Abstract
Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. According to the World Health Organization, its prevalence has tripled since 1975, reaching a prevalence of 13% of the world population in 2016. Indeed, as obesity increases worldwide, novel strategies to fight this condition are of the utmost importance to reduce obese-related morbidity and overall mortality related to its complications. Early experimental and initial clinical data have suggested that endovascular bariatric surgery (EBS) may be a promising technique to reduce weight and hormonal imbalance in the obese population. Compared to open bariatric surgery and minimally invasive surgery (MIS), EBS is much less invasive, well tolerated, with a shorter recovery time, and is probably cost-saving. However, there are still several technical aspects to investigate before EBS can be routinely offered to all obese patients. Further prospective studies and eventually a randomized trial comparing open bariatric surgery vs. EBS are needed, powered for clinically relevant outcomes, and with adequate follow-up. Yet, EBS may already appear as an appealing alternative treatment for weight management and cardiovascular prevention in morbidly obese patients at high surgical risk.
Highlights
Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries
Obesity is defined as a body mass index (BMI) greater than 30 kg/m2, while morbid obesity is defined as BMI > 40 kg/m2
Gastric fundus is mainly supplied by the left gastric artery (LGA) and sometimes by the gastroepiploic artery
Summary
Obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. The cornerstone of obesity treatment is represented by behavioral modifications (i.e., diet and physical exercise), ideally in a highly motivated patient that should be followed by a multidisciplinary team of healthcare professionals. If successful, this strategy consents modest and durable weight loss reduction of 5% to 10% [3]. Mainly represented by Roux-en-Y gastric bypass, adjustable gastric banding, sleeve gastrectomy, and biliopancreatic division (Figure 1) are reserved to morbidly obese individuals or obese individuals with one or more obesity-related comorbidities (or even lower for uncontrolled diabetes) who have not been able to reach the aforementioned goals with behavioral modifications and drug therapy.
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