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Special report: Endoscopy, beyond the cutting edge

March 25, 2013
Endoscopy International Day of Radiology 2012
From the March 2013 issue of HealthCare Business News magazine

Nevertheless, the eventual entry of intragastric weight loss balloons into the U.S. market seems likely. The product’s popularity has even prompted a surge in health tourism among obese Americans eager to use the balloon for weight loss. In fact, it’s estimated that American travelers account for almost a third of all intragastric procedures performed in Canadian clinics.

The balloon, inserted into the mouth and lowered down the throat into the patient’s stomach, is then expanded, creating a sense of early and prolonged fullness after meals. Although these balloons are still not available in the United States, the devices are widely used across the globe, including some parts of Europe, Australia, Mexico, Canada and South America.

Lingering questions around the balloon’s efficacy stand in the way of wider adoption in the U.S. The balloon must be taken out of the patient after six months, and the procedure is only designed for patients who want to lose 50 pounds or less. Because the average amount of weight lost is low compared to other bariatric procedures, and since many patients gain most of their weight back afterward, many doctors see only a limited benefit in introducing the product to the U.S. market.

However, the benefits may soon outweigh the drawbacks as manufacturers continue to refine their products. Gastric device company Spatz FGIA, Inc. recently released the world’s first intragastric balloon approved for one-year implantation. If manufacturers can prove that their products foster longer-term, sustained weight loss and better health outcomes, they may eventually justify their entrance into the U.S. market.

Popped balloons?
With the wealth of innovative products already in the works, it seems counterintuitive that the industry is also suffering from a widely acknowledged shortage of surgeons.

According to University of Chicago’s Waxman, numerous complex issues such as reimbursement policies and length of training contribute to the problem. “If I were finishing medical school right now, I would be very worried about health care reform, and training, and what am I going to get out of it. To do interventional gastroenterology when you’re already coming out with an economic burden – you’re asking people to do 11 years of training,” he says.

The surgeon shortage is a global issue as well. “The availability of trained endoscopists in some of the emerging markets is a big initiative for us,” says Boston Scientific’s Pierce. “We do a lot of specific things to help support it. For example, in India we’ve started programs to help physicians that are endeavoring to train as endoscopists so the practice can spread beyond rural areas.”

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