Gastric Bypass Alternative

A flexible, C-shaped plastic tube, designed by students and clinicians at an Israeli university, could soon offer an alternative to risky and invasive surgeries to treat obesity.

This new type of gastric sleeve, called the MetaboShield, can be inserted through the mouth and stomach to block the absorption of food from inside the small intestine.

Unlike gastric bypass and other weight-loss surgeries, this endoscopic procedure does not require general anesthesia or incisions, allowing patients to lose weight without the risk of significant complications.

Weight-Loss Device Follows Anatomy

The only gastric sleeve currently on the market relies on a stent—a mesh tube—to keep it from shifting out of place as food passes from the stomach into the small intestine. However, this type of anchor can damage the soft tissue of the digestive tract and must be removed and cleaned regularly.

MetaboShield, on the other hand, is rigid along its length but flexible along its width, which allows it to maintain the unique shape needed to do its work.

"The concept here is to follow the anatomical structure of the duodenum, a C-like structure at the entrance to the intestines from the stomach," says Yaakov Nahmias, Ph.D., head of the Bioengineering program at the Hebrew University of Jerusalem. "This anatomical structure is actually preserved in all humans, making it possible to hold a gastric sleeve in the intestine without anchoring it to the stomach using a stent."

And because the device is flexible along its width, it can absorb pressure as the intestines shift and move.

University Program Focuses on Innovation

MetaboShield was invented by students in the Biodesign program at the Hebrew University of Jerusalem, in collaboration with Hadassah Medical Center. This multidisciplinary program focuses on teaching students how to bring new medical devices to the market quickly.

"In this program we take clinical fellows, business students at their master’s stage—MBA students—and Ph.D. students in engineering," says Nahmias, "and then teach them how to create essentially start-up companies in medical technologies."

Before students start building—or even designing—new devices, they spend around four months identifying a clinical problem. But not just any healthcare issue will do. Given that most medical procedures are paid for by insurance companies, students look for problems that are also “financially rewarding.”

According to the Centers for Disease Control and Prevention, 35 percent of adults in the United States are obese. The estimated cost of this epidemic—in lost productivity at work and related complications like diabetes and heart disease—is more than $140 billion, making this a healthcare problem ripe for innovative ideas.

"The C-shape was a very, very smart idea. It was the gastroenterologist, actually, that came up with this idea," says Nahmias, referring to Dr. Ishay Benuri-Silbiger, a pediatric gastroenterologist at Hadassah Medical Center and the group clinical expert.

While the performance of the MetaboShield has been verified using a model of a small intestine, it will take some time before it can be tested in people. Moving the device beyond a simple prototype will first require animal experiments to determine its safety. In addition, plenty of money will be needed to pay for future clinical trials in people with obesity.

After eight months, though, the students have more to show than just an innovative model. With the concept already patented, several drug and medical companies are interested in taking the technology forward.

"It’s actually pretty far advanced," says Nahmias. "Most companies take about one or two years before they reach this stage—before they have a business plan, a patent, and then a prototype, and some principal experiments."

Unique Nature of Students Drives Success

In addition to the multidisciplinary nature of the Biodesign program, the non-traditional nature of the students themselves supports this type of focused innovation.

The students tend to be older—in their mid-30s—than those at many universities in the United States, partially due to Israel’s mandatory two to three years of military service for all young people.

This has provided the doctors working on these projects—who have treated combat injuries in the field—with practical experiences beyond the clinic.

"Many of our engineers, they are married, they have kids, they’re working at Intel, they’re working on semiconductors, they have industrial experience already built in," says Nahmias. "I think it works much better for biodesign."

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