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Nwaiwu et al. Mini-invasive Surg. 2025;9:20 https://dx.doi.org/10.20517/2574-1225.2024.112 Page 3 of 20

Table 1. Overview of EBMT by category: mechanisms, indications, and efficacy

Efficacy (at 12 months,
EBMT Mechanism Indication
unless otherwise specified)
Gastric remodeling/endoscopic suturing devices
2
ESG Gastric volume reduction via full-thickness endoscopic suturing BMI ≥ 30 kg/m , failed lifestyle/medical %TBWL: 15.6-19.2
therapy, bridge to surgery %EWL: 47.9-71.0
POSE Endoscopic gastric plication using suture-anchor devices Class I-II obesity, failed lifestyle/medical %TBWL: 7.0-15.7
therapy %EWL: 45.0
TOGA Stapled pouch creation along the lesser curvature Morbid obesity, early satiety induction %TBWL: Not consistently
reported
%EWL: 44.8
Space-occupying devices
IGBs
2
• Fluid-filled IGBs: Orbera balloon system, Orbera 365 balloon, Saline-filled balloons placed endoscopically; Spatz3 is adjustable BMI 30-40 kg/m ; adolescents/adults; %TBWL: 3.1-14.7; %EWL: 25.4-
ReShape balloon system, the Spatz3 adjustable balloon Gas-filled or air-filled balloons; some are capsule-based and excreted bridge therapy 29.0
2 ‡
system naturally BMI 30-40 kg/m , failed lifestyle %TBWL: 7.1-14.2 ; %EWL: Not
• Gas-filled balloons: Obalon balloon system, the modifications clearly reported
TM
Heliosphere® BAG, the Elipse balloon
TPS Intragastric-duodenal device delaying gastric emptying Class I-II obesity %TBWL: 9.5%
%EWL: Not clearly reported
SatiSphere Self-expanding duodenal device that slows food transit Obesity, delayed gastric emptying desired %TBWL: Not specified
*
%EWL: 18.4
Absorption limiting interventions
DJBL 60-cm impermeable fluoropolymer sleeve anchored in the duodenal Morbid obesity with comorbidities %TBWL: 15.0
bulb to prevent mixing of chyme with bile and pancreatic secretions %EWL: 44.5
GJBS 120-cm impermeable sleeve anchored at the gastroesophageal Obesity + diabetes %TBWL: Not reported
junction, bypassing the stomach, duodenum, and proximal jejunum %EWL: 35.9
IMAS Endoscopic placement of self-assembling magnets to create a side-to- Severe obesity +/- T2DM %TBWL: 14.6
side jejunoileal bypass without incisions %EWL: 40.2
†
MS Duodenoileostomy using self-assembling magnets T2DM with mild obesity (BMI 24-40) %TBWL: 28.1
†
%EWL: 66.2
Others
†
DMR Hydrothermal ablation of duodenal mucosa to reset intestinal Experimental, abandoned; occasional use %TBWL: ~1.9-3.1 kg (modest)
†
hormone signaling and improve insulin sensitivity with high-dose multi-injection %EWL: Not significant
2
Aspiration therapy Percutaneous gastrostomy tube used to aspirate ~30% of ingested BMI 35-55 kg/m , failed non-surgical %TBWL: 16.5-17.8
food therapy %EWL: 46.2
Intragastric BTA injection Inhibits acetylcholine, delays gastric emptying, suppresses appetite Investigational use only; largely %TBWL: 2.0-4.4 kg (BMI: 1.25
2 §
abandoned due to limited efficacy kg/m )
%EWL: Not significantly different
from control in most studies