Bio

Mohamad earned his undergraduate and MD degrees from the American University of Beirut (AUB) before completing a post-doctoral research fellowship at the GI Division of Johns Hopkins University (JHU) under Dr. Vivek Kumbhari. He then moved to Detroit for his Internal Medicine residency at Wayne State University, where he developed a special interest in improving the quality of life for patients with motility disorders. His academic interests include the intersection of neurological and gastrointestinal disorders, with a research focus on motility disorders in patients with autonomic dysfunction.

Clinical Focus

  • Fellow

All Publications

  • Impact of DAA Treatment for HCV on Hepatocellular Carcinoma in a Predominately African American Population JOURNAL OF GASTROINTESTINAL CANCER Itani, M. I., Farah, B., Wasvary, M., Wadehra, A., Wilson, T., Rutledge, B., Naylor, P., Beal, E. W., Mutchnick, M. 2024; 55 (3): 1324-1332

    Abstract

    This study tested the hypothesis that our predominately AA medical center population would demonstrate a decline in HCV-driven HCC diagnosis following the initiation of DAA treatment in 2014. Also evaluated was whether achieving an SVR prior to diagnosis of HCC improved outcomes in patients who had an HCV diagnosis after completion of treatment.All patients with HCC seen at the Detroit Medical Center from 2009 to 2021 were identified using ICD-10 codes, and medical records were evaluated. Outcomes were evaluated as either alive or death/hospice as of December of 2022.There were 461 patients with HCC of whom 433 (94%) had racial information in the database (AA = 351; non-AA = 82). HCC incidence regardless of race peaked in 2017, with a subsequent decline through 2021. HCV as a risk factor was higher in AA as compared to non-AA (85% vs. 53% p = 0.0001). Outcome (alive vs. death/hospice) was better for SVR patients compared to untreated patients (54% vs. 19%; p = 0.0009). HCC patients who achieved SVR also had better liver function at diagnosis as defined by Child-Pugh score (74% vs. 49% Class A p = 0.04) at the time of diagnosis.Racial disparity in HCC etiology was confirmed with AA more likely to have HCV than non-AA. The reduction in HCC patients with HCV confirms the impact of DAA treatment and prior successful treatment of HCV yields better outcomes. Increasing HCV treatment rates especially in AA patients will have a major impact on HCC development and treatment outcomes.• African Americans are more likely to have HCV infection as compared to non-AA. • Hepatocellular carcinoma is increasing in incidence in the US. • The role of HCV in the development of HCC remains to be further investigated.• HCC diagnosis in a single urban medical center study increased from 2009 as a result of HCV as a risk factor. • HCC declined post 2018 due primarily to a reduction in HCV infection as the risk factor. • African Americans were more likely to have HCV as the risk factor as compared to non-AA patients who were more likely to have no known risk factor on record (i.e., cryptogenic).

    View details for DOI 10.1007/s12029-024-01076-w

    View details for Web of Science ID 001263683000001

    View details for PubMedID 38972941

    View details for PubMedCentralID 2840947

  • Ulcerative Colitis Mortality Rate Trends the United States: Two-Decade Analysis Based on US Death Certificates Merza, N., Ahmed, Z., Nawras, M., Dar, S., Itani, M. I., Al-Hillan, A., Zafar, Y., Naguib, T., Kobeissy, A. A., Hassan, M., Islam, A., Alastal, Y. LIPPINCOTT WILLIAMS & WILKINS. 2023: S709-S710

    View details for Web of Science ID 001091849302063

  • Trends and Disparities in Acute Mesenteric Ischemia-Related Mortality in the United States: A Population-Based Study from 1999 to 2019 Awan, R., Sayed, A., Dar, S., Nabeel, A., Merza, N., Iqbal, A., Itani, M. I., Zafar, Y., Abegunde, A. T. LIPPINCOTT WILLIAMS & WILKINS. 2023: S176

    View details for Web of Science ID 001091849300233

  • A Systematic Review and Meta-Analysis of Folfirinox (FFX) vs Gemcitabine Plus Nab-Paclitaxel (GnP) as the Initial Treatment for Pancreatic Cancer (PC) Merza, N., Dar, S., Varughese, T., Mansur, S. A., Itani, M. I., Zafar, Y., Nawras, A., Naguib, T., Kobeissy, A. A., Islam, A., Alastal, Y., Hassan, M. LIPPINCOTT WILLIAMS & WILKINS. 2023: S39-S40

    View details for Web of Science ID 001091849300050

  • When One Hernia Is Not Enough: A Patient With a Large Type-III Hiatal Hernia and Ventral Wall Hernia Wilson, T. L., Dar, S., Merza, N., Zafar, Y., Awan, R., Iqbal, A., Itani, M. I. LIPPINCOTT WILLIAMS & WILKINS. 2023: S2660

    View details for Web of Science ID 001091849308037

  • Temporal Trends in Acute Cholangitis Mortality Rates from 1999 to 2021: An Analysis Using the CDC WONDER Database Merza, N., Dar, S., Awan, R., Iqbal, A., Itani, M. I., Zafar, Y., Naguib, T., Hassan, M., Islam, A., Alastal, Y., Kobeissy, A. A. LIPPINCOTT WILLIAMS & WILKINS. 2023: S38-S39

    View details for Web of Science ID 001091849300049

  • Pre-Cut Papillotomy vs Endoscopic Ultrasound (EUS) Rendezvous for Difficult Biliary Cannulation (DBC): A Systematic Review and Meta-Analysis Iqbal, A., Ahmad, Z., Awan, R., Merza, N., Zafar, Y., Dar, S., Itani, M. I., Hassan, M., Kobeissy, A. A. LIPPINCOTT WILLIAMS & WILKINS. 2023: S944-S945

    View details for Web of Science ID 001091849302355

  • Risk Factors and Outcomes Associated With Colonic Diverticular Bleeding: Results From Nationwide Inpatient Sample Database Tariq, T., Wilson, T. L., Damughatla, A. R., Itani, M. I., Khadra, M., Mohamad, B. LIPPINCOTT WILLIAMS & WILKINS. 2023: S592-S593

    View details for Web of Science ID 001091849301350

  • Severe Gastric and Duodenal Ulceration with Bowel Perforation as Rare Immunotherapy Related Adverse Events in Hepatocellular Carcinoma: A Case Report Wilson, T. L., Tariq, T., Itani, M. I., Majagi, A., Mohiuddin, A., Tisheh, L. A., Mohamad, B. LIPPINCOTT WILLIAMS & WILKINS. 2023: S2538

    View details for Web of Science ID 001091849307471

  • Reducing Inappropriate PPI Use Among the Veteran Population Using a Two-Step Process Saini, A., Damughatla, A. R., Wadehra, A., Itani, M. I., Wang, J., Mohamed, A., Abu-Heija, A., Bazzy, K., Antaki, F. LIPPINCOTT WILLIAMS & WILKINS. 2023: S1295

