Published online Feb 27, 2022. doi: 10.4240/wjgs.v14.i2.185
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
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.
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.
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.
Narrative review including available literature data obtained through electronic databases and authors’ experience.
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.
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.
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.