'Gut sleeve' might one day help sidestep weight-loss surgeries

A study on rats finds that a removable silicone intestinal barrier tube works similarly to far more invasive bariatric surgeries. But will it work in humans?

The silicone sleeve is placed near the end of the stomach and reaches the first part of the small intestine. Gut

Bariatric surgery is primarily performed on people who are at least 100 pounds above their ideal weight and haven't been able to lose weight via diet, exercise, or medication. The aim is to restrict the amount of food people can digest by disrupting their digestive process. It's both invasive and irreversible -- essentially a last-ditch effort.

So a new study on rats out of the University of Cincinnati is worth a look considering the upside if it works on people as well as it did on the trial rats. (At this point, that's still a big if, though co-lead author Kirk Habegger said he expects these results to carry over to humans.)

Researchers inserted tiny "intestinal barrier sleeves" just inside the ends of the rats' stomachs and extended the sleeves along the intestine. They did this surgically in the rats, but say that in humans it could be done by endoscopy -- through the mouth and down into the gut -- which may not sound pleasant but is far less invasive and doesn't require hospitalization, not to mention the procedure is reversible since the sleeve can be removed.

"The whole key of course is to remove the knife," Habegger said in an interview. "If we can get to some sort of an intervention that is at least reversible, but even more so one that wouldn't require implantation of anything, is orally active or at least injectable, that's our goal."

For now, the flexible, nonpermeable silicone sleeve works similarly to other weight-loss surgeries in that both approaches hinder the absorption of calories and nutrients from the intestine. But it is a far more reductionist approach -- using the sleeve to block absorption instead of reconfiguring the stomach and intestines to force the food to bypass the lower stomach and upper intestine. And because the sleeve fits directly below the stomach in the upper part of the small intestine, it may even have an effect on the satiation triggers in that area.

Reporting in the journal Gut this month, the researchers say the sleeve did result in significant weight loss, as well as an improved balance between glucose and fats. The results even showed a change in bile acids that may relate to weight loss -- something that is being found in similar studies looking at "good" and "bad" bacteria in our guts. The research was a collaboration between scientists from the University of Cincinnati and the Helmholtz Zentrum Munchen in Germany.

Dr. Edward Phillips, director of the Weight Loss Center at Cedars-Sinai Medical Center, told HealthDay he'll soon be involved in a related clinical trial of the sleeve (this one on humans). According to HealthDay, he said that if it proves to be safe and stays in place long enough to be effective, it may qualify a lot more people for the procedure who aren't currently overweight enough to get surgery. It could even be performed on people with Crohn's and other illnesses for whom weight-loss surgeries aren't feasible.

 

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