    View details for Web of Science ID 001091849303434

  • The Clinical Significance of Incidental GIT Uptake on PET/CT: Radiologic, Endoscopic, and Pathologic Correlation DIAGNOSTICS Hosni, M. N., Kassas, M., Itani, M. I., Rahal, M. A., Al-Zakleet, S., El-Jebai, M., Abi-Ghanem, A. S., Moukaddam, H., Haidar, M., Vinjamuri, S., Shaib, Y. H. 2023; 13 (7)

    Abstract

    Incidental gastrointestinal tract (GIT) [18F]-Fluorodeoxyglucose (FDG) uptake in positron emission technology/computed tomography (PET/CT) is an unexpected and often complicated finding for clinicians. This retrospective study reviewed 8991 charts of patients who underwent PET/CT: 440 patients had incidental GIT uptake, of which 80 underwent endoscopy. Patient characteristics, imaging parameters, and endoscopic findings were studied. Of the 80 patients, 31 had cancer/pre-cancer lesions (16 carcinomas; 15 pre-malignant polyps). Compared to patients with benign/absent lesions, patients with cancer/pre-cancer lesions were significantly older (p = 0.01), underwent PET/CT for primary evaluation/staging of cancer (p = 0.03), had focal GIT uptake (p = 0.04), and had lower GIT uptake (p = 0.004). Among patients with focal uptake, an SUVmax of 9.2 had the highest sensitivity (0.76) and specificity (0.885) in detecting cancer/pre-cancerous lesions. Lower GIT uptake was most common in the sigmoid colon, and upper GIT uptake was most frequent in the stomach. In a bivariate analysis, predictors of cancer/pre-cancer were older age, PET/CT indicated for primary evaluation, focal uptake, uptake in the lower GIT, and higher SUVmax. Further endoscopic investigation is warranted for patients with incidental GIT uptake, especially in the elderly or those presenting for primary evaluation with PET/CT, with the following findings on imaging: lower GIT uptake, focal uptake, or high SUVmax.

    View details for DOI 10.3390/diagnostics13071297

    View details for Web of Science ID 000969464800001

    View details for PubMedID 37046516

    View details for PubMedCentralID PMC10093625

  • Biliary Stenting of Caustic Proximal Esophageal Stricture Complicated by Fistula From Prior Dilation Itani, M. I., Damughatla, A. R., Osman, B., Abu-Heija, A., Diebe, L. N., Kelly, T. E. LIPPINCOTT WILLIAMS & WILKINS. 2022: S1836

    View details for Web of Science ID 000897916006244

  • A Rare Case of Ischemic Proctitis in the Setting of COVID-19 Alimohammadi, N., Itani, M. I., Wells, J., Dinary, F. LIPPINCOTT WILLIAMS & WILKINS. 2022: S1772

    View details for Web of Science ID 000897916006126

  • A Rare Case of Glomus Tumor of the Stomach With Metastatic Spread to the Liver and Lungs Damughatla, A. R., Kamatham, S., Bathla, J. S., Itani, M. I., Surapaneni, S., Milan-Ortiz, V., Shields, A. F. LIPPINCOTT WILLIAMS & WILKINS. 2022: S2330-S2331

    View details for Web of Science ID 000897916008090

  • Racial Diversity in Hepatitis C Infection and Demographics of Hepatocellular Carcinoma in an Urban Medical Center Population Itani, M. I., Abou Touk, M., Wasvary, M., Naylor, P., Ehrinpreis, M. N., Mutchnick, M. G. LIPPINCOTT WILLIAMS & WILKINS. 2022: S1005-S1006

    View details for Web of Science ID 000897916003234

  • Does endoscopic mean safer? A comparison of the short-term safety of endoscopic versus laparoscopic bariatric therapies ENDOSCOPY INTERNATIONAL OPEN Fayad, L., Schweitzer, M., Itani, M., Farha, J., Hedjoudje, A., Badurdeen, D., Kumbhari, V. 2022; 10 (04): E307-E310

    Abstract

    Background and study aims  There is minimal research on real-world, large-volume data comparing endoscopic bariatric therapy (EBT) to laparoscopic bariatric therapy (LBT). This study aimed to compare 30-day postoperative morbidity and mortality outcomes of primary EBT vs LBT using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Patients and methods  Patients aged 18 to 80 with body mass index (BMI) 35 to 40 kg/m 2 undergoing primary procedures were included. Propensity score matching 1:50 was performed for EBT versus LBT based on age, sex, and BMI. Results  We matched 211 EBTs with 9,059 LBTs. Operative length (63.9, 95 % confidence interval [CI]: 57.9, 69.8 versus 81.1, 95 % CI: 80.1, 82.1) and length of stay (0.49 days, 95 % CI: 0.29, 0.69 versus 1.43 days, 95 % CI: 1.41, 1.45) were significantly lower in the EBT group than the LBT group. There was no difference between EBT and LBT in the odds of readmission (odds ratio [OR] = 0.31, 95 % CI: 0.08, 1.25), reoperation (OR = 0.39, 95 % CI: 0.05, 2.84), or reintervention (OR = 0.98, 95 % CI: 0.24, 3.99). After controlling for chronic obstructive pulmonary disease, sleep apnea, history of myocardial infarction, hypertension requiring medications, and diabetes, EBT continued to be associated with lower odds of having any adverse event (AE) than LBT, with an OR of 0.34 (95 % CI: 0.16, 0.69). Subgroup analysis comparing EBT to laparoscopic sleeve gastrectomy (LSG) showed that EBT was associated with a lower risk having any AE than LSG, with an OR of 0.39 (95 % CI: 0.19, 0.79). Conclusions  EBT is associated with a lower 30-day AE rate and shorter procedural length and length of stay than LBT, with similar rates of readmission, reintervention, and reoperation.

