Endoscopy In Obesity Management

This text will provide a comprehensive, state-of-the art review of endoscopy in the management of the obese patient. It will serve as a valuable resource for clinicians, surgeons, endoscopists and researchers with an interest in endoscopy in the role of obesity care. The book will review how endoscopy plays a crucial role in the preoperative evaluation of a patient undergoing a surgical or endoluminal intervention, how intra-operative endoscopy allows evaluation of the newly reconstructed gastrointestinal tract and how post bariatric surgery complications can be managed. Endoscopic evaluation of normal and abnormal surgical anatomy will also be covered. A section dedicated to current and future endoluminal therapies, with a focus on safety, efficacy and technique, will also be thoroughly reviewed. This text will serve as a very useful resource for endoscopy in both a surgical and gastroenterology practice. Training, credentialing and the implementation of EBTs into ones practice, endoscopy suite and hospital will also be discussed.

To date, diet programs and medical therapies for the treatment of obesity have had limited success. Bariatric surgery, however, provides a means of effective weight loss for many of those with morbid obesity. Most of these weight loss procedures are performed with a variety of techniques that continue to evolve. Each technique is associated with unique challenges and complications and it is important for the clinician to be knowledgeable about the endoscopic management of these patients. Additionally, as endoscopic technology evolves it may offer more than just the diagnosis and treatment of complications. Endoscopic therapy may soon allow less invasive bariatric revision procedures as well as a variety of primary obesity therapies for various patient populations. Bariatric Endoscopy reviews the management of obesity, normal post-surgical anatomy, endoscopic and medical management of post-surgical complications, and future endoscopic therapies for obesity management. Organized into five sections, the volume covers an obesity overview, traditional therapy, endoscopy and the bariatric patient, medical management of post-surgical complications, and the future role of endoscopy in obesity management. Detailed illustrations are also provided for surgical procedures, complications and obesity management chapters. Authored by authorities in the field, Bariatric Endoscopy is an indispensible tool for the gastroenterologist or surgical endoscopist as they care for patients with complicated bariatric issues.

Dr. Rothstein has assembled top experts to present the current status of the role of endoscopy in managing the obese patient. Authors present current clinical information on the following topics: Small Bowel Target Devices and Techniques; Reimbursement Issues for Endoscopic Devices Used for Metabolic Endoscopy; the Physiologic Alteractions of Bariatric Surgery; Non-Balloon Gastric and Pyloric Therapies for Obesity; Aspiration Therapy for Obesity; Endoscopic Therapies after Surgery; Duodenal Mucosal Resurfacing: Role for Diabetes Treatment; Gastric Plication; and Gastric Balloons. Readers should come away with the information they need to utilize endoscopic techniques to improve outcomes in their patients.

This unique book is the first to focus on diagnostic and therapeutic endoscopy in gastrointestinal and pancreatico-biliary diseases. It provides an in-depth overview of the state of the art in diagnostic and therapeutic endoscopy of both the digestive tract and the pancreatico-biliary ductal system, and documents the latest innovations in the field. The first part of the book addresses advanced diagnostic and therapeutic endoscopy of the digestive tract, discussing bariatric endoscopic surgery, and the treatment of neoplasia and precancerous lesions of the upper and lower GI tract, motor disorders, GERD, strictures, fistulae and bleeding. The second part of the book is explores ERCP and EUS procedures, covering the diagnosis and therapy of biliary ductal system and pancreatic diseases. Each chapter includes an abundance of color images that document in detail the devices, operative techniques and outcomes. Written by leading internationally renowned experts, the book is a valuable resource for both specialists and residents in gastroenterology and surgery.

This book aims to deepen collaboration between gastroenterologists and surgeons by providing endoscopists and gastroenterologists with a clear understanding of the anatomic alterations likely to be observed after bariatric surgery and acquainting bariatric surgeons with the possibilities offered by endoscopic treatment of obesity itself and of the complications associated with bariatric surgery. The treatment approach in patients with obesity and morbid obesity is usually stepwise, starting with dietary measures, exercise, and behavioral therapy, followed by pharmaceutical therapies, endoscopic bariatric therapy, and, finally, bariatric surgery. Endoscopists and gastroenterologists are involved first because the gastrointestinal tract is affected by obesity-related co-morbidity and second because it provides access for a range of treatment modalities involving endoscopy. Bariatric surgeons may need the assistance of endoscopists and gastroenterologists in the preoperative work-up of patients, in the perioperative period, when acute complications may require an endoscopic intervention, or in the late follow-up period, when complications or insufficient weight loss may be present. This book will be of value for both groups of specialists, enabling them to optimize their cooperation to the benefit of patients.

