A decade ago, incuabators were seen as the best medicine for what then ailed the medical device industry, most notably a complex regulatory pathway and a difficult venture financing climate. Perhaps not surprisingly, as both the regulatory path and venture financing grew easier in the mid 2000s, incubators began to struggle, victims of their own financing problems. More recently, two huge acquisitions, Abbott's purchase of Evalve and Medtronic's of Ardian, suggest that at least one incubator, The Foundry, is proving that incubation works.

Numerous physiologic pathways lead to obesity; those related to hunger, satiety, the breakdown and absorption of nutrients, and the regulation of energy. Given the complexity of obesity, it's not surprising that diet and exercise aren't currently effective and that drugs have had only modest success. Bariatric surgery, on the other hand, which reduces the size of the stomach (and, in some versions, also reroutes part of the small intestine so that food bypasses it) is extremely successful. Many patients that have undergone the Roux-en-Y gastric bypass procedure have sustained losses of 50% of their excess weight out to ten years and beyond. Now companies with minimally invasive devices for the treatment of obesity hope to fill the therapy gap between dieting and invasive surgery. It's too early to claim victory, but start-ups and scientists are benefiting from a better understanding of why gastric bypass surgery works.

Early intervention is the general rule for success in treating many diseases, but in obesity, patients have to be in bad shape before they're eligible for the most efficacious treatments, which are surgical interventions. Companies with minimally invasive--and anatomy sparing--devices hope to change that paradigm.