    View details for DOI 10.1055/a-1783-8573

    View details for Web of Science ID 000782488600009

    View details for PubMedID 35433204

    View details for PubMedCentralID PMC9010103

  • Gastric Mucosal Devitalization (GMD): Using the Porcine Model to Develop a Novel Endoscopic Bariatric Approach OBESITY SURGERY Itani, M. I., Oberbach, A., Salimian, K. J., Enderle, M., Hahn, H., Abbarh, S., Kendrick, K., Schlichting, N., Anders, R. A., Besharati, S., Farha, J., Fayad, L., Kalloo, A. N., Badurdeen, D., Kumbhari, V. 2022; 32 (2): 381-390

    Abstract

    As the pig model has similar gastrointestinal anatomy and physiology to humans, we used pigs to create a gastric mucosal devitalization (GMD) model in preparation for clinical translation of this technique as an endoscopic bariatric therapy (EBT). The aims of this study were to determine the ablation parameters and technique for a successful, safe, and feasible large surface area GMD that produces weight loss.We performed GMD using argon plasma coagulation (APC) in 3 phases. Phase 1 assessed the ablation energy required to accomplish selective mucosal ablation using ex vivo pig stomachs (n = 2). Phase 2 assessed the optimal percentage of mucosal surface area to be treated and was performed on 10 pigs. Phase 3 assessed feasibility, efficacy, and safety with 8 pigs randomized into GMD (n = 4) or sham (SH, n = 4) and survived for 1 month. Body weights (GMD, n = 4, SH, n = 4) were measured daily in phase 3 for 1 month, and relative body weights were calculated and analyzed using one-tailed Student's t-test. Percent body fat was compared between GMD and SH at baseline and 1 month post-GMD.Phase 1 identified the optimal ablation parameters (120 W) that were then used in phase 2. Phase 2 revealed a trend that was suggestive that the optimal percent surface area to ablate was similar to that which is removed at laparoscopic sleeve gastrectomy. In phase 3, GMD was performed over 70% surface area of the greater curvature of the stomach in four pigs. GMD pigs had significantly lower relative body weight increase compared to SH at 1 month (1.375 ± 0.085 vs 1.575 ± 0.047, p = 0.0435). MRI showed a significantly lower body fat mass at 1 month in GMD pigs (5.9 ± 0.4% vs 12.7 ± 2.3%, p = 0.026) compared to SH.GMD resulted in decreased weight gain in the GMD group as evidenced by a lower relative body weight at 1 month. GMD in an animal model appears to show promise as a potential weight loss therapy.

    View details for DOI 10.1007/s11695-021-05773-4

    View details for Web of Science ID 000720616700003

    View details for PubMedID 34797503

  • Impact of Adjunctive Pharmacotherapy With Intragastric Balloons for the Treatment of Obesity AMERICAN SURGEON Mehta, A., Shah, S., Dawod, E., Hajifathalian, K., Kumar, R., Igel, L. I., Saunders, K. H., Kumbhari, V., Farha, J., Badurdeen, D., Itani, M. I., Moore, R. L., Starpoli, A. A., Carr-Locke, D. L., Shukla, A., Aronne, L. J., Sharaiha, R. Z. 2023; 89 (4): 707-713

    Abstract

    We conducted this study to compare the weight loss outcome of intragastric balloons (IGBs) in conjunction with pharmacotherapy vs IGB and intensive lifestyle changes alone.This was a multicenter, non-randomized, retrospective study involving 4 academic hospitals. Patients underwent IGB placement with or without concomitant anti-obesity pharmacotherapy. The primary outcome was percent total weight loss (TBWL) after IGB placement at 6 and 12 months.This study included 102 patients, with 23 patients (mean age 46.6 years, 82.6% female) treated with IGB/pharmacotherapy and 79 patients (mean age 46.0 years, 88.6% female) treated with IGB/lifestyle modifications. Patients had a 100% follow-up rate at 6 and 12 months. At 6 months following IGB placement, both groups achieved a similar %TBWL. At 12 months, %TBWL was greater in the IGB/pharmacotherapy group (12.6% ± 1.2 vs 9.7% ± 0.7, P = .04). 65.2% of patients achieved ≥10% TBWL at 12 months in the IGB/pharmacotherapy group, compared to 38.0% in the IGB/lifestyle group (P < .05). The proportion of patients that achieved ≥15% weight loss at 12 months was also significantly different between the IGB/pharmacotherapy and IGB/lifestyle groups (30.4% vs 20.3%, P < .05).IGB with concomitant use of pharmacotherapy did not improve weight loss while the IGB was in place compared to IGB and lifestyle changes. However, patients receiving IGB with pharmacotherapy did have greater weight loss and diminished weight regain after balloon removal compared to those receiving just IGB and lifestyle changes.

    View details for DOI 10.1177/00031348211038579

    View details for Web of Science ID 000684663300001

    View details for PubMedID 34384255

  • Enormous Single-Session Septotomy for the Treatment of Late Leak Postsleeve Gastrectomy ACG CASE REPORTS JOURNAL Itani, M. I., Abbarh, S., Farha, J., Kadhim, A., Kumbhari, V. 2021; 8 (7): e00626

    View details for DOI 10.14309/crj.0000000000000626

    View details for Web of Science ID 000711688600018

    View details for PubMedID 34345634

    View details for PubMedCentralID PMC8323797

  • A patient-like swine model of gastrointestinal fibrotic strictures for advancing therapeutics SCIENTIFIC REPORTS Li, L., Itani, M. I., Salimian, K. J., Li, Y., Gutierrez, O., Hu, H., Fayad, G., Donet, J. A., Joo, M., Ensign, L. M., Kumbhari, V., Selaru, F. M. 2021; 11 (1): 13344

    Abstract

    Gastrointestinal (GI) strictures are difficult to treat in a variety of disease processes. Currently, there are no Food and Drug Administration (FDA) approved drugs for fibrosis in the GI tract. One of the limitations to developing anti-fibrotic drugs has been the lack of a reproducible, relatively inexpensive, large animal model of fibrosis-driven luminal stricture. This study aimed to evaluate the feasibility of creating a model of luminal GI tract strictures. Argon plasma coagulation (APC) was applied circumferentially in porcine esophagi in vivo. Follow-up endoscopy (EGD) was performed at day 14 after the APC procedure. We noted high grade, benign esophageal strictures (n = 8). All 8 strictures resembled luminal GI fibrotic strictures in humans. These strictures were characterized, and then successfully dilated. A repeat EGD was performed at day 28 after the APC procedure and found evidence of recurrent, high grade, fibrotic, strictures at all 8 locations in all pigs. Pigs were sacrificed and gross and histologic analyses performed. Histologic examination showed extensive fibrosis, with significant collagen deposition in the lamina propria and submucosa, as well as extensive inflammatory infiltrates within the strictures. In conclusion, we report a porcine model of luminal GI fibrotic stricture that has the potential to assist with developing novel anti-fibrotic therapies as well as endoscopic techniques to address recurring fibrotic strictures in humans.

