**8. Others**

#### **8.1 SatiSphere**

The endoluminal mechanical device is a patent of Endosphere Inc. Columbus, OH, USA for implantation for 3 months. It is implanted endoscopically into the stomach and duodenum through an endoscope under general anesthesia and is composed of a nitinol backbone and spheres made of polyethylenterephtalat with two pigtails at each end. The stent form was made to stay in place by mimicking the anatomy of corresponding parts of the human intestine especially the duodenal C-shape down to the ligament of Treitz.

Results: Sauer et al. [36] reported about 26 treated patients. The study was prematurely terminated.

Complications: Migration of the endoluminal mechanical device was seen in 10/21 patients. Serious adverse events occurred in 10 out of 21 patients in the treatment group.

#### **8.2 Full sense device**

This device was introduced 2014 with an internet presentation. The Full Sense Device (Baker, Foote, Kemmeter, Walburn LLC, Grand Rapids, MI) is a temporary, reversible device that is deployed and removed endoscopically. It is a modified fully-covered stent with an esophageal component and a gastric disk component. To stretch the proximal stomach (cardia and fundus) stimulates the vagal nuclei and the vagus nervely. It is designed to induce satiety and fullness in the absence of food by applying pressure on the distal esophagus and gastric cardia.

Results: Only preliminary studies exist. Park and colleagues reported about FSD implantation in 12 pigs [37]. They used fully-covered, partially covered and uncovered stent devices. Luo and colleagues searched for the effects of this system in a rodent model [38].

Complications: There was a high migration rate (11/12) in the porcine model.

#### **9. Endoscopic post-surgical complication management**

Relevant early and longtime complications can occur after bariatric surgery. Because the majority of symptomatic patients are endoscopically evaluated, the gastroenterologists must be familiar with post-surgical anatomy and complications, and their endoscopic management.

#### **9.1 Acute complications**

#### *9.1.1 Bleeding*

Endoluminal hemorrhage after resective procedures in bariatric patients occur with an incidence of up to 5% [39]. Depending on the pathology, endoscopic

hemostasis can be achieved by clip (OTSC or TTSC), submucosal injection with fibrin glue or by endoscopic application of hematostyptics.
