Nonsurgical Weight Loss Procedures

Gastric Balloon, AspireAssist, Endoscopic Gastric Sleeve, Endoscopic Gastric Bypass Revision

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Endoscopic weight loss procedures are a promising new option for people who want help losing weight but don't want -- or may not qualify for -- bariatric surgery. These nonsurgical procedures may also be an option for people who:

Are in earlier stages of obesity
Have a BMI between 30 and 40
Don't have obesity-related medical conditions

Endoscopic weight loss procedures achieve better weight loss than medication but not as much as bariatric surgery. Because they are newer procedures, more data is needed on how they perform over the long term. Endoscopic procedures are not covered by insurance at this time.

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How Nonsurgical Weight Loss Procedures Work

An endoscope is a thin, flexible tube with a light and camera at its tip that allows your doctor to view your internal organs or perform a procedure. The endoscope is inserted through a small opening in your body, such as your mouth, to reach your GI tract. Special instruments can be passed through the endoscope so your doctor can place a device or medication in your stomach.

Trained and Skilled in GI Endoscopy

These procedures require specialists with advanced training in GI endoscopy. Our surgeons and gastroenterologist have completed this advanced training and have years of experience performing these procedures with positive outcomes. We also train future weight loss surgeons to perform these procedures.

Our Team Helps You Achieve Success

Like other weight loss procedures, nonsurgical weight loss options require lifestyle changes for you to achieve success. Our bariatric team evaluates your condition as well as your commitment to making these lifestyle changes. We help you achieve your weight loss goals.

Our Locations

Attend your pre-surgical evaluation, all appointments, and monthly support meetings near where you work or live.

Find a Location

Gastric Balloon

The gastric balloon may be an option for adults whose BMI is between 30 and 40. First, the doctor gives you a mild sedative. Then, using an endoscope passed through your mouth, the doctor will insert a soft, durable balloon in your stomach and fill the balloon with a saline solution. This takes up space in your stomach, reducing the amount of food and drink you can fit and making you feel full longer. The procedure is quick, and you go home hours later.

Temporary, Reversible Solution

Gastric balloon is a temporary procedure; the balloon is removed after six months. It can be used to jump-start weight loss and/or to help you lose weight in order to reduce risks associated with surgery.

Expected Weight Loss

Rapid weight loss is typically experienced during the first four months following placement of the balloon. People who participated in a clinical trial of the gastric balloon had lost, on average, about 25% to 29% of their body weight at 12 months.

Possible Side Effects and Complications

In the first few days after it is placed, the gastric balloon can cause abdominal pain, nausea, and vomiting. It may also cause an increase in gas, belching, or bloating.

Who Is Not a Candidate for This Procedure

People with a history of hiatal hernia, previous gastric surgery, or acid reflux are not candidates for this procedure.

Take the Next Step

Fill out our application if you are interested in starting the weight loss surgery process. Once you've submitted the application, we will call you to schedule your first appointment.

Application

AspireAssist Device

The AspireAssist may be an option for people with a BMI between 35 and 55 who have not achieved sufficient weight loss through nonsurgical treatments. Your doctor will use an endoscope, inserted through a small incision in your abdomen, to place a small tube in your stomach. The tube is attached to a disk-shaped port valve that is placed flush against your skin on the outside of your stomach. About 20 to 30 minutes after every meal, a device is attached to the port and used to drain the contents of your stomach. This removes about 30% of calories consumed. The device can be removed at any time.

Expected Weight Loss

In clinical trials, people who used the device lost about 25% of their excess body weight after one year of using the device.

Requires Frequent Monitoring

Regular medical visits are required to ensure the disk remains flush against your skin and to shorten the tube as you lose weight. We also provide regular counseling on healthy lifestyle habits.

Possible Side Effects and Complications

The AspireAssist may cause indigestion, nausea, vomiting, constipation, and diarrhea. Risks associated with the placement of the tube and port include abdominal pain, inflammation around the area where the tube is placed, and the possibility that the device might migrate into the stomach wall.

Who Is Not a Candidate for This Procedure

People with uncontrolled hypertension, eating disorders, inflammatory bowel disease, and stomach ulcers are not candidates for this procedure.

Endoscopic Sleeve Gastroplasty, Gastric Plication

People with a BMI greater than 35 may be candidates for endoscopic sleeve gastroplasty. Folds are stitched into your stomach to reduce its size by about 70%. This restricts how much food and drink you can consume and makes you feel fuller faster. No part of your stomach is cut or removed. Only stitches hold the folds in place. The procedure can be undone, but scar tissue may remain. It can also be converted into another weight loss procedure if necessary.

Expected Weight Loss

Studies report that 60% of people lost about 20% of their total body weight during the first year after surgery. Evidence suggests endoscopic sleeve gastroplasty may improve obesity-related medical conditions, such as high blood pressure, diabetes, sleep apnea, and high cholesterol.

Possible Side Effects and Complications

Possible complications include leaks from the stomach fold, a blockage in the stomach if the folds are too tight, and damage to the stitches if the stomach expands.

Bariatric Center of Excellence

Duke Regional Hospital is accredited by the American Society for Metabolic and Bariatric Surgery for its high standards of care in weight loss surgery.

Endoscopic Gastric Bypass Revision

There are times when people have trouble reaching their weight loss goals -- or even gain weight -- after gastric bypass, because of stretching that may occur in the stomach and the connection between the stomach and small intestine. In this case, we may recommend an endoscopic gastric bypass revision, which is performed by inserting a tube into your mouth to reach your stomach. Endoscopic instruments passed through the tube are used by your surgeon to place stitches in your stomach to reduce its size or the size of the outlet to the small intestine.

This page was medically reviewed on 12/03/2021 by

Dana D. Portenier, MD | General Surgeon