    View details for DOI 10.1038/s41598-021-92628-8

    View details for Web of Science ID 000669452600026

    View details for PubMedID 34172773

    View details for PubMedCentralID PMC8233336

  • Endoscopic sleeve gastroplasty plus liraglutide versus endoscopic sleeve gastroplasty alone for weight loss GASTROINTESTINAL ENDOSCOPY Badurdeen, D., Hoff, A., Hedjoudje, A., Adam, A., Itani, M. I., Farha, J., Abbarh, S., Kalloo, A. N., Khashab, M. A., Singh, V. K., Oberbach, A., Neto, M., Barrichello, S., Kumbhari, V. 2021; 93 (6): 1316-+

    Abstract

    Endoscopic sleeve gastroplasty (ESG) has been shown to be effective for inducing weight loss. The efficacy of liraglutide, a glucagon-like peptide-1 agonist, to augment weight loss after ESG is unknown. This study aims to evaluate the efficacy of ESG and liraglutide (ESG-L) compared with ESG alone.This was a retrospective study of prospectively collected data from patients undergoing ESG at 3 outpatient clinics in Brazil between November 2017 and July 2018. Liraglutide was offered to all patients 5 months after ESG. Patients who opted to take liraglutide (ESG-L) were matched 1:1 to patients who declined it (ESG). The primary outcome was percent total body weight loss (%TBWL), and percent excess weight loss (%EWL) 7 months after initiation of liraglutide (12 months after ESG). The secondary outcome was change in percent body fat 12 months after ESG. ESG technique and postprocedure follow-up were identical at all 3 sites.Propensity score matching yielded 26 matched pairs. Adjusted comparisons between the 2 groups showed that patients who opted to take liraglutide had a superior mean %TBWL 7 months after initiation of liraglutide (ESG-L) compared with those who declined it (ESG) (24.72% ± 2.12% vs 20.51% ± 1.68%, respectively; P < .001). ESG-L had a statistically greater reduction in percent body fat compared with ESG (7.85% ± 1.26% vs 10.54% ± 1.88%, respectively; P < .001) at 12 months.Addition of liraglutide at 5 months results in superior weight loss and improved efficacy as demonstrated by decreased body fat 12 months after ESG. Further studies are imperative to determine optimal dose, timing, and duration of liraglutide.

    View details for DOI 10.1016/j.gie.2020.10.016

    View details for Web of Science ID 000652833900016

    View details for PubMedID 33075366

  • Parameters of biliary hydrodynamic injection during endoscopic retrograde cholangio-pancreatography in pigs for applications in gene delivery PLOS ONE Huang, Y., Kruse, R. L., Ding, H., Itani, M. I., Morrison, J., Wang, Z. Z., Selaru, F. M., Kumbhari, V. 2021; 16 (4): e0249931

    Abstract

    The biliary system is routinely accessed for clinical purposes via endoscopic retrograde cholangiopancreatography (ERCP). We previously pioneered ERCP-mediated hydrodynamic injection in large animal models as an innovative gene delivery approach for monogenic liver diseases. However, the procedure poses potential safety concerns related mainly to liver or biliary tree injury. Here, we sought to further define biliary hydrodynamic injection parameters that are well-tolerated in a human-sized animal model. ERCP was performed in pigs, and hydrodynamic injection carried out using a novel protocol to reduce duct wall stress. Each pig was subjected to multiple repeated injections to expedite testing and judge tolerability. Different injection parameters (volume, flow rate) and injection port diameters were tested. Vital signs were monitored throughout the procedure, and liver enzyme panels were collected pre- and post-procedure. Pigs tolerated repeated biliary hydrodynamic injections with only occasional, mild, isolated elevation in aspartate aminotransferase (AST), which returned to normal levels within one day post-injection. All other liver tests remained unchanged. No upper limit of volume tolerance was reached, which suggests the biliary tree can readily transmit fluid into the vascular space. Flow rates up to 10 mL/sec were also tolerated with minimal disturbance to vital signs and no anatomic rupture of bile ducts. Measured intrabiliary pressure was up to 150 mmHg, and fluid-filled vesicles were induced in liver histology at high flow rates, mimicking the changes in histology observed in mouse liver after hydrodynamic tail vein injection. Overall, our investigations in a human-sized pig liver using standard clinical equipment suggest that ERCP-guided hydrodynamic injection will be safely tolerated in patients. Future investigations will interrogate if higher flow rates and pressure mediate higher DNA delivery efficiencies.

    View details for DOI 10.1371/journal.pone.0249931

    View details for Web of Science ID 000662174400027

    View details for PubMedID 33909609

    View details for PubMedCentralID PMC8081268

  • The Utility of EndoFLIP for Measuring Gastrojejunal Anastomosis Diameter and Distensibility in Patients Experiencing Weight Regain Post Roux-en-Y Gastric Bypass OBESITY SURGERY Haq, Z., Itani, M. I., Zhang, L., Dinary, F., Farha, J., Abbarh, S., Akshintala, V., Koller, K., Jovani, M., Hedjoudje, A., Ngamruengphong, S., Oberbach, A., Badurdeen, D., Kumbhari, V. 2021; 31 (7): 3353-3359

    Abstract

    A dilated gastrojejunal anastomosis (GJA) diameter is an independent predictor of weight regain following Roux-en-Y gastric bypass (RYGB). Despite this, there is no standardized method for GJA diameter measurement. We performed a retrospective analysis to compare endoscopic visual estimation and endoluminal functional impedance planimetry (EndoFLIP) for measuring GJA diameter in patients with weight regain post-RYGB. Visual estimation was found to overestimate GJA diameter by a mean of 4.2mm ± 4.6mm when compared with EndoFLIP. Furthermore, we identified symptomatic patients with normal GJA diameter but increased distensibility, which may represent a previously unrecognized subgroup. Our findings suggest the potential utility of EndoFLIP in the evaluation of post-RYGB weight regain and support the need for prospective studies to investigate the relationship between GJA distensibility and weight regain.

    View details for DOI 10.1007/s11695-021-05302-3

    View details for Web of Science ID 000623722500001

    View details for PubMedID 33646518

  • Gastric Per-Oral Endoscopic Myotomy for Treatment of Chronic Proximal Staple Line Leak Precipitated by Downstream Stenosis OBESITY SURGERY Zhang, L. Y., Dinary, F., Farha, J., Itani, M. I., Singh, R., Khashab, M. A., Kumbhari, V. 2021; 31 (7): 3347-3352

    Abstract

    Laparoscopic sleeve gastrectomy is now the most commonly performed bariatric surgery. Although considered a safe procedure, adverse events such as staple line leak in the context of sleeve stenosis can result in significant patient morbidity and health economic burden. Correction of the downstream stenosis is mandatory for closure of the staple line leak. Conventional endoscopic therapies offer high initial success rates, though ultimately a significant proportion proceed to revision surgery. Gastric per-oral endoscopic myotomy (G-POEM) is a novel, minimally invasive procedure which allows for a full-thickness myotomy of the stenosed segment, potentially conferring similar anatomical correction to surgical seromyotomy. We present a case of recalcitrant chronic proximal staple line leak in the context of a downstream gastric stenosis managed by G-POEM.

