Original Article
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World J Gastrointest Endosc. Sep 16, 2014; 6(9): 419-431
Published online Sep 16, 2014. doi: 10.4253/wjge.v6.i9.419
Updates on gastric electrical stimulation to treat obesity: Systematic review and future perspectives
Ryan Cha, Jacques Marescaux, Michele Diana
Ryan Cha, Jacques Marescaux, Michele Diana, IHU-Strasbourg, Image-Guided Minimally Invasive Surgical Institute, University of Strasbourg, 67091 Strasbourg, France
Jacques Marescaux, Michele Diana, IRCAD, Digestive and Endocrine Surgery, University of Strasbourg, 67091 Strasbourg, France
Author contributions: Cha R was principal investigator, contributed to literature search, study selection, data extraction/analysis, tables for the result section and produced the first draft version of the manuscript; Marescaux J was editor, reviewed and edited the draft of the manuscript; Diana M was supervisor, provided direction of the study by helping with literature search, study selection and data extraction; the manuscript was revised to produce the final version.
Correspondence to: Dr. Michele Diana, MD, IHU-Strasbourg, Image-Guided Minimally Invasive Surgical Institute, University of Strasbourg, 1, Place de l’Hôpital, 67091 Strasbourg, France. michele.diana@ihu-strasbourg.eu
Telephone: +33-38-8119118 Fax: +33-38-8119099
Received: May 26, 2014
Revised: July 3, 2014
Accepted: August 27, 2014
Published online: September 16, 2014

AIM: To evaluate the current state-of-the-art of gastric electrical stimulation to treat obesity.

METHODS: Systematic reviews of all studies have been conducted to evaluate the effect of different types of gastric electrical stimulation (GES) on obesity.

RESULTS: Thirty-one studies consisting of a total of 33 different trials were included in the systematic review for data analysis. Weight loss was achieved in most studies, especially during the first 12 mo, but only very few studies had a follow-up period longer than 1 year. Among those that had a longer follow-up period, many were from the Transcend® (Implantable Gastric Stimulation) device group and maintained significant weight loss. Other significant results included changes in appetite/satiety, gastric emptying rate, blood pressure and neurohormone levels or biochemical markers such as ghrelin or HbA1c respectively.

CONCLUSION: GES holds great promises to be an effective obesity treatment. However, stronger evidence is required through more studies with a standardized way of carrying out trials and reporting outcomes, to determine the long-term effect of GES on obesity.

Keywords: Gastric electrical stimulation, TANTALUS® system, Transcend® implantable gastric stimulator, Retrograde gastric electrical stimulation, Gastric vagal nerve stimulation, Gastric pacing, EMPOWER trial, Dual-lead implantable gastric electrical stimulation trial, Laparoscopic obesity stimulation survey, Screened health assessment and pacer evaluation

Core tip: Obesity is a major issue in many countries. Current medical treatments do not last long enough and while surgical interventions are more effective, they imply a higher risk of complications. This review contains the most up-to-date information on gastric electrical stimulation, which has shown to be a less invasive and potentially effective treatment option for the treatment of obesity.