Bariatric Endoscopy

The issues presented in this text have particular relevance in our obesogenic society. Over one-third of the adult population in the United States suffers from obesity, and it is now apparent that this epidemic is progressively becoming global in scale. Behavioral modification, dietary programs, and medical therapies have an important role, however, alone they are not adequate for many patients. Bariatric surgery has provided an effective alternative for achieving durable weight loss in many patients with morbid obesity, and there are currently several types of surgery being employed for weight loss and the treatment of obesity associated comorbid illness. It is estimated that over 200,000 bariatric procedures are performed annually in the United States. The most common are Roux-en-Y gastric bypass and sleeve gastrectomy; others include adjustable gastric band, duodenal switch, biliopancreatic diversion, among others. Each of these surgeries may also haveimportant variations, and are in turn associated with unique gastrointestinal complications. For example, one version of the Roux-en-Y gastric bypass includes placement of a Silastic ring at the gastrojejunal anastomosis which can erode the overlying mucosa and cause severe pain necessitating endoscopic removal. Additionally, some surgeons create longer Roux limbs that may render ERCP unfeasible even with longer equipment. It is important to be familiar with local surgical practice and to review operative reports prior to scheduling endoscopic procedures. This will result in better procedural planning, more accurate choice of sedation and equipment, and better outcomes. This text on bariatric endoscopy is the work of a multidisciplinary group of international experts, and is intended to serve as a comprehensive guide to the endoscopic management of patients with obesity. It is divided into three main sections: I. Obesity Overview and Medical Management;II. Traditional Bariatric Surgery and Endoscopic Management of Complications; and III. Endoscopic Bariatric Therapies. Epidemiology, pharmacological and surgical treatment of obesity, surgical anatomy, post-operative complications, endoscopic treatment of complications, and endoscopic bariatric therapies are covered in-depth. This new edition serves as a comprehensive guide to the endoscopic management of patients with obesity. Written by a multidisciplinary group of international experts, the text provides in-depth coverage of epidemiology, pharmacological and surgical treatment of obesity, surgical anatomy, post-operative complications, endoscopic treatment of complications, and endoscopic bariatric therapies. In addition to thoroughly revised chapters from the previous edition, the latest volume includes more than 10 new chapters. Clinical gastroenterologists, gastroenterologists in training, and surgeons with a special interest in obesity management will find this book to be of practical importance.