    View details for DOI 10.1007/s11695-021-05301-4

    View details for Web of Science ID 000620450300001

    View details for PubMedID 33616847

    View details for PubMedCentralID 7297609

  • Transoral outlet reduction: could additional sutures cause more harm? ENDOSCOPY Farha, J., Gebran, S., Itani, M. I., Simsek, C., Abbarh, S., Lopez, A., Haq, Z., Koller, K., Dunlap, M., Adam, A., Khashab, M. A., Oberbach, A., Schweitzer, M., Badurdeen, D., Kumbhari, V. 2021; 53 (10): 1059-1064

    Abstract

    The double purse-string pattern (DPSP) of transoral outlet reduction (TORe) should conceivably result in a more robust scaffolding for the gastrojejunal anastomosis (GJA). However, there is a paucity of literature pertaining to post-TORe stenosis as an adverse event. Our aim was to determine the rate of stenosis, its potential predictors, and other complications of DPSP TORe.We performed a retrospective analysis of a prospectively maintained database of 129 consecutive patients who underwent DPSP TORe between December 2015 and August 2019.The adverse event rate of TORe was 17.1 % (n = 22), with a 13.3 % (n = 17) rate of stenosis. Stenosis was not significantly associated with any baseline characteristics. GJA diameter pre- and post-TORe, the difference between these values, and procedure duration were not predictive of stenosis. Of patients who developed stenosis, 10 (58.8 %) responded to endoscopic balloon dilation and 7 (41.2 %) required stent placement.As the DPSP technique is a challenging procedure, with high complication rate and limited benefit, it should not be used for TORe.

    View details for DOI 10.1055/a-1325-4324

    View details for Web of Science ID 000615971300001

    View details for PubMedID 33254242

  • Endoscopic gastrointestinal anastomosis: a review of established techniques GASTROINTESTINAL ENDOSCOPY Marrache, M., Itani, M. I., Farha, J., Fayad, L., Sharara, S. L., Kalloo, A. N., Khashab, M. A., Kumbhari, V. 2021; 93 (1): 34-46

    Abstract

    Technologic advancements in the field of therapeutic endoscopy have led to the development of minimally invasive techniques to create GI anastomosis without requiring surgery. Examples of the potential clinical applications include bypassing malignant and benign gastric outlet obstruction, providing access to the pancreatobiliary tree in those who have undergone Roux-en-Y gastric bypass, and relieving pancreatobiliary symptoms in afferent loop syndrome. Endoscopic GI anastomosis is less invasive and less expensive than surgical approaches, result in improved outcomes, and therefore are more appealing to patients and providers. The aim of this review is to present the evolution of luminal endoscopic gastroenteric and enteroenteric anastomosis dating back to the first compression devices and to describe the clinical techniques being used today, such as magnets, natural orifice transluminal endoscopic surgery, and EUS-guided techniques. Through continued innovation, endoscopic interventions will rise to the forefront of the therapeutic arsenal available for patients requiring GI anastomosis.

    View details for DOI 10.1016/j.gie.2020.06.057

    View details for Web of Science ID 000600548600003

    View details for PubMedID 32593687

  • Revisional endoscopic sleeve gastroplasty of laparoscopic sleeve gastrectomy: an international, multicenter study GASTROINTESTINAL ENDOSCOPY Maselli, D. B., Alqahtani, A. R., Abu Dayyeh, B. K., Elahmedi, M., Storm, A. C., Matar, R., Nieto, J., Teixeira, A., Al Khatry, M., Galvao Neto, M., Kumbhari, V., Vargas, E. J., Jaruvongvanich, V., Mundi, M. S., Deshmukh, A., Itani, M. I., Farha, J., Chapman, C. G., Sharaiha, R. 2021; 93 (1): 122-130

    Abstract

    Laparoscopic sleeve gastrectomy (LSG) facilitates significant and durable weight loss; however, weight recidivism and need for revisional surgery occur in a subset of patients. Reduction of a dilated LSG using the revisional endoscopic sleeve gastroplasty (R-ESG) approach is an appealing and minimally invasive alternative to surgical revision that is congruent with obesity as a chronic relapsing disease model. In this study, we examine the safety and efficacy of the technique in a large multicenter international cohort.Prospectively collected data from 9 centers for 82 consecutive adults who underwent R-ESG for weight regain after LSG using the OverStitch device (Apollo Endosurgery, Austin, Tex, USA) from March 2014 to November 2019 were reviewed. Total body weight loss (TBWL) and adverse events were reported up to 12 months. Univariable logistic regression was used to identify predictors of response at 12 months.Eighty-two adults (92.7% female) experienced 27.9 ± 20.7 kg weight regain from post-LSG nadir weight, prompting R-ESG (mean age, 42.8 ± 10.4 years) at a mean weight of 128.2 ± 57.5 kg. Mean R-ESG procedure duration was 48.3 ± 20.5 minutes, and the median number of sutures used was 4 (interquartile range, 3-4). After R-ESG, TBWL (follow-up %) was 6.6% ± 3.2% at 1 month (81.7%), 10.6% ± 4.4% at 3 months (74.4%), 13.2% ± 10.1% at 6 months (63.4%), and 15.7% ± 7.6% at 12 months (51.2%). In a per-protocol analysis, ≥10% TBWL was achieved by 37 of 51 patients (72.5%) at 6 months and 34 of 42 patients (81.0%) at 12 months; ≥15% TBWL was achieved by 20 of 46 patients (43.5%) at 6 months and 22 of 42 patients (52.4%) at 12 months. Only 1 moderate adverse event occurred in the form of a narrowed gastroesophageal junction, which resolved after a single endoscopic dilation.R-ESG is a safe and effective means of facilitating weight loss for weight recidivism after LSG, with sustained results at 1 year. R-ESG should be considered before pursuing more-invasive surgical revisional options.

    View details for DOI 10.1016/j.gie.2020.05.028

    View details for Web of Science ID 000600548600016

    View details for PubMedID 32473252

  • Efficacy of Liraglutide to Prevent Weight Regain After Retrieval of an Adjustable Intra-gastric Balloon-a Case-Matched Study OBESITY SURGERY Badurdeen, D., Hoff, A., Barrichello, S., Hedjoudje, A., Itani, M. I., Farha, J., Abbarh, S., Adam, A., Singh, V. K., Ngamruengphong, S., Oberbach, A., Khashab, M. A., Neto, M., Kumbhari, V. 2021; 31 (3): 1204-1213

    Abstract

    Weight regain after balloon retrieval is a concern with all intra-gastric balloons (IGBs). The aim of this study was to evaluate the efficacy of liraglutide, a glucagon-like peptide-1 (GLP-1) agonist, to prevent weight regain following IGB retrieval.This was a case-matched study of patients undergoing Spatz3 adjustable IGB (Spatz FGIA, Inc. NY, USA) at three outpatient clinics in Brazil between November 2015 and January 2019. Seventy-seven patients that opted to take liraglutide following IGB retrieval (IGB-L) were matched 1:1 to 198 patients that declined the medication-IGB-Alone (IGB-A). Propensity score adjustment was performed at the time of balloon retrieval on factors known to influence the choice of liraglutide. Weight and percent body fat (%BF) was measured at baseline and 9 months after IGB retrieval. % BF is defined as the total mass of fat divided by total body mass, multiplied by 100. The primary outcome was weight regain, and the secondary outcome was change in %BF 9 months after IGB retrieval.Propensity score matching yielded 53 matched pairs. Weight regain to the starting point was not observed in either group. There was significantly less weight regain in IGB-L compared to IGB-A, - 1.15 ± 0.94 kg versus - 0.66 ± 0.99 kg (p = 0.010) 9 months after balloon retrieval. Additionally, %BF decline in IGB-L was superior to IGB-A - 10.83 ± 1.50 versus - 7.94 ± 2.02 (p < 0.01). There was no difference in weight regain or decline in %BF based on liraglutide dose.Liraglutide has an additive benefit with respect to efficacy and a reduction in body fat when commenced after IGB retrieval. Future randomized control studies will be needed to determine the optimal dose and duration of liraglutide to achieve superior outcomes.

