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Castro et al. Mini-invasive Surg 2020;4:47 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.14

Review Open Access

Bariatric endoscopy: current primary therapies and
endoscopic management of complications and other

related conditions

Melissa Castro, Alfredo Daniel Guerron

Department of Surgery, Duke University Health System, Durham, NC 27704, USA.

Correspondence to: Dr. Alfredo Daniel Guerron, Department of Surgery, Division of Metabolic and Weight Loss Surgery, Duke
University, 407 Crutchfield St, Durham, NC 27704, USA. E-mail: alfredo.guerron-cruz@duke.edu
How to cite this article: Castro M, Guerron AD. Bariatric endoscopy: current primary therapies and endoscopic management of
complications and other related conditions. Mini-invasive Surg 2020;4:47. http://dx.doi.org/10.20517/2574-1225.2020.14
Received: 26 Jan 2020 First Decision: 15 Apr 2020 Revised: 24 Jul 2020 Accepted: 27 Jul 2020 Published: 7 Aug 2020

Academic Editor: Wah Yang Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
The steady increase in bariatric surgery has led to room for innovation. Endoscopy has become an important tool
for evaluation, diagnosis, management of complications, and even for primary bariatric interventions. Leaks are
the most feared complication and new endoscopic therapies have been developed such as septotomy, double-
pigtail stents, and endoscopic vacuum therapy. Additionally, primary bariatric endoscopic procedures are gaining
popularity and the new procedures include intragastric balloons, stoma reduction, aspiration therapy, among
others. The altered anatomy and reoperation increase the risk of complications after bariatric surgery, especially
when managing conditions like achalasia, gastroparesis, and cholelithiasis. Per-oral endoscopic myotomy, per-oral
pyloromyotomy, and endoscopic ultrasound-guided transgastric endoscopic retrograde cholangiopancreatography
provide a less invasive approach to address these conditions. This narrative review article intends to expose
current endoscopic therapies for the management of primary bariatric procedures, complications and related
conditions.

Keywords: Endoscopy, bariatric surgery, septotomy, leaks, endosuturing, intragastric balloons, per-oral
pyloromyotomy, per-oral endoscopy myotomy

INTRODUCTION
Each year the rise of the obesity population poses a global concern, affecting more than 600 million people
[1]
worldwide . Different measures have been implemented to approach this matter and bariatric surgery
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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