Incisionless device could revolutionise treatment for metabolic diseases

A completely incisionless device that replicates metabolic surgery without making any cuts could surpass current technologies for managing conditions such as severe obesity and type 2 diabetes, a team led by an Indian researcher has found.

The ForePass device could provide unmatched treatment for millions of people who reject invasive surgery or do not respond to drugs, the researchers said.

The study led by Manoel Galvao Neto, from Sri Aurobindo Medical College in Madhya Pradesh, found that the ForePass endoscopic showed extraordinary efficacy in treating conditions such as severe obesity, type 2 diabetes, and metabolic dysfunction-associated steatohepatitis (MASH).

Results, published in the journal Gut, revealed a 79 per cent reduction in weight gain compared to the control group, suggesting it may be substantially more effective than common metabolic surgeries like gastric bypass.

The study also showed substantial improvements in how the body handles insulin and reduces glucose in the liver compared to controls, the researchers said.

It found markedly improved response to insulin, enhanced use of glucose, and beneficial changes in metabolic health-related gut bacteria, they said.

"The ForePass device will be a game-changer for treating severe metabolic conditions. It replicates the effects of metabolic surgery without invasive procedures and without making any cuts to internal organs. It's the first device of its kind and will pave the way for a new era in managing severe metabolic conditions," said Neto.

It is a crucial development, as only 1 per cent of patients opt for bariatric surgery due to its invasive nature. The medical community is eagerly anticipating the upcoming clinical trials involving the ForePass device, he added.

ForePass is an innovative device that combines a gastric balloon crossed by a central channel that connects to a flexible intestinal sleeve, thereby effectively replicating the mechanism of invasive metabolic surgery without the need for surgery or making any incisions, according to the researchers.

The device is inserted into the stomach and initial tract of the small intestine using endoscopy, a much less invasive and cheaper procedure compared to metabolic surgery, they said.

Unlike metabolic surgery, ForePass is fully reversible, making it an appealing option for patients.

For the study, pigs were implanted with ForePass for a month, and the device demonstrated a significant 79 per cent decrease in weight gain and marked enhancements in glucose balance compared to control animals who were not implanted with the device.

It also favourably altered fecal microbiota, boosting bacteria linked to metabolic well-being. These outcomes align with a reversal of severe obesity, diabetes, and MASH, indicating an overall improvement in metabolic health, the researchers added.