    View details for DOI 10.1007/s11695-020-05117-8

    View details for Web of Science ID 000590945700002

    View details for PubMedID 33211267

    View details for PubMedCentralID 5385714

  • Endobariatrics and Metabolic Endoscopy: Can We Solve the Obesity Epidemic with Our Scope? Current gastroenterology reports Farha, J., Abbarh, S., Haq, Z., Itani, M. I., Oberbach, A., Kumbhari, V., Badurdeen, D. 2020; 22 (12): 60

    Abstract

    PURPOSE OF REVIEW: Obesity is a chronic relapsing disease that results in cardiovascular disease, diabetes mellitus, and non-alcoholic fatty liver disease. Currently, surgery represents the most effective treatment. However, the advent of minimally invasive endoscopic bariatric therapy (EBT) has shifted the treatment paradigm to less invasive, cost-effective procedures with minimal complications and recovery time that are preferred by patients. In this review, we will describe current and future EBTs, focusing on outcomes and safety.RECENT FINDINGS: The endoscope has provided an incisionless portal into the gastrointestinal tract for placement of space-occupying devices and intraluminal procedures. EBTs are no longer solely manipulating anatomic alterations; instead, they aim to improve metabolic parameters such as glycated hemoglobin, low-density lipoprotein, cholesterol, and hepatic indices by targeting the mucosal layer of the gastrointestinal tract. The endoscope has succeeded in facilitating clinically meaningful weight loss and improvement of metabolic parameters. Future, solutions to the obesity epidemic will likely entail genetic testing, evaluation of the microbiome, and delivery of personalized therapy, utilizing combination endoscopic modalities that change the anatomy and physiology of individual patients, with new targets such as the abnormal metabolic signal.

    View details for DOI 10.1007/s11894-020-00798-8

    View details for PubMedID 33205261

  • Endoscopic sleeve gastroplasty with argon plasma coagulation: A novel technique JOURNAL OF DIGESTIVE DISEASES Itani, M. I., Farha, J., Sartoretto, A., Abbarh, S., Badurdeen, D., de Moura, D. H., Kumbhari, V. 2020; 21 (11): 664-667

    Abstract

    The endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure in which the anterior and posterior aspects of the greater curvature are stitched endoscopically, producing a sleeve-like anatomy mimicking that in a sleeve gastrectomy. However, suture dehiscence and enlargement of the stomach within months of the procedure have been observed. Argon plasma coagulation (APC) is widely used in gastrointestinal endoscopy and is able to induce scarring and fibrosis. We coupled ESG with APC to evaluate its potential to improve durability.A 46-year-old woman with obesity presented for ESG. Her pre-procedure weight was 117 kg with a body mass index (BMI) of 41.4 kg/m2 . After each plication was complete, APC (60 W, argon flow rate 1.2 L/min) was used to ablate the mucosal surface of the exposed plicated mucosa. APC was applied until the mucosal color was dark brown, indicating adequate and successful mucosal and submucosal ablation.The procedure was successful, and the patient recovered without peri- or post-operative complications. The procedure time was 47 minutes. A total of seven sutures were used. At 6-month follow-up the patient had lost 17 kg (37.5 lbs), equivalent to 14.5% total weight loss and had a BMI of 35.4 kg/m2 . Endoscopic follow-up at 6 months revealed enhanced fibrosis along the plications, resulting in a superior, sleeve-like lumen.The combination of ESG with APC may act synergistically to reduce weight without adding significant procedure time. Further investigation is needed to determine whether it should be widely recommended.

    View details for DOI 10.1111/1751-2980.12939

    View details for Web of Science ID 000589347600007

    View details for PubMedID 32916766

  • Endoscopic ultrasound-guided rendezvous ERCP using a steerable access device ENDOSCOPY Marrache, M. K., Al-Sabban, A., Itani, M., Farha, J., Fayad, L., Khashab, M. A., Kumbhari, V. 2020; 52 (10): E355-E356

    View details for DOI 10.1055/a-1127-2820

    View details for Web of Science ID 000572115500003

    View details for PubMedID 32219790

  • Building an endobariatric program: lessons learned ENDOSCOPY INTERNATIONAL OPEN Badurdeen, D., Hedjoudje, A., Itani, M., Fayad, L., Farha, J., Dunlap, M., Cheskin, L., Schweitzer, M., Koller, K., Hartman, C., Oberbach, A., Kashab, M. A., Kalloo, A., Kumbhari, V. 2020; 08 (09): E1185-E1193

    Abstract

    The emphasis on treating obesity has never been more critical, yet the complexity of delivering care has become more intricate due to new procedures, variable insurance coverage, and inconsistent reimbursement. This is our experience building an endobariatric program and treating overweight and obese patients with endobariatric therapies (EBTs) over 3 years. The primary intention of this manuscript was to educate the reader on how to build an endobariatric program, identify barriers, and provide succinct solutions to establish a successful program. The secondary aim was weight loss outcomes of procedures offered at our institution. We compiled a list of lessons learned, based on the difficulties we experienced to make it easy for others embarking on this journey. Herein, we present a business development strategy to overcome impediments, whilst offering high quality service. The high cost and lack of insurance coverage are significant barriers. Marketing can be costly and is often a factor that is ignored particularly early on, when finances are limited. However, it is an integral component of growing the program. The percentage total body weight loss (%TBWL) at 6 and 12 months post ESG was 17.8 ± 6.48 and 20.6 ± 8.3 ( P  < 0.001), respectively. The %TBWL at 6 months post IGB was 14.9 ± 9.8 for the Orbera IGB and 12.6 ± 7.4 for the Reshape IGB. There was a trend of preference for ESG compared to IGB placement over the 3 years. The key to building a successful endobariatric program is a motivated physician leader, collaborative bariatric surgeons, institutional support, and marketing. Insurance coverage will likely occur in the near future and programs must be prepared to manage the massive influx of patients that will likely request these procedures.

