetermined amount of time. The present review examines the evolution of these techniques from invasively positionable and removable units to completely noninvasive patient-controllable implements. Comparative discussion over the available pilot and clinical studies related to temporary controllable pseudobezoars outlines this new concept as an alternative gastric volume reduction antiobesity strategy. Available short-term studies reported an average weight loss of 6% for a 1-month period. The beneficial features of this method include patient-specific design, performance flexibility, full controllability, and particularly low level or lack of side effects. More multicenter, placebo-controlled, long-term studies on a significant number of patients and further technological improvements of the design of the pseudobezoars are required before the technique can be considered a reliable alternative to present-day bariatric surgeries.

Forensic Features of Pharmacobezoars

“…Bezoars from gelatine‐based candies have been described , and a Vaseline bezoar was reported in the cecum and ascending colon of a 13‐month‐old girl following ingestion of 50 g of Vaseline . Over the past 30 years, there has been interest in the use of “pseudobezoars” in the treatment of obesity, with the introduction of foreign bodies into the stomach to induce early satiety .…”

Transcutaneous Intraluminal Impedance Measurement for Minimally Invasive Monitoring of Gastric Motility: Validation in Acute Canine Models

“…The parameters of the expandable capsule were chosen to have minimal impact on the stomach and to maintain ease of swallowing, while still being able to ensure gastric retention, even during interdigestive periods [ 8 ]. The permeable gastric-retentive capsule design has self-disintegration capabilities in 2-3 days, with no adverse mucosal impact or evacuation/obstruction issues, as previously described [ 18 ]. In addition, in this design we utilized temperature-controllable PVA mesh, which can be immediately disintegrated on demand by administering hot (>40°C) water.…”

Gastric Electrical Stimulation for the Treatment of Obesity: From Entrainment to Bezoars—A Functional Review

“…Recently, a patent application has been filed to that extent [164]. However, although the purely mechanical presence of electrically passive pseudobezoars in the stomach has been already successfully tested on a limited number of humans [165, 166], the combined technique (gastric retentive pseudobezoar GES) has not yet been examined even in pilot studies, and its utility remains to be determined. …”