Dr. Sullivan was also the first physician in the United States to place a transpyloric shuttle device in a human patient. The shuttle consists of a large spherical bulb connected by a flexible tether to a smaller cylindrical bulb. Once placed endoscopically, the bulbs create an intermittent seal intended to reduce the rate of gastric outflow, resulting in decreased caloric intake and increased weight loss. An open-label, nonrandomized study of 20 patients treated with the transpyloric shuttle was reported at a meeting of the Society of American Gastrointestinal and Endoscopic Surgeons in 2013 (abstract AB ET013). After six months, patients achieved a mean excess weight loss of 50%±26.4% and a mean weight loss of 15.6±5.7 kg. Two patients required device removal because of persistent gastric ulceration. Experts said it could be approved in the latter half of 2017. Today, there are eight endoscopic devices and techniques for diabetes that may come into clinical use before 2020, said Lee M. Kaplan, MD, PhD, director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital, in Boston. “The hope is because these various treatments and endoscopic devices target the GI tract, which is of course where bariatric surgery works, we will get to the point where some of these endoscopic treatments fall in the space between drugs and bariatric surgery. Maybe one day they will, but they are not quite there yet.”
