Stomach with BariClip®
What is the BariClip® ?
The BariClip consists of a silicone covered titanium backbone with an inferior flexible hinged opening that separates a medial lumen from an excluded lateral gastric pouch, in a design that mimics the Magenstrasse and Mills procedure.
The BariClip marries the best qualities of the Sleeve Gastrectomy with removability. The BariClip is a removable medical device that is placed vertically parallel to the lesser curvature. The inferior opening allows the gastric juices to empty from the fundus and the body of the stomach into the distal antrum. It measures approximately 165 mm long by 11 mm wide and has a 10 mm inferior opening. It fits through a 12 mm to 15 mm Trocar when opened flat.
The BariClip requires no maintenance or adjustments. It is placed without the use of staples, without removal of any tissue, without alteration of the normal anatomical flow, and causes minimal reflux.
The BariClip is NOT a band, nor does it function as one.
The %EWL achieved by various groups throughout the world is approximately 60 % at 2 years. Our own study demonstrates approximately 45% EWL at 5 years.
Comparison of the BariClip® to the Sleeve
BariClip® Sleeve
Reversible Irreversible
Placed vertically Vertical Gastrectomy
Restricts Restricts
Minimal reflux, nausea, vomiting 35% Reflux
1 % erosions, non emergent situations 1-2% leaks, life threatening
No stapling, no cutting, no change in anatomy Most of stomach removed with Stapling
No kinking Kinking
No bleeding Bleeding
May be done as an outpatient procedure Requires Hospital Stay
If it fails may be converted to sleeve or bypass If it fails may be converted to bypass
BariClip® Procedure Animation
If a Hiatal Hernia is identified, it should be repaired before BariClip placement.
Anterior view of finished clip procedure
Once placed the resultant lumen of the stomach as seen by UGI (see below).
Since the inferior aperture of the BariClip doesn’t have a titanium base, it is wide and flexible enough to allow examination of the excluded portion of the stomach by a gastroscope. Below is an endoscopic view of the excluded portion of the stomach. The scope has passed through the inferior aperture of the clip and is looking back towards the excluded fundus. The diameter and the flexibility of the inferior aperture to distend allows for wide drainage of the fundus and body of the stomach.
The BariClip was designed in a way that the closing pressures are low. This was done to minimize the risks of erosion.
Because of the low pressure of the excluded side of the stomach and the wide inferior aperture, any back flow from the antrum or duodenum extends into the excluded stomach, thus patients don’t experience reflux .
Video of UGI Refluxing into excluded Stomach
In conclusion, the BariClip is a gentler, kinder procedure. It offers the benefits of being restrictive, requiring no maintenance or adjustments, without altering the GI tract, without the use of staples, without tissue removal, offering similar weight loss to current procedures without causing reflux, while being removable.
Our aim is not to detract from any other available procedures, but to offer an alternative that will help increase the 1% of patients who are currently being served by the only meaningful, safe and sustainable method to lose weight…Bariatric Surgery.
