Abstract
As the obesity epidemic continues to grow, the need for effective management strategies is more important than ever. There are several medical, endoscopic, and surgical management options available. The last decade has seen a rise in endoscopic bariatric interventions. These minimally invasive therapies can be used for patients who do not qualify or are unwilling to undergo bariatric surgery. Currently, there is limited formal training in bariatric endoscopy. In this commentary, we discuss our experience in establishing a center for bariatric endoscopy at a large academic medical center.
Highlights
As the prevalence and global burden of obesity continue to rise worldwide, there is a growing need for evidence-based interventions to address this issue[1]
At our program we provide a strong foundation and incorporate formal didactic lectures on primary obesity therapy management [i.e., intragastric balloon (IGB), endoscopic sleeve gastroplasty (ESG)] as well as managing complications of bariatric surgery and weight regain
We suggest that it is essential to have the commitment of the division and institutional leadership to provide financial support to have all available equipment prior to starting a bariatric endoscopy program
Summary
Institutional financial backing of the baratric center Multidisciplinary team effort including gastroentrologist, bariatric surgeons, gastrointestinal radiologists, nurses, behavioral psychologists as well as registered dieticians Robust endoscopic training in numerous endoscopic tencniques with surgical backup on hand Minimize barriers for short and long term follow up for procedural complications currently reserved for patients with a BMI of 40 or greater or those with a BMI of 35 or greater with obesity associated comorbid conditions. This multidisciplinary team includes bariatric endoscopists (gastroenterologists in our center), bariatric surgeons, gastrointestinal radiologists, nurses, behavioral psychologists as well as registered dieticians[7]. This team should have a comprehensive understanding of the pathophysiology of obesity in addition to the mastery of endoluminal device and procedure specific knowledge with respect to the mechanism of action and possible complications.
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