Sleeve gastrectomy (SG) is the most common bariatric procedure performed worldwide, more than 55% of bariatric procedures are sleeve gastrectomies. This title will be comprehensive and detail all the approaches used in performing sleeve gastrectomy, offering readers all the tools needed to perform the perfect SG. Obesity has become a major global problem that continues to spread in both developed and developing countries. It costs more than any other health problem due to its prevalence and its many costly complications such diabetes and heart disease as well as in disability and loss of productivity. While prevention of obesity is the best approach for the future, the current problem lies with managing those who are already obese or morbidly obese who constitute close to two thirds of the population in many countries such as the US. Diet, exercise, and behavioral change are the mainstays for any meaningful attempt for significant and durable weight loss. Unfortunately, for those who are morbidly obese, these measures alone almost consistently fail to achieve acceptable weight loss in the long term. Today, bariatric surgery is the only evidence-based treatment for morbid obesity with a low complication rate and acceptable results in the long-term for both weight loss and resolution of comorbidities. Despite the data, the acceptance of these operations was limited due to fear of what was perceived as major surgery. Today, applying minimally invasive technology to these complex operations made them more acceptable to patients due to decreased pain, faster recovery and fewer overall complications. This, in addition to improved outcomes as we went further along the learning curve, has made these operations more common and helped growing the field to be an independent specialty for surgeons and perhaps a new specialty for gastroenterologist. In these exciting times, the 5 international editors (one of them, Michel Gagner, is the creator of the SG) wanted to capture the global standards of practice at a time of change, excitement, and lots of controversy, regarding this common procedure. We an aim to shed light on best practices across the borders, the intention of this volume is to develop a reliable reference to guide the practicing physician anywhere in the world, and from whatever specialty (surgeon, gastroenterologist or endoscopist) to navigate through the many current options of therapy in this rapidly changing field. We also aim to provide high quality illustrations and high-definition videos of these techniques to go with the didactic chapters written by thought leaders. In this book we will focus first on the clinical problems of the patients and the indications for the sleeve. Regarding the technical aspects, we will describe the technique step-by-step (including videos) and also we will detail the staplers, its size and different colors -- and the different sizes of the bougies, and also special description of the reinforcement of the sutures after the sleeve. We know that mainly the SG has a restrictive function, but we will also describe the metabolic effects of this surgery. Then we will describe the nontraditional SG techniques, such as the endoscopic approach, staples sleeve and robotic technologies. Bariatric surgery has very few rates of complications, but when complications happen, they are severe. Thus we will describe how to identify them immediately and also the different approaches to treat them by endoscopy, laparoscopy and percutaneous image guided surgery. A chapter will also cover revisional surgery and the different revisional procedures, not only from sleeve to other procedures but also from other procedures to SG. For the last section,we will include the lessons learned from almost 20 years now since the SG was first described, providing an overview on how we imagine the future will be for the most common bariatric procedure performed worldwide. This title will be an ideal reference for general surgeons, bariatric surgeons, endoscopists and gastroenterologists with interest in obesity management as well as researchers with interest in obesity. Residents and fellows training in general and bariatric surgery as well as in endoscopy. Dietitians, diabetes specialist, psychotherapists with interest in obesity management as well as hospital administrators and quality officers in hospitals with bariatric practices will also benefit by this book.

The clinical implications of obesity have pervaded several specialties since treatments include medical and surgical intervention. In this issue, Dr. Thompson has created an issue that addresses topics of concern to endoscopists: important concerns in the endoscopic unit, presurgical evaluation, postoperative care, sedation, and endoscopic management of common complications. Further, special articles are included on endoscopic revisions to failed gastric bypass as well as reimbursement and regulatory issues.

Morbid obesity is an epidemic as more than 2/3 of the United States population is obese and as such, has a high burden of weight-related co-morbid diseases. Bariatric surgery has proven to be effective and durable for treatment of severe obesity. Technological advances including applications of laparoscopy and endolumenal techniques have rapidly advanced this field. Data and outcomes examining treatments have also improved and as providers, we have a wide spectrum of therapeutic options to treat patients. As techniques and outcomes have evolved, access to a comprehensive yet focused resource regarding bariatric surgery is currently limited. The proposed textbook is designed to present a comprehensive and state-of the-art approach to the current and future status of Bariatric interventions, which has changed significantly since the first edition of the Manual. Updates in this version will include the rapidly expanding field of endoluminal bariatric procedures, with a focus on new devices and theories of mechanisms. New data regarding laparoscopic approaches to treat obesity, as well as improved longer-term data outcomes will be reviewed. Newer surgical approaches to treat metabolic disease and obesity are included, as well as proposed mechanisms of action and efficacy. Additional new sections include sections on the application of robotic technologies, special circumstances including transplantation and pregnancy, and telemedicine and social media in bariatric surgery. Sections will address the evolution in specific treatments available to patients, initial evaluation and selection of procedures for individual patients, the latest surgical and endoscopic techniques being employed to treat patients including data on outcomes, and future directions for therapy. In particular and unique amongst references, a major focus of this text will be on both the bariatric and metabolic bases of therapies and outcomes. The SAGES Manual A Practical Guide to Bariatric Surgery, Second Edition aligns with the new SAGES UNIVERSITY MASTERS Program. The Manual supplements the Bariatric Surgery Pathway from Competency to Proficiency to Mastery. Whether it’s for Biliary, Hernia, Colon, Foregut or Bariatric, the key technical steps for the anchoring bariatric procedures are highlighted in detail as well as what the reader needs to know to successfully submit a video clip to the SAGES Facebook Channels for technical feedback. Readers will also learn about how to count credits for Bariatric from the other Master Program Series, Guidelines, Top 21 Videos, Pearls, FLS, FES, FUSE, SMART and Annual SAGES Meeting. The Masters Program promotes lifelong deliberate learning.