    View details for DOI 10.1055/a-1198-4598

    View details for Web of Science ID 000564256200015

    View details for PubMedID 32908949

    View details for PubMedCentralID PMC7473785

  • Endoscopic sleeve gastroplasty: suturing the gastric fundus does not confer benefit ENDOSCOPY Farha, J., McGowan, C., Hedjoudje, A., Itani, M. I., Abbarh, S., Simsek, C., Ichkhanian, Y., Vulpis, T., James, T. W., Fayad, L., Khashab, M. A., Oberbach, A., Badurdeen, D., Kumbhari, V. 2021; 53 (07): 727-731

    Abstract

    BACKGROUND : There is heterogeneity regarding the technical aspects of endoscopic sleeve gastroplasty (ESG), such as applying fundal sutures. Our aim was to determine whether ESG with fundal suturing (ESG-FS) affects weight loss and the serious adverse event (SAE) rate when compared with ESG with no fundal suturing (ESG-NFS). METHODS:  We conducted a two-center retrospective analysis of 247 patients who underwent ESG with or without fundal suturing. The primary outcome was percentage excess weight loss (%EWL) at 3, 6, and 12 months post-ESG. The secondary outcomes included the SAE rate and procedure duration. RESULTS:  At 3, 6, and 12-months, ESG-NFS had a significantly greater mean %EWL compared with ESG-FS (38.4 % [standard deviation (SD) 15.3 %] vs. 31.2 % [SD 13.9 %], P = 0.001; 54.7 % [SD 19.2 %] vs. 37.7 % [SD 17.3 %], P < 0.001; 65.3 % [SD 21.1 %] vs. 40.6 % [SD 23.5 %], P < 0.001, respectively). There was no statistically significant difference in the SAE rates for ESG-NFS (n = 2; 2.0 %) and ESG-FS (n = 4; 2.6 %; P > 0.99). The mean procedure time was significantly shorter in the ESG-NFS group at 59.1 minutes (SD 32.7) vs. 93.0 minutes (35.5; P < 0.001), and a lower mean number of sutures were used, with 5.7 (SD 1.1) vs. 8.4 (SD 1.6; P < 0.001). CONCLUSION : ESG-NFS demonstrated greater efficacy and shorter procedure duration. Therefore, fundal suturing should not be performed.

    View details for DOI 10.1055/a-1236-9347

    View details for Web of Science ID 000576155300001

    View details for PubMedID 32777827

  • Treating an Esophagojejunal Stricture: Needle-Knife Stricturotomy, Endoscopic Balloon Dilation, and Triamcinolone Injection AMERICAN JOURNAL OF GASTROENTEROLOGY Farha, J., Itani, M. I., Ichkhanian, Y., Khashab, M. A., Ngamruengphong, S., Selaru, F. M., Kumbhari, V. 2020; 115 (8): 1164

    View details for DOI 10.14309/ajg.0000000000000684

    View details for Web of Science ID 000619500100011

    View details for PubMedID 32427680

  • ENDOSCOPIC ULTRASOUND GUIDED BILIARY DRAINAGE (EUS-BD) WITH LUMEN APPOSING METAL STENTS FOR MALIGNANT BILIARY OBSTRUCTION: A MULTICENTER NORTH AMERICAN EXPERIENCE David, Y. N., Kakked, G., Dixon, R. E., Nieto, J., Deshmukh, A. A., Krafft, M. R., Shah-Khan, S. M., Nasr, J. Y., Trindade, A. J., Hoerter, N. A., Khanna, L., Tzimas, D., Kedia, P., Kumbhari, V., Itani, M. I., Farha, J., Chapman, C. G., Kasmin, F., Gress, F. G., Nagula, S., Greenwald, D. A., DiMaio, C. J., Waye, J. D., Kumta, N. A. MOSBY-ELSEVIER. 2020: AB311-AB312

    View details for Web of Science ID 000545678400621

  • DOES FUNDAL SUTURING AFFECT OUTCOMES OF ENDOSCOPIC SLEEVE GASTROPLASTY? Farha, J., McGowan, C., Hedjoudje, A., Itani, M. I., Simsek, C., Ichkhanian, Y., Vulpis, T., James, T. W., Fayad, L., Badurdeen, D., Kalloo, A. N., Khashab, M. A., Oberbach, A., Kumbhari, V. MOSBY-ELSEVIER. 2020: AB217-AB218

    View details for Web of Science ID 000545678400435

  • GASTRIC MUCOSAL DEVITALIZATION (GMD): A DOSE-FINDING STUDY Itani, M. I., Oberbach, A., Badurdeen, D., Enderle, M. D., Hahn, H., Schlichting, N. S., Farha, J., Fayad, L., Khashab, M. A., Kalloo, A. N., Kumbhari, V. MOSBY-ELSEVIER. 2020: AB221

    View details for Web of Science ID 000545678400441

  • DOES THE MAGNITUDE OF WEIGHT REGAIN AFTER ROUX-EN-Y GASTRIC BYPASS PREDICT RESPONSE TO TRANSORAL OUTLET REDUCTION (TORE)? Farha, J., Gebran, S., Itani, M. I., Simsek, C., Lopez, A. C., Hedjoudje, A., Ichkhanian, Y., Badurdeen, D., Kalloo, A. N., Khashab, M. A., Oberbach, A., Kumbhari, V. MOSBY-ELSEVIER. 2020: AB221-AB222

    View details for Web of Science ID 000545678400442

  • ENDOSCOPIC BARIATRIC THERAPIES ASSOCIATED WITH LOWER RATE OF ADVERSE EVENTS AND LENGTH OF STAY THAN LAPAROSCOPIC BARIATRIC THERAPIES Fayad, L., Itani, M. I., Farha, J., Schweitzer, M., Badurdeen, D., Khashab, M. A., Kalloo, A. N., Kumbhari, V. MOSBY-ELSEVIER. 2020: AB223-AB224

    View details for Web of Science ID 000545678400445

  • ENDOSCOPIC REVISION OF LAPAROSCOPIC SLEEVE GASTRECTOMY IS SAFE, EFFECTIVE, AND DURABLE: A MULTI-CENTER STUDY Maselli, D. B., Elahmedi, M., Abu Dayyeh, B. K., Storm, A. C., Matar, R., Vargas, E. J., Jaruvongvanich, V., Mundi, M., Kumbhari, V., Itani, M. I., Farha, J., Teixeira, A., Neto, M., Al Khatry, M. S., Nieto, J., Deshmukh, A. A., Sharaiha, R. Z., Alqahtani, A. MOSBY-ELSEVIER. 2020: AB11

