COMMITTEE SPOTLIGHT: What's Next: Emerging Technologies

Published in May Issue             

An Interview with Aurora D. Pryor, MD
Emerging Technology and Procedures Committee Chair

Recently, the ASMBS Emerging Technology and Procedures Committee took an inventory of new technologies, concepts, treatments and procedures in various stages of development for obesity. This inventory provides information about the device or drug, its potential indication, mechanism of action, the company behind the product or procedure, its status in the market, ongoing studies, and any data that has been published thus far. connect sat down with committee chair, Aurora D. Pryor, MD on the state of innovation in metabolic and bariatric surgery and how the ASMBS views its role in helping to advance new treatments.

Also check out Dr. Pryor on earlier this month discussing emerging technologies and advances in the field on behalf of the ASMBS.

connect: What does the ASMBS Emerging Technology and Procedure
Committee do?

Our 18-member Emerging Technology and Procedures Committee advises the Executive Council, other committees and the general membership on new and emerging technologies and procedures and how these may impact current and future care of patients. Our goal is to educate members on the state of the evidence, how to evaluate it, and possibly incorporate new treatments into practice. We also identify and promote appropriate research to support their safe and effective use. Many new products and procedures turn out to be highly effective, while some need further investigation.

connect: What distinguishes an “emerging technology” from an
“established” treatment?

The quality, consistency and volume of clinical evidence and data are what primarily separates an emerging technology, treatment or procedure from an established one. Well designed clinical investigations or trials published in peer-reviewed journals are critical in the review and evaluation of new technologies. Nonetheless, while new treatments by their very nature have less evidence than more established treatments, there does come a point when there is enough evidence to consider support for a new treatment as a standard option. Once that happens, it is the job of the ASMBS Clinical Issues Committee to develop evidence-based guidelines or position statements outlining our support or non-support of a new treatment.

connect: What are the key areas of focus in emerging technologies
and procedures?

Evidence continues to grow around endoscopic bariatric therapies (EBT) in treating obesity and obesity-related diseases. In 2011, the ASMBS, along with the American Society for Gastrointestinal Endoscopy (ASGE), issued a white paper based on guidance from our joint task force. At that time, we concluded that EBT appeared to have a favorable risk/benefit profile and had the potential to achieve weight loss superior to medical and intensive lifestyle interventions. Researchers continue to investigate the role of EBT as a primary therapy, early intervention, bridge therapy and/or metabolic therapy, and our committee continues to monitor and evaluate the data. Other areas of focus in emerging technologies include gastric stimulation for obesity and diabetes, intragastric balloons, laparoscopic gastric plication with or without banding and cervical banding, for both primary and revision procedures.

connect: What impact do emerging technologies have on patients?

Some emerging technologies get a lot of attention in the media and patients often times cannot distinguish between what appears to be promising and what is actually proven. Patients may go into doctors' offices asking for a particular treatment only to find out that it has not yet been approved by the FDA or wanting a procedure that cannot be done outside of an Institutional Review Board (IRB) or clinical trial. That's why it's important for our members to keep abreast of these technologies so they can appropriately guide or advise patients on the realities of the clinical situation. However, some patients are undeterred and seek the emerging treatment that they want where they can find it. This is leading to a new kind of medical tourism, one where patients seek treatments not yet approved in the U.S., but are approved elsewhere. This is why it is so important to encourage innovation in this country and help break down the barriers that may prevent or delay good treatments.

connect: Where can ASMBS members go if they have questions or input about an emerging technology?

Please e-mail  to submit information about new technologies and procedures or any relevant comments to the committee for consideration.

Dr. Pryor is a Professor of Surgery and Vice Chair for Clinical Affairs, Chief, General Surgery Division and Director, Bariatric and Metabolic Weight Loss Center for the Stony Brook School of Medicine in Stony Brook, NY.