de Moura DTH, Dantas ACB, Ribeiro IB, McCarty TR, Takeda FR, Santo MA, Nahas SC, de Moura EGH. Status of bariatric endoscopy–what does the surgeon need to know? A review. World J Gastrointest Surg 2022; 14(2): 185-199 [PMID: 35317547 DOI: 10.4240/wjgs.v14.i2.185]
Corresponding Author of This Article
Igor Braga Ribeiro, MD, Doctor, Research Assistant, Research Scientist, Surgeon, Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao Paulo, Serviço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSP, Av. Dr Enéas de Carvalho Aguiar, 225, 6o andar, bloco 3, Cerqueira Cesar, Sao Paulo 05403-010, Brazil. igorbraga1@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Feb 27, 2022; 14(2): 185-199 Published online Feb 27, 2022. doi: 10.4240/wjgs.v14.i2.185
Status of bariatric endoscopy–what does the surgeon need to know? A review
Diogo Turiani Hourneaux de Moura, Anna Carolina Batista Dantas, Igor Braga Ribeiro, Thomas R McCarty, Flávio Roberto Takeda, Marco Aurelio Santo, Sergio Carlos Nahas, Eduardo Guimarães Hourneaux de Moura
Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Eduardo Guimarães Hourneaux de Moura, Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao Paulo, Serviço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSP, Sao Paulo 05403-010, Brazil
Anna Carolina Batista Dantas, Flávio Roberto Takeda, Marco Aurelio Santo, Sergio Carlos Nahas, Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Unidade de Cirurgia Bariátrica e Metabólica, Disciplina de Cirurgia do Aparelho Digestivo e Coloproctologia, Sao Paulo 05403-010, Brazil
Thomas R McCarty, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Boston, MA 021115, United States
Author contributions: All authors performed the conception and design of the work; de Moura DTH, Dantas ACB and Ribeiro IB drafted the manuscript; all authors contributed to the critical review of the manuscript for important intellectual contents; McCarty TR, Santo MA, Nahas SC, and de Moura EGH contributed to the manuscript supervision; all authors contributed to the approval of the version to be published, have participated in conceptualizing the research or content of the manuscript, in writing or critically editing the manuscript, and/or in analysis of data presented in the manuscript; Consent to submit has been received from all co-authors.
Conflict-of-interest statement: Dr. Eduardo Guimarães Hourneaux de Moura reports personal fees from Boston Scientific, personal fees from Olympus, outside the submitted work; Dr. Diogo Turiani Hourneaux de Moura reports personal fees from Bariatek, outside the submitted work; The others authors reported no potential conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Igor Braga Ribeiro, MD, Doctor, Research Assistant, Research Scientist, Surgeon, Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao Paulo, Serviço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSP, Av. Dr Enéas de Carvalho Aguiar, 225, 6o andar, bloco 3, Cerqueira Cesar, Sao Paulo 05403-010, Brazil. igorbraga1@gmail.com
Received: July 29, 2021 Peer-review started: July 29, 2021 First decision: October 3, 2021 Revised: October 14, 2021 Accepted: February 12, 2022 Article in press: February 12, 2022 Published online: February 27, 2022 Processing time: 208 Days and 12.7 Hours
ARTICLE HIGHLIGHTS
Research background
Obesity is a chronic and recurrent disease resulting in a global pandemic associated with several associated comorbidities. Current treatments include lifestyle modifications including behavioral, dietary, exercise changes, and medications which are associated with less than ideal long-term outcomes. Bridging the gap between these therapies and traditional bariatric surgery is the field of bariatric endoscopy, which seeks to provide less invasive therapies to treat primary obesity, treat weight regain after bariatric surgery, and manage complications of bariatric surgery.
Research motivation
To review the current literature of bariatric endoscopy and highlight the field of to colleagues from other disciplines such as surgeons, endocrinologists, and primary care physicians.
Research objectives
Discuss the current state of bariatric endoscopy, including primary therapies, endoscopic management of weight regain, and the management of complications after bariatric surgery including hemorrhage, stenoses, and leaks and fistulas.
Research methods
Narrative review including available literature data obtained through electronic databases and authors’ experience.
Research results
Bariatric endoscopy is in constantly evolving field which comprises primary and revisional treatment as well as the management of surgical complications. While longer-term, randomized studies are still warranted to fully validate primary and revisional endoscopic therapies, the field provides a high effective and safe means to treat patients with obesity and associated comorbid conditions. Regarding endoscopic treatment of post bariatric surgery complications, endoscopic management remains a first-line strategy to avoid the morbidity and mortality associated with repeat surgical operations.
Research conclusions
Bariatric and metabolic endoscopic therapies are in constant development, including devices with a wide variety of mechanisms of action. Available endoscopic approaches have proved to be effective and safe for a variety of obesity associated treatments. In this manuscript, we have highlighted these indications, provided a detailed review of the literature, and summarized our own experience to improve the management and care of patients with obesity.
Research perspectives
The advances in the bariatric endoscopy field have the unique opportunity to improve the quality of life and health outcomes for patients with obesity and associated comorbid conditions. The field as a whole as the ability to bridge the gap between lifestyle modifications and conventional surgery to provide treatment to a wide range of individuals, offering a minimally invasive approach for conditions and complications that previously required surgery.