    View details for Web of Science ID 000545678400018

  • ESG PLUS LIRAGLUTIDE IS SUPERIOR TO ESG ALONE FOR WEIGHT LOSS IN OVERWEIGHT AND OBESE PATIENTS Badurdeen, D., Hoff, A., Hedjoudje, A., Itani, M. I., Farha, J., Kalloo, A. N., Khashab, M. A., Neto, M., Barrichello, S. A., Kumbhari, V. MOSBY-ELSEVIER. 2020: AB215

    View details for Web of Science ID 000545678400431

  • ENDOSCOPIC REVISION OF LAPAROSCOPIC SLEEVE GASTRECTOMY IS SAFE, EFFECTIVE, AND DURABLE: A MULTI-CENTER STUDY Maselli, D. B., Elahmedi, M., Abu Dayyeh, B. K., Storm, A. C., Matar, R., Vargas, E. J., Jaruvongvanich, V., Mundi, M., Kumbhari, V., Itani, M. I., Farha, J., Teixeira, A., Neto, M., Al Khatry, M. S., Nieto, J., Deshmukh, A. A., Sharaiha, R. Z., Alqahtani, A. MOSBY-ELSEVIER. 2020: AB61

    View details for Web of Science ID 000545678400114

  • A NOVEL SWINE ESOPHAGEAL STRICTURE MODEL CREATED VIA ESOPHAGOGASTRODUODENOSCOPY ARGON PLASMA COAGULATION PROCEDURE Li, L., Li, Y., Gutierrez, O., Hu, H., Itani, M. I., Fayad, G., Donet, J. A., Kumbhari, V., Selaru, F. MOSBY-ELSEVIER. 2020: AB265-AB266

    View details for Web of Science ID 000545678400530

  • Gastrogastric fistula as a possible adverse event of transoral gastric outlet reduction GASTROINTESTINAL ENDOSCOPY Itani, M. I., Fayad, L., El Nahla, A., Farha, J., Kumbhari, V. 2020; 91 (6): 1395-1396

    View details for DOI 10.1016/j.gie.2020.01.032

    View details for Web of Science ID 000534601400025

    View details for PubMedID 31991121

  • Anatomical Configuration of the Stomach Post-Endoscopic Sleeve Gastroplasty (ESG)-What Are the Sutures Doing? OBESITY SURGERY Runge, T. M., Yang, J., Fayad, L., Itani, M. I., Dunlap, M., Koller, K., Mullin, G. E., Simsek, C., Badurdeen, D., Kalloo, A. N., Khashab, M. A., Kumhbari, V. 2020; 30 (5): 2056-2060

    Abstract

    Endoscopic sleeve gastroplasty (ESG) is a procedure in which endoscopically placed sutures involute the stomach and promote weight loss. There is limited data on the durability of these sutures.This was a single center series of 5 patients who underwent ESG performed by a single endoscopist. Patients underwent repeat endoscopy for different clinical indications.ESGs were successfully reversed at 3 weeks and 1 month following index ESG without significant fibrosis or scaring. At 8 and 14 months, a few sutures had dehisced though there were extensive areas of fibrosis. By 2 years, most of the sutures had dehisced; however, the gastric volume remained reduced.This case series offers an intriguing evaluation of the anatomical changes induced by ESG.

    View details for DOI 10.1007/s11695-019-04311-7

    View details for Web of Science ID 000525315100058

    View details for PubMedID 31858398

  • Anatomical Configuration of the Stomach Post-Endoscopic Sleeve Gastroplasty (ESG)-What Are the Sutures Doing? (vol 30, pg 2056, 2020) OBESITY SURGERY Runge, T. M., Yang, J., Fayad, L., Itani, M. I., Dunlap, M., Koller, K., Mullin, G. E., Simsek, C., Badurdeen, D., Kalloo, A. N., Khashab, M. A., Kumbhari, V. 2020; 30 (5): 2061

    Abstract

    The name of author Vivek Kumbhari was misspelled in the original article.

    View details for DOI 10.1007/s11695-020-04538-9

    View details for Web of Science ID 000525315100059

    View details for PubMedID 32157521

  • Endoscopic sleeve gastroplasty by use of a novel suturing pattern,which allays concerns for revisional bariatric surgery. VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy Marrache, M. K., Al-Sabban, A., Itani, M. I., Sartoretto, A., Kumbhari, V. 2020; 5 (4): 133-134

    View details for DOI 10.1016/j.vgie.2019.11.013

    View details for PubMedID 32258839

  • The Effects of Bariatric Surgery and Endoscopic Bariatric Therapies on GERD: An Update. Current treatment options in gastroenterology Itani, M. I., Farha, J., Marrache, M. K., Fayad, L., Badurdeen, D., Kumbhari, V. 2020; 18 (1): 97-108

    Abstract

    PURPOSE OF REVIEW: Bariatric surgery and endoluminal bariatric therapies (EBTs) form an increasingly utilized therapeutic approach to treat obese patients but may worsen gastroesophageal reflux disease (GERD). In this updated article, we review the evidence on the effects of bariatric procedures on GERD.FINDINGS: Recent evidence implicates sleeve gastrectomy with the highest rates of de novo GERD and Barrett's esophagus (BE), whereas malabsorptive-restrictive procedures such as Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) were shown to have significantly lower reported rates. The intragastric balloon (IGB) has been associated with increased likelihood of GERD, whereas insufficient evidence exists linking endoscopic sleeve gastroplasty (ESG) to GERD.SUMMARY: Gastroesophageal reflux disease may be treated with some bariatric procedures but is often developed de novo as a result of the change in anatomy. Patients set to undergo bariatric surgery may benefit from pre-procedural endoscopy to choose the more suitable therapy. Further studies with objective measurements of GERD post procedure may provide more insight into the effects of bariatric therapies on reflux, especially more novel ones such as ESG.

    View details for DOI 10.1007/s11938-020-00278-y

    View details for PubMedID 31960281

  • Gastric Per-Oral Endoscopic Myotomy (G-POEM) for the Treatment of Gastric Stenosis Post-Laparoscopic Sleeve Gastrectomy (LSG) OBESITY SURGERY Farha, J., Fayad, L., Kadhim, A., Simsek, C., Badurdeen, D. S., Ichkhanian, Y., Itani, M. I., Kalloo, A. N., Khashab, M. A., Kumbhari, V. 2019; 29 (7): 2350-2354

    Abstract

    Laparoscopic sleeve gastrectomy (LSG) has become the most common form of bariatric surgery performed worldwide. However, it is associated with potentially debilitating adverse events such as post-operative stenosis. Finding effective and minimally invasive treatments for such complications is of paramount importance. Gastric per-oral endoscopic myotomy (G-POEM) is a novel procedure developed over the past decade to treat conditions that delay gastric emptying. We present a case demonstrating the use of G-POEM in the successful endoscopic management of post-LSG gastric stenosis.

    View details for DOI 10.1007/s11695-019-03893-6

    View details for Web of Science ID 000469767700048

    View details for PubMedID 31001761